ASA Generations - Generations: The Latest Age-Related News, Articles and Opinions

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Why is housing a backburner issue, how does it determine health, what are the inequities and how might we fix it?

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Abstract

Housing is central to older adults’ life outcomes. Housing’s affordability, physical quality, and location can impact physical and mental health. Housing policies and practices have systematically limited access to homeownership for persons of color and segregated many into disadvantaged neighborhoods. For many, this has curtailed economic and wealth building opportunities over the life course and exposed them to negative health consequences of segregated neighborhoods. Encouraging and supporting equitable access to safe and quality housing options for older adults should be a role for all aging services stakeholders.

Key Words

housing policy, social determinants of health, homeownership, equity, discrimination, COVID-19

Housing policy tends to be overlooked when it comes to older adults. Attention is focused on programs and services that help older adults to stay in their homes—homemaker supports, personal care assistance, or meal deliveries—but housing fails to command the same consideration.

Maybe this is because housing policy, in my opinion, has broadly been a backburner issue. Despite the housing affordability “crisis” that has been impacting broad swaths of American households for years, for example, housing is infrequently addressed in presidential or other election campaigns.

Part of the challenge is that housing in America is viewed as a private market good, and framed as a way to build wealth. As such, housing policies, regulations, and practices are largely viewed through the lens of homeownership, increasing and protecting home values, and allowing market forces to dictate response. For example, the largest federal housing subsidy remains the mortgage interest deduction, even after the Tax Cuts and Jobs Act of 2017 lowered the cap on the size of the mortgage on which interest can be deducted (Thornton and Estep, 2019). In many cities, a large proportion of land is zoned exclusively for single-family homes (Manville, Monkkonen, and Lens, 2019).

Recently, however, the aperture on housing has been expanding. As the social determinants of health gain attention and racial and ethnic inequities are spotlighted, we’re recognizing housing’s role in physical and mental health and life opportunities.

Social Determinants of Health

The social determinants of health are the social, economic, and physical conditions under which people are born, grow, live, work, and age. These conditions affect a person’s health risks and outcomes. Housing—including stability and affordability, physical structure, and location—is a key social determinant.

Affordability and stability: Individuals who are unstably housed, which may mean they are falling behind on rent, moving frequently, or staying with friends or relatives, are more likely to experience poor health than those who are stably housed. Research has found that people who are housing insecure are less likely to have a usual source of medical care, more likely to delay doctor’s visits and to use the emergency room for treatment, report poor or fair health, or report poor health that limits their daily activities (Stahre et al., 2015; Braveman et al., 2011).

‘Housing in America is viewed as a private market good, and framed as a way to build wealth.’

Studies also have found housing instability is related to elevated stress levels, depression, and hopelessness (Center for Housing Policy and Enterprise, 2007). Unsurprisingly, high housing costs can force people to make tradeoffs with other essentials like food, healthcare and medications, and heating or cooling (Joint Center for Housing Studies of Harvard University [JCHS], 2019).

Physical structure: Quality and safety deficits in one’s home can be detrimental to health. Water leaks, poor ventilation, dirty carpets, or bug infestations can produce mold, dust mites, or other allergens associated with poor health. Lack of heating or air-conditioning, leading to extreme high or low indoor temperatures, has been associated with increased mortality. Structural features such as steep stairs, holes in floors, or inaccessible bathrooms and kitchens can result in accidents and injuries (Braveman et al., 2011).

Location: The environment in which one’s home is located can also impact health and well-being. Older adults often spend decades in their communities and thus experience higher levels of exposure to neighborhood conditions. In addition, as older adults retire or become less mobile, they may spend more concentrated time in their neighborhood.

