Author Archives for Herb Weiss

New Approach to Support Caregivers Needed

Published in Woonsocket Call on September 18, 2016

Currently 18 million people across the nation provide assistance with activities of daily living, transportation, finances, wound care and giving injections to their aging parents, spouses, family and friends. AARP Rhode Island estimates that 148,000 Rhode Islanders are caregivers. The future is bleak for those requiring caregiving assistance in the near future. According to a recently leased report by The National Academies of Sciences, Engineering, and Medicine (NASEM), the need for family caregivers will drastically increase but demographic shifts reduce the potential pool of caregivers to tap.

Being a Caregiver in America

The 340 page NASEM report (taking 20 months to produce) calls for the retooling of the nation’s health and long-term care delivery system through team based care (using a person and family care model approach) and policy changes to better support family caregivers in the delivery of care to older Americans.

The recommendations detailed in Families Caring for an Aging America, released on September 13, 2016, challenges policy makers “to transform the health care experience for older adults and their family caregivers,” says Nancy Morrow-Howell, PhD, president of the Washington, D.C.-based The Gerontological (GSA) Society of America, the nation’s largest interdisciplinary organization devoted to the field of aging. “The approach requires a multidimensional, interdisciplinary effort that spans diverse settings of care. GSA strongly supports this effort to create a person- and family-centered model for team-based care that recognizes and rewards the role of the family caregiver,” she notes.

Adds Richard Schulz, who chaired NASEM’s Committee on Family Caregiving for Older Adults (consisting of 19 caregiving experts) that oversaw this study and who serves as Distinguished Service Professor of Psychiatry, University of Pittsburgh, “Ignoring family caregivers leaves them unprepared for the tasks they are expected to perform, carrying significant economic and personal burdens.”

Schultz adds, “Caregivers are potentially at increased risk for adverse effects in virtually every aspect of their lives – from their health and quality of life to their relationships and economic security. If the needs of the caregivers are not addressed, we as a society are compromising the well-being of elders. Supporting family caregivers should be an integral part of the nation’s collective responsibility for caring for its older adult population.”

According to a release, NASEM’s highly anticipated report noted that by 2030, 72.8 million U.S. residents – more than 1 in 5 – will age 65 or older. According to the National Survey of Caregivers, in 2011, 17.7 million people – or approximately 7.7 percent of the total U.S. population aged 20 and older – were caregivers of an older adult because of health problems or functional impairments. This estimate does not include caregivers of nursing home residents.

Furthermore, being a caregiver is not a short-term obligation, says the report, noting that the median number of years of family care for older adults with high needs is around five years. The proportion of older adults who are most likely to need intensive support from caregivers – those in their 80s and beyond – is projected to climb from 27 percent in 2012 to 37 percent by 2050.

A Shrinking Pool of Caregivers

The NASEM’s Family Caregiving Committee says that little policy action has been taken to prepare the nation’s health care and social service delivery systems for this demographic shift. While the need for caregiving is rapidly increasing, the number of the potential family caregivers is shrinking. Current demographic trends – including lower fertility, higher rates of childlessness, and increases in divorced and never-married statuses – will decrease the pool of potential caregivers in the near future. Unlike past years, aging baby boomers and seniors will have fewer family members to rely on for their care because they will more likely be unmarried or divorced and living alone, and may be even geographically separated from their children.

The in-depth report found that family caregivers typically provide health and medical care at home, navigate a very complicated and fragmented health care and long-term services and support systems, and serve as surrogate decision makers. Although these individuals play a key role caring for older adults with disabilities and complex health needs, they are oftentimes marginalized or ignored by health care providers. Caregivers may be excluded from treatment decisions and care planning by providers who assume that they will provide a wide range of tasks called for in the older adult’s care plan.

Confirming other research studies, the committee found that caregivers have higher rates of depressive symptoms, anxiety, stress, social isolation, and emotional difficulties. Evidence also suggests that they experience lower physical well-being, elevated levels of stress hormones, higher rates of chronic disease, and impaired preventive health behaviors.

Those taking care of very impaired older adults are at the greatest risk of economic harm, because of the many hours of care and supervision they provide. However, caregiving can provide valuable lessons, helping the caregiver deal with difficult problems and bringing them closer to the recipient of care.

Next Steps

NASEM’s report calls for the next presidential administration to take immediate action to confront the health, economic, and social issues facing family caregivers. Also, the committee urges the secretary of the U.S. Department of Health and Human Services, in collaboration with other federal agencies, and private-sector organizations, to develop and implement a National Family Caregiver Strategy that recognizes the essential role family caregivers play in the well-being of older adults.

The report recommends that the nation’s health and long-term care systems must support caregiver’s health, values, and social and economic well-being, as well as address the needs of the of a growing caregiver population that is both culturally and ethnically diverse.

Federal programs (such as Medicare, Medicaid and Veterans Affairs) must also develop, test and implement effective mechanisms to ensure that family caregivers are routinely identified, assessed, and supported. Payment reforms can motivate providers to engage caregivers in the delivery of health care, too.

