Alzheimer’s Disease Initiative Program Grant Now Recruiting Rhode Island Participants

Published in RINewsToday on August 15, 2022

Last January, CareLink, a nonprofit network of post-acute and community-based providers, received a grant from the Administration for Community Living, a division of the U.S. Department of Health and Human Services. After the required planning period, and identifying community resources and referral organizations, and training staff, CareLink is now able to recruit program participants. Carelink, an East Providence-based healthcare organization, received funding for a three-year grant that offers innovative therapeutic services and programs. In addition, it connects participants with resources and provides caregiver education.  

CareLink’s services and programs will support older people with ADRD who live in the community alone or with a care partner, individuals with intellectual and developmental disabilities who are at greater risk for developing dementia, and persons living in ethnically and culturally diverse communities with limited access to medical care due to economic, language, or other barriers. 

The $904,133 Alzheimer’s Disease Program Initiative (ADPI) grant enables the nonprofit to better support the 24,000 Rhode Islanders with Alzheimer’s Disease and Related Disorders (ADRD). These services are even more critical as this number is projected to double by 2040. In addition to individuals with ADRDs, the grant targets services for individuals with intellectual and developmental disorders and those living at home alone with a diagnosis of cognitive impairment. 

Grant funds will be used to deliver two nationally recognized, non-pharmacological, evidence-based treatment programs – Cognitive Stimulation Therapy (CST) and Skills2Care®. These programs are provided to individuals living with ADRD, and when appropriate to their caregivers, at no cost. Specially trained CareLink occupational therapists and speech-language pathologists who have experience working with individuals with Dementia and their caregivers provide these interventions.   

Two Nationally Recognized Therapeutic Interventions to be Offered

CST addresses memory, thinking skills, and quality of life thru 14-biweekly sessions of structured 45-minute therapy sessions, featuring different topics.  Each session includes a warm-up activity, a song, and a “reality orientation board” that details the date, time, place, and weather.  Sessions include a variety of activities including the discussion of current news, listening and singing to music, playing word games, and participating in activities such as baking. This program can be provided using both individual and group sessions meant to foster social engagement and community. Both Speech-Language Pathologists and Occupational Therapists provide this beneficial program.

Skills2Care® provides training for the individual and their caregiver on managing challenging behaviors. This program, delivered by a trained Occupational Therapist, during five ninety-minute home visits, includes techniques to reduce challenging behaviors, promote functioning, improve caregiver communication, home environment safety, and tips focused on caregiver self-care, including problem solving and teaching stress management techniques. 

“Our focus is on providing innovative treatment for individuals with dementia and their caregivers,” explains Dr. Chris Gadbois, chief executive officer of CareLink, Inc. “We’re integrating interventions and supports for patients and caregivers within the home environment, building upon the recommendations of the individual’s medical professional and resources within the community.” 

“The strong relationships CareLink has with a wide array of community partners will enable this program to reach Rhode Islanders from different backgrounds across the state. We have been overwhelmed by the enthusiastic support of the community for this effort to improve the lives of patients and their caregivers,” says Gadbois. 

“The Rhode Island Alzheimer’s Disease and Related Disorders Advisory Council congratulates CareLinkRI on securing this competitive funding for these important services,” said Council Chair Nancy Sutton, MS, RD.

“A diagnosis of Alzheimer’s or a related dementia is a devastating diagnosis for an individual, their family, and their loved ones. People need to talk to their healthcare provider about any concerns of memory loss, regardless of their age. We know that an early diagnosis allows patients and caregivers to connect with services and resources right away—before they experience a crisis.”

“Dementia care is complex and requires a full team to assist patients and their families navigate the healthcare system and community resources. This funding helps to support and expand a much-needed program where providers can refer patients and caregivers as soon as they receive a diagnosis.”

Christine Gadbois, representing CareLinkRI, is an active member of the Rhode Island Alzheimer’s Disease and Related Disorders Advisory Council, and has informed the Council on this newly funded initiative. Other Council members include the Rhode Island Department of Health, Office of Healthy Aging, Butler Hospital, and Rhode Island Hospital’s memory clinics, and the Alzheimer’s Association – Rhode Island Chapter, and they are all collaborating with CareLinkRI to ensure easy access.