Research shows that living in disadvantaged neighborhoods—characterized by high poverty—is associated with weak social ties, problems accessing healthcare and other services, reduced physical activity, health problems, mobility limitations, and high stress. The difference can be explained, in part, by the characteristics of people living in these neighborhoods, but also studies suggest that neighborhood characteristics may independently influence older residents’ health and well-being. Disadvantaged neighborhoods often have more crime, more pollution, poorer infrastructure, and fewer healthcare resources. Walkability; accessibility (including public transportation); safety; availability of public resources, like community centers, parks and libraries, and grocery stores with nutritious food; and healthy air all are related to health behaviors and outcomes (Mather and Scommegna, 2017, Bell et al., 2013, Braveman et al., 2011).

Housing Inequities

Today’s neighborhoods are shaped by mortgage lending practices started almost 100 years ago. In the 1930s, the Home Owners Loan Corporation graded neighborhoods according to lending risk, which was based largely on their minority makeup. Neighborhoods with racial and ethnic minorities were deemed “hazardous” and outlined in red on maps. The newly created Federal Housing Administration (FHA) would not insure loans in or near these neighborhoods, which effectively led to the entire mortgage industry refusing to make home loans to persons of color. As home ownership is a key source for building wealth in this country, this set the stage for the racial wealth gap that persists today.

Additionally, the FHA also encouraged the use of race restrictive covenants by lowering the mortgage risk on individual properties with exclusionary deed language. It also often required that developers receiving construction loans place race restrictive covenants in their subdivisions’ property deeds (Rothstein, 2017). This denied African Americans the opportunity to participate in the postwar housing boom and to move to new suburbs, trapping them in inner cities that faced declining investment.

Discriminatory lending practices were legal until 1968, when the Fair Housing Act was passed. Despite being outlawed, discriminatory and predatory lending practices and residential segregation continue today (Massey, 2015).

It is important to understand the impact of these housing practices on many current and future older adults of color.

‘In 2018, 82 percent of white adults ages 65 and older owned a home, compared to 62 percent of black older adults.’

Black older adults have had less opportunity to purchase a home. In 2018, 82 percent of white adults ages 65 and older owned a home, compared to 62 percent of black older adults (JCHS, 2019). For those who were able to buy, many have been limited to neighborhoods with lower home value appreciation and-or may have only had access to unfavorable loan products and terms. In 2012, the median home value for black households ages 65 and older was $93,000, compared to $165,000 for older white households (Butrica and Mudrazija, 2016).

These circumstances inhibited minority older adults’ opportunity to accumulate wealth over their lifetime. In 2013, the median net worth of African American older adult households ($56,700) was roughly one-fifth of the median net worth of white older adult households ($255,000) (Rosnick and Baker, 2014). While this difference cannot be attributed to home ownership alone, home equity is a primary way for American households to gain wealth

Because the housing stock in redlined areas tends to be older, older adults’ homes in these neighborhoods may be in greater need of repair (Perry and Harshbarger, 2019). With lower home values or growth in home values, older adults of color may have less equity that could be tapped into to finance needed repairs or modifications to help maintain the safety and accessibility of their home. This could put them at risk for falls or other injuries. Also it could limit their ability to ambulate in and out of the home, leading to social isolation. Similarly, they have less equity to tap into to pay for services to help them age in place, if needed.

Historically redlined neighborhoods have been and generally remain more segregated and more economically disadvantaged today than other neighborhoods (Perry and Harshbarger, 2019). These neighborhoods have faced a legacy of disinvestment, which has impacted economic opportunities, access to resources, and the physical environment.

Evidence suggests segregation is a primary cause of racial difference in income by impacting access to education and employment opportunities (Williams and Collins, 2001). Lower incomes in addition to lower opportunity for home ownership has impacted the ability of older adults of color to build wealth to help support them in retirement.

Disadvantaged and segregated neighborhoods have less access to options for buying affordable and healthy food and fewer healthcare resources (United States Department of Agriculture, 2009; Gaskin et al., 2012).

Disadvantaged neighborhoods also often have higher crime, more environmental pollution, and poor infrastructure (sidewalks, street lighting, and traffic-calming measures). These elements can influence residents’ sense of safety and willingness or ability to engage in physical activity (Center on Social Disparities in Health, 2015).