AARP Rhode Island State Director Kathleen Connell agrees with the NASEM’s report’s assessment that the importance of a caregiver’s role in an aging society cannot be overstated. At her organization she clearly sees an increased demand for caregivers and knows all-to-well the impact of a shrinking pool of potential caregivers on those in need.

“It is essential that we take action now to do all we can to remove obstacles and additional financial strain and mitigate physical and mental stress where possible for caregivers,” says Connell. AARP has compiled a wealth of research and information on aging issues that can be accessed on http://www.AARP.org.

Final Thoughts…

On Jan. 1, 2016, a new Rhode Island law took effect that would help Rhode Islanders avoid costly and time-consuming red tape when exercising health care, financial and other legal responsibilities for their out-of-state, elderly loved ones.

Why reinvent the wheel? Rhode Island law makers, the state’s Division on Elderly Affairs and the Lt. Governor’s Long-Term Care Coordinating Council can do more to support the state’s growing caregiver population. With the next session of the Rhode Island General Assembly starting in January 2017, state officials and lawmakers can reach out to other states to learn what state-of-the art caregiver programs can be implemented here.

For a copy of the report go to: nationalacademies.org/caregiving

We Haven’t Turned the Page on Reading Yet

Published in Woonsocket Call on September 11, 2016

In May 1897, the great American humorist, novelist, publisher and lecturer Samuel Clemens – who we all know as Mark Twain – was in London on a world-wide speaking tour. In this City someone had started a rumor that he was gravely ill, ultimately the rumor changing to he had died.

When Twain was told that one major American newspaper actually printed his obituary, when he was told about this by a reporter, he quipped: “The reports of my death are greatly exaggerated.”

As the rumor about Twain’s death was “greatly exaggerated” those lamenting the decreasing number of Americans who read print books, even predicting its demise with the advent of e-books, audio books and computer tablets is not correct, says a new Pew Research Center Survey released. Researcher Andrew Perrin notes in his study, “Book Reading 2016” that printed books remain more popular than books in digital formats for American Readers.

AAmericans Love Print Books

According to the survey findings, released on September 1, 65 percent of Americans have read a print book in the last year, more than double the share that has read an e-book (28 percent) and more than four times the share that have listened to an audio book (14 percent).

While the total share of Americans who have read a book in the last 12 months (73 percent) has remained consistent since 2012, nearly four-in-ten Americans read print books exclusively. Just 6 percent of Americans are digital-only book readers, adds the Pew Research Center Survey findings.

Although print remains the most popular book format, Americans who do read e-books are increasingly turning to multipurpose devices such as smartphones and tablet computers, says Pew Research Center Survey findings. The share of e-book readers on tablets has more than tripled since 2011, and the number of readers on phones has more than doubled over that time, says.

Perrin’s 9 page report also details other key findings.

The study found that 84 percent of American adults read to research specific topics of interest, while 82 percent read to keep up with current events, 80 percent read for pleasure, and 57 percent read for work or school. Also, 19 percent of Americans under the age of 50 have used a cellphone to read e-books, and cellphones play a relatively prominent role in the e-reading habits of blacks (16 percent) and those who have not attended college (11 percent).

As to education, the study found that college graduates are nearly four times as likely to read books – and twice as likely to read print books and listen to audio books – compared with those who have not graduated high school. In addition, Americans read an average, or mean, of 12 books per year; however, the typical, or median, American has read 4 books in the last 12 months.

Finally women (77 percent) are more likely than men (68 percent) to read books in general, and they are also more likely to read print books (70 percent). However, men and women are equally likely to read digital-format books such as e-books and audio books.

Book Buying Strong in Rhode Island

Jennifer Massotti, who manages both the Barrington and Cranston locations for Barrington Books, has some thoughts about the recently released report. “The survey findings support the reading style and buying trends that we have seen from our loyal customer base for years. The majority of our customers prefer to read from a physical book. Even those who use their smart phones to research titles, still come in looking to buy the book instead of ordering it online or downloading. This could be personal reading preference or in support of the localism movement. Either way, book buying is strong,” she says.

Massotti does not see book stores becoming obsolete because of today’s digital age. “While the advent of e-readers and online buying options certainly altered the book industry several years back, it has not been the nail in the proverbial coffin that everyone predicted … If anything, there has been a resurgence in the independent bookstore industry, specifically. Brick and mortar stores that are supported by and steeped within their communities are thriving,” she says.

Massotti says, “In fact, in the last year, RI and neighboring MA have seen that growth first-hand with the highly anticipated opening of three new bookstores. It’s a feel-good time in our industry.”

But, the general manager of Barrington Books notes, “downloading a book to your smartphone is convenient and serves a purpose to some. But it doesn’t come close to replicating the authentic experience one finds when perusing the carefully curated stacks in a bookstore, or engaging in a conversation with a like-minded bookseller.”

According to Massotti, bookstores aren’t like most other retail outlets that are in the business of selling goods; bookstores, and books, are the original social media. “It’s a sharable experience, it’s about community. You can’t get that delivered to your door or your phone,”

As to the future of reading, Massotti firmly says that e-books and digital formats will never replace print books.

