Calls for Rhode Island to become more “Age Friendly”

Published in RINewsToday on January 24, 2022

On Aug. 3, 2020, The Decade of Healthy Aging 2020-2030 proposal was endorsed by the 73rd World Health Assembly. It was presented to the U.N. General Assembly Dec. 14, 2020, (Resolution 75/131), leading to the proclamation of a U.N. Decade of Healthy Aging (2021-2030).

The four-page Resolution expressed concern that, despite the predictability of population aging and its accelerating pace, the world is not sufficiently prepared to respond to the rights and needs of older people. It acknowledges that the aging of the population impacts our health systems but also many other aspects of society, including labor and financial markets and the demand for goods and services, such as education, housing, long-term care, social protection and information. It thus requires a total whole-of-society approach to make changes.

The passed Resolution called on the World Health Organization (WHO) to lead the implementation of the decade, in collaboration with the other U.N. organizations. Governments, international and regional organizations, civil society, the private sector, academia and the media are urged to actively support the decade’s goals.

According to WHO,  the world’s population is aging at a swifter pace than any time in the past and this will have an impact on all aspects of society.  There are more than 1 billion people aged 60 years or older, most of these individuals living in low- and middle-income countries. “Many do not have access to even the basic resources necessary for a life of meaning and of dignity. Many others confront multiple barriers that prevent their full participation in society,” says WHO.  

In a December 14, 2020, statement announcing the passage of Resolution 75/131, Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, stated that it “sends a clear signal that it is only by working as one, within the United Nations system and with governments, civil society and the private sector that we will be able to not only add years to life, but also life to years.”

“By adopting a U.N.-wide approach in support of healthy aging, we will be able to galvanize international action to improve the lives of older people, their families and communities, both during the COVID-19 pandemic and beyond,” Dr Etienne Krug, Director of the Department of Social Determinants of Health at added World Health Organization (WHO).

The WHO says that the ongoing COVID-19 pandemic highlights the seriousness of existing gaps in policies, systems and services and a decade of concerted global action is urgently needed to ensure that older people can fulfil their potential in dignity and equality and in a healthy environment.  

WHO’s worldwide initiatives would seek to change “how we think, feel and act toward age and aging; facilitate the ability of older people to participate in and contribute to their communities and society; deliver integrated care and primary health services that are responsive to the needs of the individual; and provide access to long-term care for older people who need it.” 

Healthy Aging Baseline Data Released

Just days ago, WHO released, “Decade of Healthy Ageing: Baseline Report,” in all official U.N. languages, to support member states, academia, civil society, U.N. partners and others to aid in evidence-based decision making on the policies, programmes and services needed to support all people, in particular older persons, to live long and healthy lives.

The Baseline report, released January 20, 2021, brings together data available for measuring healthy aging, defined by WHO as “the process of developing and maintaining the functional ability that enables well-being in older age.”

According to WHO, optimizing “functional ability” is the goal of the Decade of Healthy Aging, which began in 2021 and addresses five interrelated abilities that all older people should enjoy:  the ability to meet basic needs; to continue to learn and make decisions; to be mobile; to build and maintain relationships; and to contribute to society. The report also takes a look at people’s capacities (including physical and mental) and the environments (spanning attitudes, services, natural and built) in which people live, which contribute to functional ability.

The 203-page baseline report, now available in Arabic, Chinese, English, French, Russian and Spanish, introduces the concepts of health aging and strategies for achieving the initiatives goals by 2030. It provides a first-time baseline (in 2020) for healthy aging worldwide and takes a look at what improvements that can be made by 2030.  It documents progress and scenarios for improvement. The report addresses how stakeholders can work together and impact the functional abilities of older people. Finally, it outlines next steps detailing opportunities that can increase collaboration and impact by 2023, the next reporting period.

Is Rhode Island Becoming Age Friendly?   

Maureen Maigret, policy consultant and chair of the Aging in Community Subcommittee of Rhode Island’s Long-Term Care Coordinating Council, says that many Rhode Island communities are involved to 1 degree or another in what we consider age-friendly activities. “The initiative is usually led by the local senior center and in some instances volunteer programs such as RSVP and AARP and The Village Common of RI,” she says.

According to Maigret, over the last five years the state’s Long-Term Care Coordinating Council Aging (LTCCC) in Community Subcommittee has adopted and continues to work to support WHO’s decadelong initiative, adding the domains of Food & Nutrition and Economic Security and Supports to Remain at Home.

Maigret noted that Newport was the first community to join the AARP age-friendly network; Cranston, Providence and Westerly following. The state’s Office of Healthy Aging has adopted its State Plan on Aging, calling for Rhode Island to become an age-friendly state.

