Bipartisan efforts strengthens the Dementia public health infrastructure

Published in RINewsToday on December 2, 2024

In the waning days of the Biden administration, Congress has moved one step closer to assisting states to continue to effectively implement dementia interventions.  Following passage of H. R. 7218 on Sept. 17th, by voice vote on Nov. 21st, the U.S. Senate passed S. 3775, also without objection. At press time, the bipartisan legislation now heads to President Biden’s desk to be signed into law.

Once signed, the new law re-authorizes the Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer’s Act (P.L.115-406) enacted in 2018, empowering public health departments across the country to implement effective dementia interventions in their communities.

In a March 2024 fact sheet, the Alzheimer’s Impact Movement (AIM) calls for Alzheimer’s and other dementias to be considered an urgent public health issue, noting that nearly 7 million seniors across the nation are currently living with Alzheimer’s.

While partisan bickering has reduced the number of bills passed during the 118th Congress, Democratic and Republican lawmakers seek solutions for containing the skyrocketing costs of care, finding a cure for debilitating brain disorders, and supporting caregivers. 

The nation spends more than $360 billion per year, including $231 billion in costs to Medicare and Medicaid. Barring any major breakthroughs to prevent, slow down, or cure Alzheimer’s, the number of Americans with Alzheimer’s is expected to double by 2060, costing the nation more than $1.1 trillion per year, says AIM’s Fact Sheet.

Congress continues funding of Dementia effective interventions

In the Senate, S. 3775 was spearheaded by Sens. Susan Collins (R-ME) Catherine Cortez Masto (D-NV), Tim Kaine (D-VA), and Shelley Moore Capito (R-WV), and cosponsored by Sens. Jack Reed and Sheldon Whitehouse.  It’s companion measure, H.R. 7218, was introduced in the House by Reps. Brett Guthrie (R-KY), Chairman of the Health Subcommittee of the House Energy & Commerce Committee, along with Chris Smith (R-NJ), Paul Tonko (D-NY), and Maxine Waters (D-CA).

With its enactment in 2018, P.L. 115-406 accelerated a multi-pronged public health approach to reduce risk, detect early symptoms, advance care, improve data, and ultimately change the trajectory of this devastating disease.

Headed by the Centers for Disease and Prevention (CDC), the reauthorization would authorize $33 million per year, in line with current appropriations, over the next five years to support:

1.  Alzheimer’s Disease and Related Dementias Public Health Centers of Excellence dedicated to promoting effective Alzheimer’s disease and caregiving interventions, as well as educating the public on Alzheimer’s disease, cognitive decline, and brain health. 

2.  Public Health Cooperative Agreements with the CDC that are awarded to State Health Departments to help them meet local needs in promoting brain health, reducing risk of cognitive decline, improving care for those with Alzheimer’s, and other key public health activities. 

3.  Data Grants to improve the analysis and timely reporting of data on Alzheimer’s, cognitive decline, caregiving, and health disparities at the state and national levels.

Since the original Bold Infrastructure for Alzheimer’s Act passed, the CDC has made 66 awards to 45 state, local and tribal public health departments to help them implement effective dementia interventions such as reducing risk, increasing early detection and diagnosis, and supporting the needs of caregivers.

“Alzheimer’s disease is one of the greatest and most under-recognized public health threats of our time. Nearly seven million Americans—including 29,600 Mainers—are living with the disease, and that number is soaring as our overall population grows older and lives longer,” said Maine Sen. Collins, a founder and Senate co-chair of the Congressional Task Force on Alzheimer’s Disease in a statement announcing the passage of the legislation.  

“The passage of this bipartisan legislation is a tremendous victory for families and communities nationwide. By reauthorizing the BOLD Infrastructure for Alzheimer’s Act, we are reaffirming our commitments to providing the tools needed to fight this devastating disease, and to not let Alzheimer’s be one of the defining diseases of our children’s generation as it has ours,” says Collins.

“Since the original BOLD Infrastructure for Alzheimer’s Act passed, public health departments have been able to improve brain health across the life course in their communities,” said Robert Egge, Alzheimer’s Association chief public policy officer and AIM president. “The BOLD Reauthorization Act will help public health departments implement effective strategies that promote brain health, address dementia, and support individuals living with dementia and their caregivers,” said Egge. “We urge the President to support the Alzheimer’s community and swiftly sign this bipartisan bill into law,” he says.