“Alzheimer’s disease and related dementias take such a toll on our communities, and support services like those provided through CareLink and its partners are essential for thousands of constituents and their families,” states Senator Louis DiPalma (D-District 12). “I’m extremely grateful for this award to CareLink which will make an enormous difference in the lives of Rhode Islanders in the years to come.” 

While CareLink is the grant recipient and manager, they have partnered with numerous local agencies, including The Cove Center, Avatar, Trudeau Center, Accesspoint RI, and Meals on Wheels. CareLink is also reaching out to local medical providers, including specialty clinics such as RI Mood and Memory. “We know it is critical to engage community partners to successfully reach a diverse group of individuals who will benefit from these services across the state,” says Robyn Earley, Chief Growth Officer of CareLink. 

“We know these programs are impactful and we are working to integrate these services into the larger landscape of resources for persons with dementia and related disorders, adds Earley. 

Looking for Participants

On May 26, 2022, Earley reports that CareLink began its recruitment efforts for study participants in the community through general outreach. “We are now working on outreach to Rhode Island medical providers, senior centers, intellectual and developmental disability service organizations, senior housing, and other community agencies that serve individuals with cognitive impairments. We are targeting individuals at home through outreach/partnership with MOW, Hope Health, etc.” she says, noting that a plan is in place to outreach to Resident Services Coordinators at senior high-rises to reach the live-alone population.

“The investment in these therapeutic tools has a significant impact on the quality of life and independence of those with dementia,” she says. These interventions enable individuals with cognitive impairments such as ADRD to live longer and more successfully in the community. 

Ultimately, CareLink intends to provide services to over 300 people by the end of grant, three years from now.  

“We have already learned so much from the first month of service and I anticipate continued growth and learning throughout,” says Earley.

For details about this study or for referrals, please contact CareLink at ADPLdementia@carelink.org.  Or call 401 490-7610, Ext. 116.  

To learn more about CareLink, go to www.carelinkri.org/

Herb Weiss, LRI’12, a Pawtucket writer covering aging, health care and medical issues. To purchase his books, Taking Charge: Collected Stories on Aging Boldly, and a sequel, go to herbweiss.com.

New resources to protect Seniors before, during and after Natural Disasters

Published in RINewsToday on July 18, 2022

Just last year alone, the Washington, DC-based AARP noted that the nation experienced more than 1,300 tornadoes, 21 named storms (with winds of 39 mph or greater), nearly 59,000 wildfires that burned more than 7.13 million acres, along with numerous ice storms and other weather events that caused major damage and fatalities. With hurricane season now approaching, AARP teamed up with the U.S. Federal Emergency Management Agency (FEMA), announcing the release of new resources specifically designed to help local and state officials and Emergency Management Agency (EMA) officials protect seniors in their communities.

“By 2034, adults ages 65 and over will outnumber those under 18 in the United States for the first time. This has profound implications during natural disasters and extreme weather events,” said Nancy LeaMond, Executive Vice President and Chief Advocacy & Engagement Officer at AARP, in a statement announcing the released resources. “State and local leaders and emergency officials must be better equipped and prepared to ensure that older adults are kept safe and their needs are met when a disaster strikes,” warns LeaMond.

The 9-page, Guide to Expanding Mitigation: Making the Connection to Older Adults, released by FEMA, highlights how natural hazards uniquely affect seniors and provides specific remedies as to how local mitigation and emergency planners can include seniors in community efforts to lower their risks.

Throughout its 44 pages, the AARP Disaster Resilience Took Kit features strategies to help local, state and community leaders and aging advocates reduce the risk and impact of disasters on older persons. 

The guide and tool kit are the result of a multi-year collaboration between AARP and FEMA to identify and provide resources, spark ideas and encourage organizations to better engage older Americans in disaster mitigation, preparedness, response and recovery operations. This long-term, strategic alliance aims to advance accessible, safe and livable communities for people of all ages, says AARP.

“Adults aged 65 and older are a growing demographic who are often disproportionately impacted by severe weather. These disparities can be compounded by other factors, such as low-income or chronic illness, producing inequitable results for this vulnerable population when it comes to disaster preparedness,” said FEMA Administrator Deanne Criswell in a statement. 

“Effective mitigation planning requires that we consider the needs of all populations, and FEMA’s partnership with AARP on these guides will help community planners ensure our older communities are more resilient in the face of hurricanes and other natural disaster,” she said.