Governor Dan McKee’s proposed budget for FY2023 includes an additional $200,000 for local senior programs increasing the total amount to $1 million. Maigret calls for adding an additional  $800,000 so each municipality would be allocated $10 per person aged 65 and over to support local senior programs. Advocates had promoted this since at least 2018 to make up for prior budget cuts and inflation, she says.

Don’t forget improving and expanding the state’s transportation options for older Rhode Islanders who have mobility needs and are no longer able to drive. “This could be accomplished by adding trip types to the state funded Elderly Transportation Program,” she says, noting that trips are now limited for trips to medical appointments, adult day care services, meal sites and Insight. Why not provide trips for older adults to access volunteer activities, she adds.

“We also need to adequately fund our subsidized home care programs by providing realistic reimbursement to address the huge workforce challenges we face,” warns Maigret, noting that seniors are waiting over two months to get service. “This is a travesty,” she says.

“It is tragic that the state’s Office of Healthy Aging is so under resourced in so many areas,” says Maigret, putting the spotlight on the lack of affordable home maintenance and chore services to keep people in their homes. “There is also a need to provide greater supports for our family caregivers who provide the vast majority of caregiving in our state and nation,” she adds. 

Getting Municipalities Involved

Maigret suggests that Rhode Island’s cities and towns review their community’s Comprehensive Plans to see how age-friendliness is addressed. “This is what Newport did. They can also form local Steering Committees to identify local needs and develop recommendations to address them both at the local and state level,” she says.

Governor Dan McKee can also issue an Executive Order directing all state departments and agencies to review programs and policies for age-friendliness and provide incentive funding for local communities to assess their communities. Several states have done this. NY, MA, CO, FL, MI, ME, CA, she says. 

While aging advocates pushed for McKee and lawmakers to allocate ARPA COVID-19 federal funds to make Rhode Island a more age friendly, it’s gotten little attention, says West Warwick resident Vin Marzullo. “Quite frankly its shocking — that there is yet an explicit acknowledgement that the aging community needs resources, support, more collaborative arrangements, to extend living in-place. There seems not to be any sensitivity to the fact that 90% of the COVID deaths were adults 60 and over – and 53% were in congregate care,” says Marzullo, a  well-known aging advocate who served as a federal civil rights and national service administrator.

“The ARPA funds were authorized to be used to ameliorate the impact on the populations, communities, sectors, etc. that were adversely impacted. Our older adults must be in the conversation and not neglected,” says Marzullo.

Maigret agrees. “It is tragic that neither the McKee-Matos’ “Rhode Island 2030 Plan” nor the Rhode Island Foundation report outlining the use of ARPA funds gave sufficient attention to the needs of our state’s older population, she says, warning that this population is increasing, and getting more economically insecure and diverse,” she says.

“When we look at the exceedingly high cost of residential institutional care,  much of which is paid for taxpayers through government programs, we can make a strong case that funding programs helping older persons remain healthy and living in their homes and communities are important investments,” says Maigret. 

To obtain a copy of WHO’s “Decade of Healthy Ageing: Baseline Report,” go to:

https://www.who.int/publications/i/item/9789240017900.

Campaign reminds Veteran caregivers to “Take Care of Themselves”

Published in RINewsToday on January 17, 2022

Since 2011, AARP and the Ad Council have launched public service announcements (PSAs) encouraging America’s caregivers to care not only for their loved ones, but also for themselves. Over the years, these PSAs s have targeted women aged 40 to 60, male caregivers aged 35 to 60 and Hispanic/Latino and African American/Black caregivers with an emphasis on women ages 35 to 60.The partner-driven ad campaign directs viewers to AARP’s Family Caregiving site, where caregivers can find free care guides, self-care tips, planning resources, legal and financial guidance and more.

Now AARP and the Ad Council’s have released the PSA, “Roxana’s Story,” on Dec. 9th. The latest evolution of the Caregiver Assistance campaign aims to acknowledge the unique challenges that military veteran caregivers face and provide them with free resources from AARP to better care for their loved one and themselves.

Roxana Tells Her Caregiving Tale

In 2003, Roxana, a full-time student, became the full-time caregiver of her husband, Victor. In the PSA she recalled receiving a 4 a.m. phone call where she learned that her husband had been wounded in action in Afghanistan, having received a moderate traumatic brain injury. Roxana was suddenly thrust into the role of caregiver to Victor, through his initial recovery process, and then having to adjust to his injury for the rest of their lives.

Reflecting over the last 18 years, Roxana stated in the PSA the realization that one of the most important components of being a caregiver is taking care of yourself. “I didn’t want to forget that I also had goals, and a life,” she said, noting that she asked Victor to “meet me halfway.” With assistance from his therapists, he was able to help with everyday chores.