Rhode Island response

“Getting this bill across the finish line is a win for the 25,000 Rhode Islanders living with Alzheimer’s, their adult children who work tirelessly as unpaid family caregivers, and for the health and economic needs of the next generation too.  We must continue the progress we’ve made against Alzheimer’s.  We’ve got to find better treatments for Alzheimer’s and related dementias. The federal government must do its part to reduce risk, detect early symptoms, and advance care while lifting the burden on unpaid caregivers,” said RI Sen. Reed.

Since the original BOLD Infrastructure for Alzheimer’s Act passed in 2018, Reed noted that the Rhode Island Department of Health (RIDOH) has been awarded $3.8 million in BOLD Infrastructure for Alzheimer’s Act grants from the CDC. RIDOH has used the federal BOLD grant funds to help to implement effective Alzheimer’s interventions, including boosting early detection and diagnosis, reducing risk, and preventing avoidable hospitalizations, he says.

Victoria O’Connor, program manager at the RIDOH’s Alzheimer’s Disease and Related Disorders (ADRD), who chairs the state’s Advisory Council on ADRD, agrees with Sen. Reed’s assessment about the positive impact of this federal grant on state-wide public health interventions for those caring for persons with dementia.

“The RIDOH Alzheimer’s Disease and Related Disorders Program leads a statewide Advisory Council, convening critical partners, subject matter experts, and people with lived experience to advise implementation of the BOLD funded workplan as well as oversee the Rhode Island State Plan on Alzheimer’s Disease and Related Disorders 2024-2029. This collaborative approach has led to successful implementation of public health interventions statewide that aim to empower all individuals impacted by dementia to achieve their best quality of life.” says O’Connor.

Other congressional actions to combat Alzheimer’s  

Earlier this year, Sen. Reed helped pass the National Alzheimer’s Project Act (NAPA) Reauthorization Act and the Alzheimer’s Accountability and Investment Act (AAIA).  Sen. Whitehouse was also a cosponsor of the National Alzheimer’s Project Act (NAPA) Reauthorization Act.  Both bills were signed into law by President Biden. 

The NAPA Reauthorization Act (P.L.,118-93) reauthorizes NAPA through 2035, considered a roadmap to coordinate federal efforts in responding to Alzheimer’s and other forms of dementia.  Since NAPA was first passed in 2011, Alzheimer’s research funding has increased seven-fold.  Today, funding for research into Alzheimer’s and other dementias totals over $3.8 billion.

The Alzheimer’s Accountability and Investment Act (P.L. 118-93) would require the Director of the National Institutes of Health (NIH) to submit an annual budget to Congress estimating the funding necessary to fully implement NAPA’s research goals.  This will help ensure Congress can make a well-informed decision to determine necessary Alzheimer’s research funding levels.

We have made tremendous progress in recent years to boost funding for Alzheimer’s research, which holds great promise to end this disease that has had a devastating effect on millions of Americans and their families,” said Sen. Collins, who authored NAPA and AAIA.

“These two bills will maintain our momentum and make sure that we do not take our foot off the pedal just as our investments in basic research are beginning to translate into potential new treatments. We must not let Alzheimer’s to be one of the defining diseases of our children’s generation as it has ours,” she says.

And as a member of the Appropriations subcommittee that oversees funding for the National Institutes of Health (NIH), Sen. Reed helped provide a $275 million increase for Alzheimer’s disease research in the fiscal year 2025 Senate Labor, Health and Human Services, Education, and related Agencies Appropriations bill.  In 2019, NIH awarded Brown University researchers, along with Boston-based Hebrew SeniorLife (HSL), over $53 million in federal research funds  to lead a nationwide effort to improve health care and quality of life for people living with Alzheimer’s disease and related dementias, as well as their caregivers.

Talking political turkey during Thanksgiving dinner

Published in RINewstoday on November 25, 2024

We face increased demands of family obligations planning for the upcoming Thanksgiving holiday. Baking and cleaning to host dinner, and even unrealistic expectations about our families, or having a dysfunctional family, can produce extra stresses, feelings of anxiety, isolation, and depression.  

Especially after this year’s presidential election that continued to polarize the nation, expect more holiday stress caused by political sparring at the dinner table.  Heated political conversations over the results of the recent presidential election, even debates over divisive policy issues like abortion, immigration, the economy, and health care can lead to family conflicts and boycotting the traditional holiday celebration. 