According to AARP, a growing body of evidence compiled shows that seniors are disproportionately impacted by the types of weather-related emergencies and natural disasters that are becoming increasingly frequent and severe. Individuals who have chronic illnesses, functional limitations or disabilities are especially vulnerable, as evidenced by the impact of the global COVID-19 pandemic on seniors.  Not only are older people at a higher risk of death from infectious diseases and disasters, but the long-term effects on those who survive often undermine their physical and mental health, economic security and overall well-being.

Although many communities support older adults in preparation for disasters, expanded mitigation planning can help reduce the loss of life and property by minimizing the impact of disasters before they happen, says AARP, noting that mitigation actions and strategies that make cities, towns and neighborhoods safer for older adults can benefit all residents and increase community resilience overall.

Protecting Seniors from Natural Disasters in the Ocean State

“One standout recommendation from the AARP/FEMA report was the adoption of more resilient and efficient building and land use standards, including the consideration of hazards in siting senior living facilities,” says RI Lieutenant Governor Sabina Matos, who oversees the Emergency Management Advisory Council that reviews information and programs regarding emergency management and makes recommendations to the Governor on these issues.

“One of my highest priorities is the creation of more affordable housing of every kind, and we have to walk the line of growing not only quickly, but thoughtfully. As we consider how to use this budget’s $250 million investment in housing, we want to ensure that new developments meet FEMA standards and will keep Rhode Islanders safe. We’re already working with local communities’ EMA departments to review their community disaster preparedness plans, as well as their applications for FEMA Hazard Mitigation Grants — funding to help implement exactly the strategies outlined in this report,” she says.

“One omission that stands out to me is resources for unhoused seniors. According to the Rhode Island Coalition to End Homelessness’s 2021 State of Homelessness report, over 500 Rhode Islanders aged 55 or older experienced homelessness over the course of a year. We need to strongly consider what kinds of hazard mitigation strategies could help this uniquely vulnerable population. Additionally, Rhode Island must especially focus on preparing sustainable mitigation and response systems that account for the effect of climate change on our coastal communities, which we know have large senior populations and will become increasingly vulnerable to flooding,” says Matos.

”FEMA has provided a very valuable tool with the Guide to Expanding Mitigation – Making the Connection to Older Adults guide. At the Rhode Island Emergency Management Agency,  we work with our local emergency managers, non-profits (Rhode Island Community Food Bank, Red Cross of Rhode Island, United Way and more) and other state agencies including the Department of Health and the Office of Healthy Aging to ensure older Rhode Islanders have the resources they need when disaster strikes. These reports will help us in our efforts to continue to support individuals in this vulnerable group,” says Director Marc Pappas, of the Rhode Island Emergency Management Agency.

“Preparedness is a core function of public health. This is especially true when it comes to climate change and older adults. As these resources highlight, it is critical that the unique needs of older adults are considered when planning for weather-related emergencies and natural disasters. This is already a priority for us at the Rhode Island Department of Health when it comes to emergency preparedness, and it will continue to be a focus,” says Joseph Wendelken, Public Relation Officer for the Rhode Island Department of Health.

“Before, during and after a natural disaster, the safety and wellbeing of older Rhode Islanders must always be a top concern,” said AARP Rhode Island State Director Catherine Taylor

“Emergency planners and managers at the state and especially local levels, along with first responders and many others, play a critical role in reducing anxiety and any subsequent harm when disaster strikes. Whether it’s a hurricane, flooding, extreme heat or infectious disease, ongoing planning and the coordination of all available resources is necessary to minimize consequences,” says Taylor.

“The AARP/FEMA guide and toolkit can go a long way towards mitigating deaths and long-term impacts among Rhode Island’s most vulnerable citizens. We encourage all leaders involved in Rhode Island public safety and public health to take advantage of this new resource. There are many aspects of age-friendly, livable communities – resilience in the face of disaster is chief among them,” Taylor adds.

AARP Rhode Island Volunteer State President Marcus Mitchell has firsthand disaster management experience. “As a former Division Commander with the US Coast Guard Auxiliary and Community Emergency Response Team Instructor for Providence Emergency Management Agency, I am actively involved with emergency & disaster mitigation, response and recovery efforts that dramatically and profoundly impact our older population physically, emotionally and financially,” he said. 