The PSA, the first-ever targeting caregivers of veterans and current members of the military, addresses the unique caregiving challenges facing these individuals, reminding the more than 6.5 million military veteran caregivers that there are resources available to them. The PSA is recorded as either a :30 or 60-second message, was filmed and directed by military veterans from the veteran-owned creative shop Gig line Media (the production arm of We Are the Mighty).

Military veteran caregivers experience unique challenges when providing care. For many in this group, their caregiving journey starts earlier in life (85% are under 40) and lasts longer, according to Caregiving in the U.S. 2020, a report by AARP and the National Alliance on Caregiving. They deal with challenges that civilian family caregivers don’t normally face, including unseen injuries and wounds. They also consistently experience worse health outcomes, greater strains in family relationships, and more workplace problems than non-caregivers. Many also spend more time helping with emotional support or social interaction due to mental or behavioral health diagnoses.

“Oftentimes those caring for veterans and current member of the military experience a high emotional and physical toll, including consistently worse health outcomes and greater strains in family relationships compared to other caregivers,” said Bob Stephen, vice president of family caregiving and long-term care at AARP in announcing AARP’s lates PSA campaigned targeting military veteran caregivers. “Through this campaign, AARP will continue to recognize and provide resources to support these valued caregivers who play such a vital role for veteran and military families,” he says.

For caregivers who are unsure about seeking help because they think it’s selfish or a sign of failure, the PSA campaign reminds them that they can’t care for their loved one without also caring for themselves.

The PSAs direct viewers to AARP’s Family Caregiving site at www.AARP.org/Caregiving and www.AARP.org/Cuidar, where caregivers can download a free military veterans Caregiving Guide for self-care tips, planning resources, legal and financial guidance, and more in English and Spanish as well as AARP’s new Veterans and Military Families Health Benefits Navigator, a one-stop-resource in English and Spanish to help make the process less confusing and overwhelming when it comes to available options for U.S. Dept. of Veterans Affairs (VA) health benefits, military Tricare, Medicare, private insurance and Medicaid.

“Taking care of a veteran in your life often means that you start younger and care for longer. In many cases, this means you’re forced to manage situations other family caregivers aren’t forced to face,” said Michelle Hillman, Chief Campaign Development Officer of the Ad Council. “We’re humbled to continue this campaign to remind the millions of military veteran caregivers that they do not face these unique challenges alone.”

For more information about caregiving resources, please visit AARP.org/Caregiving or call 1-877-333-5885 or www.AARP.org/Cuidar or call 1-888-971-2013 for Spanish resources.

Tech use flourishes during pandemic, particularly among seniors

Published on January 10, 2022 in RINewsToday

Over the course of 71 episodes of the widely-acclaimed Sopranos, Dr. Jennifer Melfi met with Tony Soprano in her office. The office had paneled walls, was decorated with a diploma on the wall, and next to that was a bookshelf filled with books. Melfi was counseling Mob Boss Tony Soprano for anxiety and depression. This was the typical office setting in any community before the COVID-19 pandemic spread like wildfire across the nation.  But now with the ongoing COVID-19 pandemic, therapists are using alternative ways to reduce increasing depression and mental health needs of the patients. The typical face-to face therapy, like Melfi offered Soprano and her other patients, has been replaced by computer and smartphone-based tele-treatment. 

While it remains unclear whether the technique is as effective as face-to-face psychotherapy that takes place in an office, they do offer a promising alternative to address the growing mental health needs spawned by the continuing COVID-19 pandemic, and in a safe way, according to a research study published last month by the Washington, DC based American Psychological Association.  

“The year 2020 marked 30 years since the first paper was published on a digital intervention for the treatment of depression. It also marked an unparalleled inflection point in the worldwide conversion of mental health services from face-to-face delivery to remote, digital solutions in response to the COVID-19 pandemic,” said lead author Isaac Moshe, MA, a doctoral candidate at the University of Helsinki in a Dec. 13 statement announcing the study’s findings.

“Given the accelerated adoption of digital interventions, it is both timely and important to ask to what extent digital interventions are effective in the treatment of depression, whether they may provide viable alternatives to face-to-face psychotherapy beyond the lab and what are the key factors that moderate outcomes,” he said.

The research article, “Digital interventions for the treatment of depression: A meta-analytic review,” was published online in the journal Psychological Bulletin. Psychological Bulletin, published on Dec. 13, 2021.

According to researchers, digital interventions, instead of the face-to face counseling sessions, typically require patients to log in to a software program on a computer website or app to read, watch, listen to, and interact with a series of content structured modules or lessons. Individuals oftentimes receive homework assignments relating to the modules and regularly complete digitally administered questionnaires relevant to their presenting mental health problems. This allows clinicians to monitor their progress and outcomes in cases where digital interventions include human support. Digital interventions are not the same as teletherapy, which has gotten much attention during the pandemic, according to Mosh, noting that teletherapy uses videoconferencing or telephone services to facilitate one-on-one psychotherapy.

