Experts Say Isolation and Loneliness Impacting More Older Americans

Published in Woonsocket Call on April 30, 2017

Sarah Hosseini, a blogger on Scary Mommy, a website bringing entertainment and information to millennial mothers, penned a touching story about Marleen Brooks, a California resident, who came home to find a heartbreaking hand-written note from Wanda, her 90-year-old neighbor, asking her to be friends.

Wanda wrote: “Would you consider to become my friend. I’m 90 years old – live alone. All my friends have passed away. I’m so lonesome and scared. Please I pray for someone.”

According to Hosseini’s blog posting, Brooks shared this note with KTVU News Anchor Frank Somerville, who posted it on his Facebook page. She responded to the posting by saying, “Came home to this note from a lady that lives down the street from me. Makes my heart sad, but on the bright side it looks like I will be getting a new friend.”

That evening Brooks visited her new friend, bearing a gift of cupcakes. After the visit, she wrote to Somerville describing this initial visit (which was posted on his Facebook page), says Hosseini. In this update posting, Brooks observed, “She’s such as sweet lady! And she was over the moon when we came over.” Brooks reported what Wanda said during the impromptu get together: “I hope you didn’t think I was stupid for writing you, but I had to do something. Thank you so much for coming over. I’ve lived here for 50 years and don’t know any of my neighbors.”

Wanda shared with her new acquaintance that she is on oxygen has congestive heart failure, osteoporosis and other age-related ailments, and her two surviving sons do not live by her,” noted Hosseini’s blog posting.

Zeroing in on a Growing Societal Problem

Wanda’s isolation and loneliness is not a rare occurrence. It happens every day throughout the nation. The U.S. Senate Special Committee on Aging recently put a spotlight on the growing number of Americans who are socially isolated and lonely, like Wanda, and expert witnesses detailed the negative consequences of this tragic societal problem.

In Room 403 of the Dirksen Senate Office Building, U.S. Senators Susan Collins and Bob Casey, the Chairman and Ranking Member of the Senate Aging Committee, held a morning hearing on April 27, 2017, “Aging Without Community: The Consequences of Isolation and Loneliness.”

he Senate Aging panel hearing (lasting almost two hours), the first in a two-part series, took a close look at the mental and physical health effects of social isolation and loneliness. The next hearing will explore ways to reconnect older people to their communities.

“The consequences of isolation and loneliness are severe: negative health outcomes, higher health care costs, and even death. The root problem is one that we can solve by helping seniors keep connected with communities,” said Senator Collins in her opening statement. “Just as we did when we made a national commitment to cut smoking rates in this country, we should explore approaches to reducing isolation and loneliness. Each has a real impact on the health and well-being of our seniors,” noted the Maine Republican Senator.

Adds, Senator Bob Casey, “Older Americans are vital to the prosperity and well-being of our nation.” The Democratic Senator said, “Our work on the Aging Committee to ensure that we all remain connected to community as we age is important to maintaining that vitality. It is for that reason that we, as a federal government, need to sustain and improve our investments in programs that help seniors stay connected — from Meals on Wheels to rural broadband to transportation services.”

When approached for her thoughts about the Senate Aging panel, Nancy LeaMond, AARP Executive Vice President and Chief Advocacy & Engagement Officer said, “We know that social isolation and loneliness has severe negative effects on older Americans and we’re pleased the US Senate Committee on Aging held a hearing on this important issue. As they explore solutions for social isolation and loneliness amongst older Americans, AARP looks forward to working with them on these issues in 2017.”

Senator Sheldon Whitehouse says, “When seniors get involved, the community benefits from their valuable contributions. And the personal connections seniors make engaging in the community can help them stay healthy and productive.” Whitehouse, who sits on the Senate Aging panel, will work to protect funding for senior centers and programs that Rhode Island seniors rely on to stay connected, like Meals on Wheels and Senior Corps.”

Social Isolation is a “Silent Killer”

Speaking before the U.S. Senate Special Committee on Aging today, social work professor Lenard W. Kaye, DSW, PhD, urged lawmakers to support programs that help older adults stay connected to their communities.