Just cruise the internet and you will find a popular meme that clearly illustrates the damage that can be caused by the discussion of politics at Thanksgiving or family gatherings.  “I just saved a ton of money on Christmas gifts discussing politics during Thanksgiving dinner,” says the meme, noting that it can be explosive at best and fracture family relationships. 

Post-Election stress creeping into Thanksgiving

Weeks after the 2024 presidential election, the stress of political disagreements continues to strain family dynamics just in time for Thanksgiving. According to Gray News, a new survey from Raleigh, North Carolina-based Spruce reveals how post-election tension threatens to derail the holiday season, with families feeling emotionally exhausted from political debates. 

The Spruce survey looked at 2,000 people across all 50 U.S. states, equally split among men and women. Adults aged 25-65 who regularly celebrate Thanksgiving were surveyed, says the statement announcing its findings.

“Elections stir deep emotions, especially when they tap into our fears and values,” says Tony Spencer, CEO and family relationship expert at Spruce. “Left unmanaged, post-election stress can create rifts that spill over into personal relationships, making Thanksgiving feel like a political battleground. But with a bit of intentional effort, we can shift the focus back to what really matters—family,” he says.

According to Spruce’s recently released survey, 64% of respondents reported that election-related stress is affecting their holiday planning and 59% say they are worried about political disagreements causing tension at their Thanksgiving gatherings.

The survey findings note that 52% admitted to already having arguments with family members about political differences since the election. While 32%  are looking forward to discussing politics, 68% of respondents want to avoid politics talk completely this Thanksgiving. Moreover, 49% want to have a total politics conversation ban for all guests and family members.

Boycotting the family dinner is an option for some to reduce family tension.  Twenty-three percent are even considering skipping Thanksgiving altogether to avoid family stress.

When the dust settled after the election, supporters of the winning and losing candidates were stressed out.  Fifty two percent say President-elect Trump supporting family members are the source of their election and Thanksgiving anxiety, while 48% say VP Kamala Harris supporting family members cause them anxiety. About equal.

Finally, the survey found that 63% plan to set boundaries around political discussions. With the right strategies, families can still preserve the holiday spirit.

Practical strategies to preserve the Holiday spirit

“This year’s holidays may be uncomfortable because so many people either are going to love or hate the election results. It will be hard to ignore the election over Thanksgiving because it is so recent and people still feel so intensely about the results,” said Darrell M. West is a senior fellow in Governance Studies at the Brookings Institution and a former professor at Brown University.

“There should be no gloating or ‘I told you so’ over the holidays” says West, this reducing family antagonism. “Winners should be gracious and understand their gal/guy won and they shouldn’t rub the noses of opponents into the ground. Those on the losing side probably want to avoid detailed discussions of politics,” he says, suggesting that there should be informal ceasefire rules in effect for the holidays with a cessation of hostilities for Thanksgiving. 

During her 45-year career as a licensed practicing psychologist in Los Angeles and at State College, Pennsylvania, Elaine Rodino, Ph.D., a fellow and former president of the American of the American Psychological Association’s division of psychologists in independent practice, has had a longstanding interest in the holiday blues and has helped many of her patients cope with this issue over the years. 

“It is a challenging year for families who are getting together for holidays who differ politically, says Rodino. Defusing tension can be as simple as asking guests to refrain from talking about politics and/or the election results, says Rodino.

“If you think your guests are going to have a difficult time “refraining” from talking about politics – make it a hard and fast RULE – “I would love for you to come to our dinner, but only if you will promise not to talk about or engage in any conversations about politics,” suggests Rodino.

Rodino warns Thanksgiving Day hosts to be alert during the dinner to conversations and if they hear any that seem to be approaching the forbidden topic intervene immediately and ask them to please stop or redirect the conversation.

Why not make a game or contest to see if people can refrain from talking about politics, says Rodino, or even charge a fine to anyone mentioning politics or the election. Prizes will be given to the winners and the losers will be asked to leave, she adds, noting that everyone would need to agree to these actions before coming.  Or, something like that.

Some may even be cancelling their Thanksgiving plans, notes Rodino. “This may not be the year to host/hostess a Thanksgiving gathering of politically different family and friends. Think about taking a weekend trip and skip the festivities this year,” she says.

No right or wrong answers

“If folks would prefer to avoid these topics and all can commit to holding their tongues, that’s perfectly reasonable,”  says Todd Schenk, an associate professor and chair of the Urban Affairs and Planning Program at Virginia Tech. “However, many families—like my own—can’t ever seem to avoid politics” he adds, noting that many want to have these conversations both because of their convictions and they want to understand their loved ones. That’s perfectly reasonable too. 