Self-Publishing Leaves a Legacy

Author Steven R. Porter, a publisher, and president of the Association of Rhode Island Authors (ARIA), representing over 260 independent and traditionally published authors who live and write in Rhode Island, says that Rhode Islanders love to read locally written books and to chat with the authors. “Readers also find great value in a signed book. There is something special about reading and sharing a book that the author held in their hands. The bottom line is that people who love to read are voracious. They can’t get enough. And we can’t write them fast enough,” he says.

Porter has seen an “explosion of self-published books”in the last 5 years, but more recently, the rate has leveled off. “I think most of the leveling has to do with the fact that there were thousands of frustrated writers in the world and when the gates finally opened, and they all rushed through at the same time,” he says, noting that improved information and technology has efficiently assisted authors getting their books to market.

“Seniors are publishing more and more every day. I think there is an inherent need in all of us to have some sort of legacy. That legacy for many may be achieved through your life’s work, or through your family, says Porter. It is the “ultimate expression of immortality,” he says.

Like Massotti, Porter agrees with the findings of the Pew Research Center’s report on book reading in America. “More people are writing than ever before, and reading than ever before. It’s a great time to be a writer and a reader!,” he says.

To read the report, go to http://www.pewinternet.org/2016/09/01/book-reading-2016/.

Remembering Abby

Published in Woonsocket Call on September 4, 2016

In March 2009, we formally adopted an impaired chocolate Labrador with a host of medical problems. With the signing of legal papers, four-year-old Abby met Murray, her elder adoptive canine sibling, who was also a chocolate Labrador.

Four months earlier Abby had arrived at the Pawtucket Animal Shelter, weak, malnourished and showing signs of abuse. She appeared to suffer from blindness and a host of other medical ailments. Animal Control Officer John Holmes had sought veterinary care for her, but the medical testing came back inconclusive. It could be a brain tumor or lead poisoning affecting her vision, he would tell us, which for many potential families seeking adoption may be unappealing.

Officially Adopting Abby

According to Holmes, Abby’s Labrador Retriever breed made her a very popular candidate for adoption, but when people learned about her medical issues they had second thoughts. Abby might just be a good younger companion for our 11-year-old chocolate lab, Murray. We had good luck with this breed and were looking to adopt another chocolate lab.

Six months prior to Abby’s “official adoption” we made an unusual request from the Pawtucket Animal Shelter asking if a “foster care” arrangement could be made to see how well Abby got along with Murray. Having nothing to lose and everything to gain – they agreed.

When Abby came home our first priority was to try to make her gain some weight, which she eventually did. She adjusted well to Murray and her new surroundings, but during the first week she would have a seizure. We watched helplessly as this four year old canine shook all over, with her tongue lolling, her mouth foaming and her eyes rolling back into their head. It was not pleasant to watch, and we initially thought she was dying. Ultimately, with anti-seizure medication her seizures were under control and Abby thrived by gaining weight and becoming increasingly playful to the aging Murray.

We were extremely happy with the new addition to the family, even though we were now taking care of two medically needy pets instead of just one. Abby was given her daily pill in peanut butter to control seizures and Murray, a diabetic, was given insulin shots twice a day.
Health issues would force us to put Murray down in 2010. It would take months for Abby to adjust to his passing. She just knew her companion was gone. But, over the years she adjusted to being the only pet in our household.

Getting Into the Household Routine

A new regiment took over, and every morning, like clock-work, Abby would carefully walk up the stairs, ending up at my bedroom door. The routine shaking of her head, her dog tags would jingle, sending the message to me that it was time to start the day. She was telling me to get up, serve her breakfast and let her outside. As the years began to pass and she grew older, her medical issues became more prominent and it was difficult for her to walk those stairs.

Abby’s internal clock would also place her at the front door at 9:00 p.m. for her nightly walk, too. She had now become a visible fixture in my neighborhood of Oakhill. Neighbors would see us taking our daily nightly walk, but when I began walking by myself they hesitated before asking me “is Abby ok.” No, I say, she is not.

The Moment of Truth

It happened quickly the day before we were to take her on vacation with us. We came home to find her with legs spread out on the floor with no ability to stand up. Her once healthy appetite suddenly diminished. After almost a week of veterinary care my wife, Patty and I came to a decision to end the suffering of Abby, our 11-year-old chocolate Labrador. Looking to ease her pain and reduced quality of life, we made the hard and painful decision to put her down. After all, Abby was an integral part of our family.

Pet owners will share the trauma of putting their furry friend to sleep. Many may even tell you they relive their decision for decades, while some vow never to get another pet for fear of reliving the moment.

So as I pen this weekly commentary in a very quiet house. Abby’s water and food bowls are put away. Her cremated ashes and collar will be placed next to Murray’s wooden box containing his ashes, which sits on the mantle of our fireplace in the living room.

We think about her daily, may be more than once. But, perhaps there will be a time when we will bring another shelter animal into our house, hopefully a female chocolate Labrador. Maybe even two.

To cope with the loss of your pet go to https://rainbowsbridge.com/Poem.htm.