Kaye serves as director of the University of Maine Center on Aging. Joining three other experts, he reported to the committee that social isolation is a “silent killer” — due to placing people at higher risk for a variety of poor health outcomes — and he warned that more Americans are living in isolation than ever before.

“The prevalence may be as high as 43 percent among community dwelling older adults,” Kaye said. “And the risk is high as well for caregivers of older adults given that caregiving can be a very isolating experience.”

Kaye’s testimony also highlighted the state of current research in solving the problem of social isolation among older adults.

“Due to the various life events that can trigger social isolation, from death of a significant other, to loss of transportation to health decline, effective interventions will need to be diverse and they will need to be tailored to the personal circumstances of the isolated individual,” he said.

Kaye added that there is still significant progress to be made in determining what works for helping to reduce social isolation. Lack of rigor in studies of interventions aimed at reducing loneliness can make it difficult to evaluate some of these strategies.

In Pima County, 46 percent of nearly 2,300 seniors surveyed in its 2016 community needs assessment cited social isolation as a significant concern of those living alone, said W. Mark Clark, president of the Pima Council on Aging.

In his testimony, Clark says, “Changes to mobility, cognitive ability or health status can cause an individual to hold back from previously enjoyed social activities. Older adults in rural areas who can no longer driver are at incredible risk of physical and social isolation unless transportation options are available.”

“While aging at home is cited as a top priority by a majority of older people, and doing so has both emotional and economic benefits, aging in place at home can also lead to isolation,” said Clark, noting that connections to the community wane as one gets older due to less opportunities to build new social networks.

In her testimony, Julianne Holt-Lunstad, a psychology researcher at Brigham Young University, estimated that over 8 million seniors are affected by isolation and social disconnect is increasing.

Holt-Lunstad told the Senators that research shows that social isolation and loneliness is as dangerous as being obese, as risky as smoking up to 15 cigarettes per day. and associated with higher rates of heart disease, a weakened immune system, anxiety, dementia, including Alzheimer’s disease and nursing facility admissions.

Finally, Witness Rick Creech, who was born with cerebral palsy, shared to the Senate Aging panel how disabilities can isolate a person. He described how an alternative communication (AAC) device, costing $10,000, a van concerted for a powered wheel chair passenger and smart home equipment to help him grow a “productive, independent adult.”

Meals on Wheels Program Vital Program for Isolated Seniors

It was clear to Senate Aging panel members and to expert witnesses that local Meals on Wheels programs can bring good nutrition and companionship to older American’s reducing social isolation and loneliness. Over two years ago, a Brown University study confirmed another benefit of visitors regularly knocking on the doors of seniors in need: a significant reduction in their feelings of loneliness.

“This continues to build the body of evidence that home-delivered meals provide more than nutrition and food security,” said study lead author Kali Thomas, assistant professor of health services, policy and practice in the Brown University School of Public Health and a researcher at the Providence Veterans Affairs Medical Center.

Thomas, a former Meal on Wheels volunteer said that the study is one of few to rigorously examine the long-presumed psychological benefits of home-delivered meal service. She believes it is the first randomized, controlled trial to assess the effect on loneliness, which has been linked by many studies to a greater risk for medical problems, health care utilization, and mortality.

“In a time when resources are being further constrained and demand is increasing, it is important that we have evidence that guides decision-making in terms of what services to provide and how best to provide them,” Thomas said.

Senator Susan Collins, chair of the U.S. Select Senate Committee on Aging, sees Meals on Wheels as policy strategy to address the growing number of isolated seniors and their loneliness. At the Senate Aging panel, Collins said, “For many, Meals on Wheels is not just about food – it’s about social sustenance, also. Seniors look forward to greeting the driver with a bit of conversation.” And the Republican Senator called for adequate funding to the nationwide Meals on Wheels network, comprising 5,000 local community-based programs. President Trump’s proposed cuts to Meals on Wheels were, “pennywise and pound foolish because in the end they’re going to cause more hospitalizations, more nursing home admissions, and poor health outcomes.”

Like Brooks, we should reach out to our older isolated neighbors in our community. A simple gesture like this can have a lasting, positive impact on both parties.