“Digital interventions have been proposed as a way of meeting the unmet demand for psychological treatment,” notes Moshe. “As digital interventions are being increasingly adopted within both private and public health care systems, we set out to understand whether these treatments are as effective as traditional face-to-face therapy, to what extent human support has an impact on outcomes, and whether the benefits found in lab settings transfer to real-world settings,” he said.

According to the website article, researchers conducted a meta-analysis of 83 studies testing digital applications for treating depression, dating as far back as 1990 and involving more than 15,000 participants in total, 80% adults and 69.5% women. All of these studies were randomized controlled trials comparing a digital intervention treatment to participants on a waitlist or receiving no treatment at all, or those receiving treatment as usual or with face-to-face psychotherapy. The researcher primarily focused on individuals with mild to moderate depression symptoms. 

Overall, researchers found that digital interventions improved depression symptoms over control conditions, but the effect was not as strong as that found in a similar meta-analysis of face-to-face psychotherapy. There were not enough studies in the current meta-analysis to directly compare digital interventions to face-to-face psychotherapy, and researchers found no studies comparing digital strategies with drug therapy.

But digital treatments that involved a human component, whether in the form of feedback on assignments or technical assistance, were the most effective in reducing depression symptoms. This may be partially explained by the fact that a human component increased the likelihood that participants would complete the full intervention, and compliance with therapy is linked to better outcomes, according to Moshe.

Depression is predicted to be the leading cause of lost life years due to illness by 2030. At the same time, less than 1 in 5 people receive appropriate treatment, and less than 1 in 27 in low-income settings. A major reason for this is the lack of trained health care providers,” Moshe said. “Overall, our findings from effectiveness studies suggest that digital interventions may have a valuable role to play as part of the treatment offering in routine care, especially when accompanied by some sort of human guidance.” 

Tech use by Seniors skyrocketed

As noted above, while the continuing COVID-19 pandemic has increased the popularity of using digital intervention, teletherapy uses videoconferencing or telephone services to facilitate one-on-one psychotherapy, a newly released AARP Tech Trends reports an increased use of technology by seniors to facilitate social contact to families and friends to reduce isolation.

According to AARP’s report released on Dec. 21, tech use by people age 50 and over, skyrocketed during the pandemic and those new habits and behaviors appear to continue.  What’s more, 70% of those surveyed purchased tech last year, with spending far greater today than it was in 2019; $821 now as versus $394, then. Smartphones, and related accessories, along with Bluetooth headsets topped the list of their purchases, but smart home technology was vital to them, too.

Unsurprisingly the researchers say that technology use has facilitated social connectedness with others throughout the pandemic. They found that the rates of reliance on tech for social connection is consistently high across age ranges: 76% of those in their 50s, 79% of those in their 60s, and 72% of people 70+ all count tech as their link to their families and the wider world.

“The pandemic redrew the lines: Tech has gone from a nice-to-have to a need-to-have for Americans 50+, and their new habits are here to stay,” said Alison Bryant, AARP Senior Vice President of Research in a Dec. 21 statement announcing the study’s findings. “Those who can afford tech are spending a lot more than they did just a few years ago – more than twice what they spent in 2019. And their motivations vary: Some use tech to work, others to stay connected to family and friends, and others still to enable them to age in place or get assistance with needs. At the same time, we’re also mindful of the digital divide, where a lack of affordability can also mean no access to tech and its benefits,” says Bryant.

The Tech report noted that seniors continue to incorporate tech into their daily lives. Certain tech behaviors formed during the ongoing pandemic appear to be here to stay such as video chat, making online purchases, ordering groceries, doing banking, and engaging in health services, with seniors making more purchases and financial transactions online compared to previous years. 

Researchers also found that during the last two years, older adults’ usage of a home assistant and owning a wearable has doubled. The Tech study also reveals that learning how to use and manage smart home technology is a top interest of seniors. Smartphones continue to be adopted in new ways to manage day-to-day living and entertainment. This year, one third of seniors ordered take-out food from a restaurant and one in four listened to podcasts on their smartphones. 

Health-related innovations and daily objects that automatically track health measures on tech devices are also of top interest, say the researchers, noting that 42% of older adults feel tech is not designed with them in mind.

Finally, the AARP Tech Trends report found that 30% of older adults are using tech to pursue personal passions, mostly with video content. Streaming content continues to increase with most of them subscribing on average to three platforms. 

With the ongoing COVID-19 pandemic not going away in the near future, the use of technology will continue to increase to maintain contact with family and friends, to access education, telehealth services, for use in financial transitions, shopping, and entertainment.