The COVID-19 Effect, on Housing

Housing is probably not the first thing that comes to mind when considering the effects of COVID-19 on older adults. The economic impact of the pandemic, however, is potentially concerning, particularly for near retirees. Drawing on the 2008 Great Recession for comparison, experts predict the COVID-19 pandemic could diminish current and future retirement savings, as well as threaten public and private retirement systems (Johnson, 2020).

Older adults may be more inoculated from the economic impact of the pandemic than younger persons, as many are already retired and-or own their home outright. However, some near retirees may have lost their jobs, thus potentially impeding their ability to save for retirement. This could impact their future ability to sustain housing costs or inhibit future choices about housing, such as making repairs or modifications, or moving to an alternative housing type. For some lower-wage near retirees without a savings cushion, it could have a more immediate and lasting impact on their ability to afford housing costs.

Why Does This Matter for Aging Services Stakeholders

Housing is a broad and complex topic, and aging services stakeholders may not understand the connection to their role, or know how to engage. But the discussion above shows that an older adult’s housing situation plays a fundamental role in their ability to maintain health and quality of life. Aging services providers and policymakers should consider it a key platform supporting the implementation or success of their services and initiatives.

Affordability: Housing affordability is a fundamental problem in this country, including for older adults. Nearly 10 million older adult households, both owners and renters, are cost-burdened and pay more than 30 percent of their income for housing (JCHS, 2019). Excessive housing costs can lead to tradeoffs on other necessities like food or medications, living in unsafe conditions, or, at the extreme, homelessness.

Options: Zoning and other land-use regulations often create and protect single-family development, which can limit the range of housing types and impact affordability in neighborhoods. Rental housing or alternatives such as accessory dwelling units or cottage housing may be excluded. This limits opportunities for older adults to leverage their housing for income or care needs or to downsize or move to an alternative housing type to fit their changing needs and interests and remain in their neighborhood, where they have history and a social network.

Opportunity: Older Americans’ life course contributes to their health (Vega and Wallace, 2016). The ability of many older adults of color to purchase a home has been systematically limited, impeding a primary path for building economic opportunity and wealth; and many have been segregated into disadvantaged neighborhoods, limiting economic opportunity and exposing them to environments that increase risks for health problems.

While many aging services stakeholders may not be engaged in housing delivery or policy, the success of their services and supports often is intertwined with the stability and quality of their client’s or constituent’s housing. Aging services providers and policymakers should look for opportunities to support or encourage initiatives that will provide older adults (particularly lower income elders and older adults of color) with adequate housing. This could include paying attention to and being an ally around funding for the creation and preservation of affordable housing stock and rental subsidies, mechanisms for financing home repairs and adaptations, reforms to local and state land-use regulations and building inclusionary zoning opportunities, granting approvals for construction of new affordable senior properties, promoting and enforcing equitable housing finance opportunities, and eliminating barriers to fair housing.

Where we live has a profound impact our opportunities and outcomes in life. It’s important to recognize this for today’s older adults and to shape the prospects for future older adults.

Alisha Sanders, M.P.Aff., is director of Housing and Services Policy Research at LeadingAge, in Washington, DC.

References

Bell, J., et al. 2013. “Access to Healthy Food and Why it Matters: A Review of the Research.” Oakland, CA: PolicyLink. tinyurl.com/l8l4flw. Retrieved May 22, 2020.

Braveman, P., et al. 2011. “How Does Housing Affect Health?” Issue Brief #7. Princeton, NJ: Robert Wood Johnson Foundation. tinyurl.com/y82zk7oh. Retrieved May 22, 2020.

Butrica, B. and Mudrazija, S. 2016. “Home Equity Patterns Among Older American Households.” tinyurl.com/y9n6zfpw. Retrieved June 11, 2020.

Center for Housing Policy and Enterprise. 2007. “The Positive Impact of Affordable Housing on Health: A Research Study.” tinyurl.com/y8oonp4k. Retrieved May 22, 2020.