We Need Congress to Step Up and Fix Social Security, Medicare

Published in Woonsocket Call on July 3, 2016

Expect the nation’s Social Security program to be fully funded for nearly two decades, and Medicare’s solvency to continue courtesy of health care reforms. Social Security beneficiaries may even get a very small .2 percent cost of living (COLA) adjustment next year but will get wacked with a Medicare premium increase. These facts are reported in the recently leased 262 page report issued by the Trustees of the Social Security and Medicare funds, transmitted to Congress and President Obama. This is the 76th report issued by the Trustees that financially reviews these two of the nation’s largest entitlement programs.

This 2016 Trustee Report, released on Jun 22, should be of interest to Rhode Island’s retirees who receive checks from Social Security, According to AARP, 153,349 Rhode Islanders received Social Security checks as of the end of 2014. Also, 22 percent of Rhode Island retirees depend on their Social Security check for 90 percent or more of their income. Their average benefit is $1,341 per month.
The Devils in the Details

The recently released 2016 Trustees Report notes there is now $2.81 trillion in the Social Security Trust Fund, which is $23 billion more than last year and that it will continue to grow by payroll contributions and interest on the Trust Fund’s assets.

Meanwhile, Social Security remains well-funded. In 2016, as the economy continues to improve, Social Security’s total income is projected to exceed its expenses. In fact, the Trustees estimate that total annual income will exceed program obligations until 2020.

The Trustees say that Social Security will be able to pay full benefits until the year 2034, the same as projected in last year’s Report. After that, Social Security will still have sufficient revenue to pay about 79% of benefits if no changes are made to the program.

Although the Trustees project a .2% Cost of Living Adjustment increase, retirees will be hit with a premium increase next year. Medicare Part B premiums are projected to increase by only a very small amount for about 70 percent of beneficiaries in 2017 from $104.90 to $107.60. The standard monthly premium is projected to increase from $121.80 to $149.00 while the annual deductible is projected to increase from $166 to $204 for all beneficiaries.

The Trustees peg Medicare solvency to the passage of healthcare reform, with the program paying full benefits until 2028, 11 years later than was projected prior to passage of the Affordable Care Act. However, this is two years earlier than projected in 2015.

Congress Must Step to the Plate

Responding to the Social Security Trustees report, recently released report, AARP CEO Jo Ann Jenkins, said, “While the Trustees once again report that the combined Old Age, Survivor and Disability Insurance Trust can pay full retirement, survivor and disability benefits for some time, we know that if no action is taken, benefits could be cut by nearly 25 percent in 2034, and families could lose up to $10,000 per year in benefits.”

“Social Security remains a critical part of the fabric of our lives to protect us from both expected and unexpected challenge,” says Jenkins.

Jenkins calls on Presidential candidates and those running for Congress and the Senate to make a commitment to strengthening Social Security and outline their plans for the fix. “Throughout the 2016 election, we’ll continue to push candidates to take action if elected,” she says.

As to Medicare, Jenkins adds, “This year’s Medicare Trustees report reinforces the recent progress that has been made through greater Medicare savings and lower costs per enrollee. The report also highlights the financial challenges that continue to face the Medicare program, which is projected to provide critical health coverage to 64 million Americans by 2020.”

“A typical senior today has an annual income of just under $25,000 and pays roughly one out of every six dollars of this in out-of-pocket health care costs. The more than 55 million older Americans who today depend on Medicare for guaranteed, affordable health coverage simply cannot afford more than they already pay,” says Jenkins.

The Solution Could Be Simple

Jenkins urges Congress to make simple solutions to bring stability to the nation’s Medicare program. She suggests Congress find ways to reduce high prescription drug costs, improve the nation’s health care outcomes, eliminate unnecessary diagnostic testing, curb excess paperwork, and identify waste and fraud in the program.

Adds, Max Richtman, President/CEO of the National Committee to Preserve Social Security and Medicare, “What’s likely to be missing in headlines about today’s Social Security Trustees Report is that the program remains well-funded with total income, again, projected to exceed expenses. However, in order to head off a benefit cut in 2034 Washington should embrace the growing movement to lift the payroll tax cap and expand benefits for the millions of seniors struggling to get by on an average $1,300 retirement benefit.