“Research strongly suggests that healthy discourse can foster empathy, and thus restore those relationships,” notes Schenk. “Whether its friends, family, neighbors, or beyond, political tension is, at least in part, about differences in values, interests, and priorities on important policy matters. While consensus is rarely easy and not always possible, healthy dialogue can help us to better understand the complexities associated with these issues and seek solutions that are more accommodating to various groups,” he says.  

“We often do want to persuade others, which is absolutely understandable. Persuasion is, however, typically a long-term process that requires sustained dialogue; it usually involves gaining a strong understanding of how those you are engaging with feel and, more importantly, why, and then working to find ways in which the position you are seeking to sway them to actually reflects their own values,” adds Schenk.  

Finally, Schenk shares the following six tips as to how we can talk to others at the Thanksgiving table who have differing political viewpoints.  

1) Start with the explicit acknowledgement that you both/all want to have the conversation in a healthy way. It might sound silly, but, especially if you think it could get heated, it can help to establish some informal ‘ground rules’ up front. These don’t have to be complicated, just things like ‘no interrupting’, ‘no personal attacks’, and ‘describe your own views but don’t make assumptions about others.  

2) This is really contextual, but certain times and places may be more or less conducive to healthy conversation than others. For example, you may want to avoid conversations in front of the cousins that you know are going to egg it on, or especially after a few glasses of wine, or in front of young children who may think the whole family is arguing, causing them great anxiety and concern.

 3) Aim to speak honestly about your reasons for holding a particular perspective, speaking from your own experience and perspective as much as possible.  

4)  Be ready to really listen, affirming that you hear what they are saying and asking probing questions (see active listening below).  

5)  Attempt to understand, rather than just persuade.  

6)  Remember that body language is important too.  

In Conclusion…  

Schenk quips, if all else fails, put plastic on the furniture and buckle up. ”In all seriousness, humor and charitableness can go a long way – I think it behooves us all to remember the bonds we have with those around the table with us and to start from that place,” he says.   

Brown University alum Dr. Myechia Minter-Jordan leads AARP, follows Jo Ann Jenkins

Published in RINewsToday on November 18, 2024

With AARP Chief Executive Officer (CEO) Jo Ann Jenkins announcing her decision eight months ago in a statement by Lloyd Johnson, Chair of AARP Board of Directors, he pledged that his Board would move “diligently to find the right person to lead AARP on the next leg of its journey.”  The Board supported by Heidrick and Struggles, an international executive search and management consulting company headquartered in Chicago, Illinois, recruited Dr. Myechia Minter-Jordan to serve as its next CEO.

Minter-Jordon, 52, a physician and former president and CEO of CareQuest Institute for Oral Health, a nonprofit group that promotes dental health, will oversee 21 departments at the Washington, DC-based AARP, which has state affiliates in all 50 states, as well as the District of Columbia, Puerto Rico, and the Virgin Islands.  According to Forbes, as of February 2024, AARP had 2,250 employees and was ranked No. 31 in its America’s Best Midsize Employers listing.  The Paddock Post reported that the organization’s total revenue in 2022 was $ 1.8 billion.

Leading AARP into the Future

“Dr. Minter-Jordan joins us with the necessary attributes to successfully guide AARP on the next leg of our journey to help people live better as they age,” says AARP’s Board Chair Johnson in a Nov. 12 statement announcing her hiring. “She is an accomplished physician and innovative business leader who brings to AARP a strong passion for our social mission, demonstrated ability to balance strategic decisions with financial discipline, build strong teams, foster collaboration and lead organizations through rapid change and growth. We’re thrilled to have her leading the fight for what matters most to older Americans during this time of increasing social and technological change,” he says.

According to AARP, prior to Minter-Jordan’s new role at AARP, she served as President and CEO (2021-2024) of CareQuest Institute for Oral Health. As a physician and business executive, she played a key role in advising and shaping strategic initiatives aimed at improving dental health care outcomes through advocacy, policy development, and philanthropic efforts. In the spring of 2024, she testified before the Senate Committee on Health, Education, Labor, and Pensions (HELP) about the dental care crisis in America.

Before joining CareQuest Institute, Minter-Jordan’s bio noted that she served as chief medical officer and CEO of the Dimock Center, one of the largest community health centers in Massachusetts. During that time, Dimock was recognized as a national model for comprehensive, integrated health and human services.