Center on Social Disparities in Health. 2015. “How Do Neighborhood Conditions Shape Health?” tinyurl.com/y7bxt6ya. Retrieved May 29, 2020.

Gaskin, D., Dinwiddie, G., Chan, K. and McCleary, R. 2012. “Residential Segregation and the Availability of Primary Care Physicians.” Health Services Research 47(6): 2353-2376. tinyurl.com/y8s3yzw6. Retrieved June 11, 2020.

Johnson, R. 2020. “Seven Ways the COVID-19 Pandemic Could Undermine Retirement Security.” Urban Wire. tinyurl.com/ybloxa5p. Retrieved May 29, 2020.

Joint Center for Housing Studies of Harvard University. 2019. Housing America’s Older Adults 2019. Boston, MA: Joint Center for Housing Studies of Harvard University.

Manville, M., Monkkonen, P., and Lens, M. 2019. “It’s Time to End Single-Family Zoning.” Journal of the American Planning Association 86(1): 106–12. tinyurl.com/y9m989zl. Retrieved June 2, 2020.

Massey, D. 2015. “The Legacy of the 1968 Fair Housing Act.” Sociological Forum 30(1): 571–88.

Mather, M., and Scommegna, P. 2017. “How Neighborhoods Affect the Health and Well-Being of Older Americans.” Today’s Research on Aging. Washington, DC: Population Reference Bureau. tinyurl.com/y94ztxr9. Retrieved May 22, 2020.

Perry, A. and Harshbarger, G. 2019. “America’s Formerly Redlined Neighborhoods have Changed and so Must Solutions to Rectify Them.” tinyurl.com/yczg24ko. Retrieved May 22, 2020.

Rosnick, D., and Baker, D. 2014. “The Wealth of Households: An Analysis of the 2013 Survey of Consumer Finances.” Center for Economic and Policy Research. tinyurl.com/ybzk5h7z. Retrieved May 29, 2020.

Rothstein, R. 2017. The Color of Law: A Forgotten History of How Our Government Segregated America. New York: Liveright.

Stahre, M., et al. 2015. “Housing Insecurity and the Association with Health Outcomes and Unhealthy Behaviors, Washington State, 2011.” Preventing Chronic Disease 12: 140511. tinyurl.com/ydy7m3e4. Retrieved May 22, 2020.

Thornton, A., and Estep, S. 2019. “Take Stock of Spending Through Tax Code.” tinyurl.com/y9r9fvne. Retrieved June 2, 2020.

United States Department of Agriculture. 2009. “Access to Affordable and Nutritious Food: Measuring and Understanding Food Deserts and Their Consequences.” Report to Congress. tinyurl.com/yx5hwfxo. Retrieved May 29, 2020.

Vega, W., and Wallace, S. April 2016. “Affordable Housing: A Key Lever to Community Health for Older Americans.” American Journal of Public Health, 106(4): 635–6. tinyurl.com/yc4anlh9. Retrieved June 3, 2020.

Williams, D., and Collins, C. 2001. “Racial Residential Segregation: A Fundamental Cause of Racial Disparities in Health.” Public Health Reports, Volume 116. tinyurl.com/y7sm7lml. Retrieved June 2, 2020.

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Housing

Byline

By Alisha Sanders

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Averting a Housing Crisis and Shining a Light on Inequities in Elder Housing

asa_admin — Tue, 07 Jul 2020 21:12:35 +0000

Averting a Housing Crisis and Shining a Light on Inequities in Elder Housing asa_admin Tue, 07/07/2020 - 23:12

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‘I wanted to recognize the key role of the “shelters” in which most older adults live.’

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Summer Generations Guest Editor Alisha Sanders

When asked about her motivation for guest-editing this Summer issue of Generations, Guest Editor Alisha Sanders said, “I wanted to help bridge two worlds–to help aging services people understand more about housing and to help housing people understand more about older adults.”