The Trustees also project a tiny .2% cost of living adjustment next year yet Medicare premiums will increase in 2017, says Richtman. “Seniors continue to see their modest Social Security benefits eaten away by growing healthcare costs which illustrates, once again, that the current Social Security COLA formula isn’t accurately measuring seniors’ expenses. Congress needs to adopt a fully developed CPI for the elderly (CPI-E) and begin work on the many Social Security expansion bills now languishing in the House and Senate,” he adds.

This [Trustee’s] report reinforces the importance of ensuring that Social Security and Medicare are preserved and guaranteed, especially for working and middle class Rhode Islanders,” said Rep. David Cicilline (D-Rhode Island) who is a co-sponsor of the Protecting and Preserving Social Security Act. “Reasonable measures, such as raising the cap on high-income contributions, should be considered by Congress to extend the solvency of these programs. I will continue to advocate for commonsense legislation that strengthens benefits for working families and ensures the long-term stability of Social Security and Medicare,” he says.

RI. Reps Protect Social Security

Like Cicilline, Rep. Jim Langevin and Democratic Senators Jack Reed (D and Sheldon Whitehouse both view Social Security as an earned benefit and the primary source of income to millions of retirees that must be protected. The Rhode Island Congressional Delegation has fought off Republican efforts to privatize Social Security and have supported legislation to strengthen this program and Medicare.

It is very clear to aging advocates and to the Trustees of the Social Security and Medicare trust funds that the next President and Congress put political differences aside to make legislative fixes to strengthen and ensure the long-term stability of Social Security and Medicare.

The Trustees say this very clearly in their report, “Lawmakers have many policy options that would reduce or eliminate the long-term financing shortfalls in Social Security and Medicare. Lawmakers should address these financial challenges as soon as possible. Taking action sooner rather than later will permit consideration of a broader range of solutions and provide more time to phase in changes so that the public has adequate time to prepare.”

Political compromise will be the way to hammer out Social Security and Medicare reforms. When the dust is settled after the upcoming November president elections hopefully this message was delivered at the ballet box.

Calling on Congress to Increase Alzheimer’s Funding

Published in Woonsocket Call on February 21, 2016

Three weeks before President Obama released his Fiscal Year 2017 Budget on February 9,  Senators Susan Collins (R-ME), who chairs the U.S. Select Committee on Aging, and Amy Klobuchar (D-MN) along with seven of their colleagues, called on the Democratic President to increase funding for Alzheimer’s research as part of his last proposed budget request. Senator Sheldon Whitehouse (D-RI), who sits on the Senate Aging Panel, was among the cosigners.

In the bipartisan January 28 correspondence,  the cosigners said, “If nothing is done to change the trajectory of Alzheimer’s, the number of Americans afflicted with the disease is expected to more than triple between 2015 and 2050,” the Senators wrote.  Already our nation’s costliest disease, Alzheimer’s is projected to cost our country more than $1 trillion by 2050… Surely, we can do more for Alzheimer’s given the tremendous human and economic price of this devastating disease.”

Furthermore, cosigners warned that “$2 billion per year in federal funding is needed to meet the goal of preventing or effectively treating Alzheimer’s by 2025.” 

 Aging Groups Express Disappointment

Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM), says that the Consolidated Appropriations Act, 2016, (P.L.114-113) provided $936 million in FY 2016 (a $350 million or 59.7% increase over FY 2015) for Alzheimer’s disease research at the National Institute on Aging (NIA), the nation’s leading funder of Alzheimer’s disease research.

Richtman expressed disappointment that Obama’s budget proposal did not recommend funding about the FY 2016 level for Alzheimer’s disease and dementia research, it was essentially flat funded.

“Scientists have estimated that spending at least $2 billion a year on research is necessary to accomplish the national Alzheimer’s plan goal of preventing or effectively treating Alzheimer’s disease by 2025,” says Richtman.

According to NCPSSM’s 2016 Legislative Report, “the number of people suffering from Alzheimer’s disease or a related dementia is expected to skyrocket over the next few decades because many people are living longer and the incidence of Alzheimer’s disease increases with age.”

Richtman says “making a significant investment in funding towards finding a cure and appropriate treatments for persons with Alzheimer’s disease and dementias is key to reducing the massive financial drain this disease will impose on the future of the Medicare program, along with the devastating emotional and financial toll exacted on the millions of Alzheimer’s victims and their family members and caregivers.”