AARP’s new exec was also active as a Board member to an array of nonprofits.  She served on several boards and committees at BlueShield of California, the Yawkey Foundation, Penn Dental Medicine, the Isabella Stewart Gardner Museum, and board emeritus at The Boston Foundation, and Point32 Health. Previously, she held appointed positions at agencies including the Massachusetts Health Planning Council Advisory Committee and the City of Boston Public Health Commission.

Once a Rhode IslanderBrown grad

Minter-Jordan once called Rhode Island her home. She earned both her undergrad degree and doctor of medicine degree from Brown University School of Medicine and a master of business administration degree from Johns Hopkins University Carey School of Business. She also received honorary doctorates from Northeastern University and Newbury College.

“This is a pivotal moment for AARP and the nation,” says Minter-Jordan, noting that for more than 65 years, the nonprofit has been instrumental in improving the lives of older Americans by “helping people age on their own terms and live their lives to the fullest.” 

“As AARP looks ahead, we have exciting opportunities to empower, uplift and make a positive impact on the health, wealth and wellness of the more than 110 million Americans ages 50 and older and the entire country,” she says.

Jenkins’ farewell to AARP

Jo Ann Jenkins

On March 21, 2024, AARP CEO Jo Ann Jenkins, 66, announce her decision to step down when her contract expired at the end of the year.  She began her long-time relationship with AARP in 2004 when she joined the AARP Services, Inc. (ASI) Board of Directors. She served as ASI’s Chair from 2009 to 2010.  In 2010, she became President of AARP’s Foundation, and three years later became AARP’s Executive Vice President and later its CEO.

With the announcement of her departure, AARP Board Chair Johnson recognized her “impressive record of accomplishments in advancing AARP’s mission and serving our members.”   He added, “Jo Ann has led AARP on a transformational journey to redefine the organization’s vision, challenge outdated attitudes and stereotypes about aging, and spark innovative solutions that empower people to choose how they live as they age.”

Among the accomplishments during her tenure, Jenkins championed the multi-generational workforce, healthy longevity, protecting Social Security and Medicare, and lowering the cost of prescription drugs. She has led through a spirit of innovation, creating AgeTech and launching a Digital First journey to help AARP better serve our members in the future.

Under Jenkins leadership, AARP has received the Malcolm Baldrige National Quality Award, has been recognized by Ethisphere as one of the World’s Most Ethical Companies, has been named as one of Fast Company magazines Best Workplaces for Innovators, and for the past seven years has been named as a Washington Post Best Workplace. In 2019 and 2021, Fortune magazine named her as “One of the World’s 50 Greatest Leaders.” Her national best-selling book, Disrupt Aging: A Bold New Path to Living Your Best Life at Every Age, became a signature rallying cry for revolutionizing society’s views on aging.

A fond farewell

In a “Farewell to AARP” posted on the nonprofit’s Advocacy webpage on Nov. 6, 2024, Jenkins reflected on her first speech as AARP’s CEO at an AARP national member event at the San Diego Convention Center.

“That day I made a promise to AARP’s members: “As your CEO, I will be unapologetic in fighting for the wants and needs of people 50-plus. As AARP’s new CEO, I wanted to change the conversation about what it means to grow older. I said we need to “disrupt aging”—to challenge outdated stereotypes and attitudes about getting older and spark new solutions that help people live better as they age. I challenged our members to help me do that,” she recalled.

“We changed not just the conversation about aging but also what it means to grow older,” she stated in that posting. And she concluded, “As I wind up my tenure as the steward of the legacy of our founder, Dr. Ethel Percy ­Andrus, I’m proud that we have lived up to the motto she gave us more than 65 years ago — ‘To serve; not to be served.’ I leave confident that AARP is well positioned to continue building on that legacy.”

“Serving as your CEO has been a tremendous privilege and extraordinary experience. What I will miss the most is you, the members and volunteers, and the exceptional staff whose passion for our mission and commitment to service is second to none,” said in her swan song posting.

“As I bid you farewell, I want to thank you from the bottom of my heart for your support, your service and all you do to disrupt aging,” she added, noting that while leaving AARP, “rest assured that I will continue to be unapologetic in fighting for the wants and needs of people 50-plus.”

Jenkins has surely made her mark as the nation’s top advocate.  She leaves AARP in Minter-Jordan’s capable hands.  Good luck to both of you.