“Not only are seniors often hit first and hardest but their families are deeply affected as well,” Mitchell added. “We hope to save lives throughout the community, mitigate damages and reduce injury by vigorously distributing the new guide and toolkit to our members and the community at large.”

West Warwick resident Vincent Marzullo gives a thumbs up to AARP/FEMA’s released resources, saying that their information will be extremely valuable to the State and local EMA officials charged with protecting the state’s aging and vulnerable population during natural disasters. “Several barriers prevent older adults from evacuating when needed. Many older adults cannot drive and do not have access to reliable, accessible public transportation, depend on home-based medical equipment, require specialized accessibility supports, or cannot bring pets when evacuating. Some older adults are caregivers to spouses or partners with one or more vulnerabilities that may also hinder their ability to take timely action and remain safe, says Marzullo, who served for 31 years as a federal civil rights & social justice director for the Corporation for National & Community Service and a Federal Disaster Cadre Coordinator for the National Service Agency.

“State and local EMA officials must regularly outreach to the older Rhode Islander on the Rhode Island Department of Health’s “Special Needs Emergency Registry” to check their status/needs, especially individuals who are isolated and immobile.  There are approximately 15,000 individuals with chronic illnesses that have opted-in to the registry in order to be checked in times of emergency/disasters.  These older adults are vulnerable and need periodic support,” says Marzullo.

Marzullo calls for on-going disaster resilience webinars to be available to better prepare State and local EMA officials and organizations to respond to sudden natural disasters.  Targeted organizations might include the Red Cross, AARP RI, Senior Agenda Coalition of RI, Senior Center Directors Association, AARP members, RIElder Info, 211/The Point, and the Emergency Management Advisory Council (EMAC).

Melissa Carden, RIEMA’s Chief Public Affairs Officer says while winter storms, hurricanes and flooding are most common in the Ocean State, expect climate change to have a profound effect on the weather, including more storms and greater precipitation. “This fuels other extreme weather events like flooding (coastal and inland – remember the flooding in RI in 2010). Although scientists are uncertain whether climate change will lead to an increase in the number of hurricanes, there is more confidence that warmer ocean temperatures and higher sea levels are expected to increase their intensity and impacts.”

 To view and download the Guide to Expanding Mitigation: Making the Connection to Older Adults, visit  https://www.fema.gov/sites/default/files/documents/fema_mitigation-guide_older-

adults.pdf

To download a PDF of the AARP Disaster Resilience Tool Kit, featuring strategies to help local, state and community leaders and advocates reduce the risk and impacts of disasters on older adults, go to  https://www.aarp.org/content/dam/aarp/livable-communities/tool-kits-resources/2022/AARP%20Disaster%20Resilience%20Tool%20Kit-singles-060122-.pdf

The following (free) Livable Publication booklets and guides, go to https://www.aarp.org/livable-communities/tool-kits-resources/livable-publications-order-form/https://www.homecareassistancerhodeisland.com/

AARP Rhode Island Shows RI Facilities Remain Hotbed for COVID-19

Published in RINewsToday on February 14, 2021

As the Rhode Island Health Department (RIDOH) announces that cases of COVID-19 are declining and is loosening up restrictions on the reopening of bars and our social gatherings, AARP Rhode Island warns that the state’s nursing homes remain a hotbed for COVID-19 infections, and the “death rate remains disturbing.”  Rhode Island’s largest aging advocacy group calls on the General Assembly to take action this session to enact legislation to protect facility staff and residents. 

Since the beginning of the pandemic, more than 162,000 residents and staff in nursing homes and other long-term care facilities have died nationwide, and nearly 1.3 million people are known to have been infected with coronavirus in these facilities. Rhode Island has recorded 1,430 deaths in skilled nursing facilities, nursing homes, assisted living facilities and other eldercare facilities.
On Feb. 11, AARP Rhode Island released its Nursing Home COVID-19 Dashboard, the data revealing that the COVID-19 pandemic crisis in these facilities still continues despite incremental improvements in all four dashboard categories.

The dashboard analyzes federally reported data in four-week periods going back to June 1, 2020. Using this data, the AARP Public Policy Institute, in collaboration with the Scripps Gerontology Center at Miami University in Ohio, created the dashboard to provide snapshots of the virus’ infiltration into nursing homes and impact on nursing home residents and staff, with the goal of identifying specific areas of concern at the national and state levels in a timely manner.