The Alzheimer’s Foundation of America (AFA) also expressed disappointment in the proposed $337 million cut in research funding at NIA, contained in Obama’s 2017 Fiscal year budget proposal. “The Administration has been a champion in the fight against Alzheimer’s disease; however, we are disappointed that, in his final budget, the President is retreating,” said CEO and President Charles J. Fuschillo, Jr., of the Alzheimer’s Foundation of America (AFA). “We were hoping President Obama would take the dramatic step necessary to confront the dementia crisis in this country head-on. We will continue to work with Congressional appropriators to ensure we are on the path to a cure,” says Fuschillo, Jr.

Like NCPSSM, Cicilline, Reed, Whitehouse, and many members of congress, the New York-based AFA urged the Administration to build on the historic 60 percent increase in Alzheimer’s research funding that was included in this year’s budget that provided an additional $1 billion in research funding in the upcoming federal budget.  If done, total federal spending would reach almost $ 2 billion, an amount that Alzheimer’s experts say is necessary to finding a cure or meaningful treatment by 2025 (detailed in the National Plan to Address Alzheimer’s Disease.

According to AFA, currently Alzheimer’s disease is the sixth leading cause of death in the United States, with studies indicating it could actually be as high as the third-leading caused.  But this devastating disorder is the only disease in the top 10 for which there is neither a cure nor impactful treatment.  Furthermore, “even with the Fiscal Year 2016 funding increase, funding for Alzheimer’s lags far behind HIV/AIDS, cancer and heart disease.

On the Home Front

Congressman David N. Cicilline, who successfully led the effort in the House to increase funding for Alzheimer’s research by more than 50% last year, sees a need for increased funding a necessity in the Fiscal Year 2017. “Alzheimer’s disease afflicts 22,000 Rhode Islanders and their families each year,” the Democratic congressman representing Congressional District 1.

With Congress poised to begin hammering out next year’s federal budget, Cicilline plans to continue his efforts in the House to fight for an increase federal funding for a treatment and a cure of the devastating disorder.  He urges for Alzheimer’s disease research remain a major funding priority for policymakers at every level of government.

Senator Jack Reed, serving as a member of the Labor-HHS Appropriations Subcommittee, says, “Last year, we successfully included a $350 million boost in new spending for Alzheimer’s research, a 60% increase over the previous year.  Looking ahead to the coming fiscal year, we still have our work cut out for us in this challenging budgetary climate, but I am pushing to secure additional resources to help prevent, treat, and cure Alzheimer’s, as well as for education and outreach.”

“More and more Americans are being impacted by Alzheimer’s disease and we need a serious national commitment to finding cures and treatments.  That means making strategic investments now that will help save lives and future dollars in the long-term,” notes the Senator.

A Call for Action

Experts tell us an impending Alzheimer’s disease epidemic is now upon us. Federal and state officials are scrambling to gear up for battle, developing national and state plans detailing goals to prevent or treat the devastating disease by 2025.

According to the Rhode Island Chapter of the Alzheimer’s Association, an estimated five million Americans over age 65 are afflicted with Alzheimer’s disease in 2013.  The prevalence may well triple, to over 16 million, if research does not identify ways to prevent or treat the cognitive disorder, says the Rhode Island nonprofit.  By 2050, it’s noted that the estimated total cost of care nation-wide for persons with Alzheimer’s disease is expected to reach more than $1 trillion dollars (in today’s dollars), up from $172 billion in 2010.

Congress must not act “penny wise and pound foolish” when it ultimately comes to determining the amount of federal dollars that will be poured into Alzheimer’s research in next year’s fiscal budget.  Less dollars or level funding will only increase state and federal government’s cost of care for Alzheimer’s care in every municipality in the nation.  A total of 469 seats in the Congress (34 Senate seats and all 435 House seats) are up for grabs in the upcoming presidential election in November.  Lawmakers must remember that every voter may be personally touched, either caring for a family member with the cognitive disorder or knowing someone who is a caregiver or patient.  That ultimately becomes a very powerful message to Capitol Hill that it is important to increase the funding to NIA to find the cure.