Taking a Snapshot 

According to the data (Dec. 21 to Jan. 17) from AARP Rhode Island’s latest Nursing Home COVID-19 Dashboard, the rate of new coronavirus cases per 100 residents declined from 15.7 to 10.6 among residents and from 12.5 to 10.6 among staff. While cases are lower than in the previous time period, resident cases remain the second highest in New England in AARP’s dashboard analysis, with nearly four times the cases in Rhode Island nursing homes reported in October and November.

Meanwhile, the latest dashboard data indicated that resident death rates dropped from 2.60 to 1.82 for every 100 people living in a nursing home and that nursing home staff cases dropped from 12.5 per 100 workers to 10.6.The dashboard also reveals that PPE shortages dropped sharply. Shortages of personal protective equipment (PPE) have declined from 20.3 percent of nursing homes without a one-week supply to 4.3 percent — the lowest number since the first dashboard report in June, 2020. Staff shortages were relatively steady, dropping from 41.9 percent of facilities reporting shortages to 40 percent.

AARP Rhode Island calls on Governor Gina Raimondo and Lt. Governor Dan McKee to protect nursing home residents and staff from COVID-19. “We are approaching the one-year anniversary of the first known coronavirus cases in nursing homes, yet they remain appallingly high, said AARP Rhode Island State Director Kathleen Connell in a statement announcing the release of the latest dash data said, “The devastation this pandemic has brought to nursing home residents and their families has exposed fundamental reforms that must be made in nursing homes and to the long-term care system. We cannot lower our guard, she says.

AARP Rhode Island’s COVID-19 Legislative Agenda

The Rhode Island nursing home industry has struggled with quality care and infection control for years. Connell called for Rhode Island lawmakers to act immediately, focusing this year on: 

1.   Enacting or making permanent the components of AARP’s five-point plan:·         

— Prioritizing regular and ongoing testing and adequate personal protective equipment (PPE) for residents and staff—as well as for inspectors and any visitors.·  

—  Improving transparency focused on daily, public reporting of cases and deaths in facilities; communication with families about discharges and transfers; and accountability for state and federal funding that goes to facilities.·         

— Ensuring access to in-person visitation following federal and state guidelines for safety, and require continued access to virtual visitation for all residents.·        

—  Ensuring quality care for residents through adequate staffing, oversight, and access to in-person formal advocates, called long-term care Ombudsmen.

2.      Reject immunity and hold long-term care facilities accountable when they fail to provide adequate care to residents.

3.      Establishing minimum nursing staffing standards.

4.      Ensuring that increases in facility’s reimbursement rates are spent on staff pay and to improve protections for residents.

5.      Ensuring progress is made so that in-person visitation can safely occur and facilitating virtual visitation.

“Additionally, our leaders must reject policies that take away the rights of residents to hold nursing homes accountable when they fail to provide adequate care, Connell added. “Now is not the time to let nursing homes off the hook for abuse, neglect, and even death.”  AARP Rhode Island wrote a letter to Gov. Raimondo, urging her to withdraw her nursing home immunity Executive Order.  At press time, there has been no reply.

As the first year of the COVID-19 pandemic approaches, RIDOH notes that 64 percent of all deaths have women and men in Rhode Island’s nursing homes and assisted living facilities. In the past 13 days, 116 new cases in these facilities have been diagnosed – with 41 new deaths. At weekly updates from Dr. Nicole Alexander-Scott, it used to be that the death statistics were broken down by age, noting how many were lost “in their 60s, in their 70s”, etc. but notably this no longer is reason for pause and expression on condolence.

Unless Rhode Island lawmakers act quickly, older Rhode Islanders in these facilities will continue to be at a very high-risk of catching COVID-19 and the fatality death rate will remain disproportionately high for seniors. As residents receive their vaccine shots, first and second, we in turn hope that the refusal rate of staff to the vaccination is going down.

It’s time to act. 

The full Nursing Home COVID-19 Dashboard is available at  www.aarp.org/nursinghomedashboard.  

For more information on how COVID is impacting nursing homes and AARP’s advocacy on this issue, visit www.aarp.org/nursinghomes.