Sanders directs housing and services policy research at LeadingAge, in Washington, DC, and is thrilled that Generations chose to devote an edition of the journal to housing.

“Housing doesn’t often get emphasized in the aging services world,” said Sanders. “My intent with this collection of articles was to keep the focus on ‘housing’ and not slide into residential care settings. That’s not to say those settings aren’t crucial, and of course there are important policy and practice issues to address in that realm. But I wanted to recognize the key role of the ‘shelters’ in which most older adults live, to help people to fully understand the housing situations of older adults, where gaps exist and which issues need addressing,” she added.

At LeadingAge, Sanders studies programs and models that link affordable senior housing communities with health and supportive services. With colleagues and partner organizations, they’ve built a new knowledge and evidence base on the implementation and outcomes of these initiatives to help foster their spread.

“I’ve always been passionate about housing policy, and sort of ‘fell into’ the older adult aspect,” Sanders said. She stayed in the older adult arena, however, because she’s intrigued by the way housing intersects with other aspects of older adults’ lives, and how central the combination can be to quality of life, especially for low-income older adults.

‘I wanted to recognize the key role of the “shelters” in which most older adults live.’

Sanders also feels it is critical to recognize older adults in housing discussions, as currently they are often left out. A perception remains that older adults tend to live in stable situations in housing they own. But older adults face significant gaps in access to quality, affordable housing, and many live in precarious situations. And there are a burgeoning number of older adults with no housing at all. Plus, as the work LeadingAge and others have done has shown, housing can play a key role in addressing social and health needs as well.

“I hope these articles will help to reveal the significant implications housing policy has on other aspects of life, particularly for persons of color. Current U.S. housing policy is strongly intertwined with economic opportunity and security, which is clearly shown in the disparities in homeownership rates, home values, and wealth between white older adults and black older adults,” said Sanders.

She points to a recent study showing that homeowners in previously redlined neighborhoods—in which, until 1968, federal government policy effectively denied mortgage loans to people of color—have gained 52 percent less in home equity over the past 40 years than homeowners in previously greenlined areas.

“Home equity is a key component of wealth in this country,” said Sanders. “And this study found that black homeowners today are about five times more likely to own a home in a formerly redlined area than a greenlined neighborhood. So many black homeowners are not able to realize the same potential wealth-building benefit as white homeowners because they have been tracked into segregated neighborhoods that have faced decades of underinvestment.

Many older adults will be unable to afford the care they will need as they age in the years to come, and housing is at least one contributor to this lack of funds. Many elders of color would have been denied the opportunity to purchase a home or would have been limited to neighborhoods that experienced and continued to experience years of disinvestment, thus earning far less in home equity. To the extent that an older adult may tap into home equity or sell a home to help support care needs, this source of funds is limited for those whose housing equity opportunities have been curtailed.

Black homeowners are about five times more likely to own a home in a formerly redlined area.

Of course, for many older adults who were lower-wage workers over their lifetime, buying a home was never an option. Many of these older adults tend to rely largely on Social Security for their retirement income. According to the Social Security Administration, Social Security makes up 90 percent or more of the income for 45 percent of unmarried older adults. In May 2020, the average monthly benefit for retired workers was $1,512. Given high rent costs across the country, it is clear that many lower-income renters will struggle to find affordable options.

Sanders encourages ASA members to become allies to housing advocates and help push for expansions in rental subsidies, learn more about local or state housing advocacy organizations to build collaborations, and get out and help advocate for better housing policies, building and land use regulations, and funding initiatives. “An older adults’ housing situation can have implications on their health, functionality, and quality of life--all of which many ASA members are addressing,” said Sanders. The success and optimization of the services they are providing can be intertwined with the safety and quality, accessibility, and affordability of their constituents’ housing. Sanders hope this collection of articles will help build ASA members’ understanding of housing issues and the connection they can have to their work.

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By Alison Biggar

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Overcoming the 'silver tsunami'

asa_admin — Tue, 07 Jul 2020 05:00:00 +0000

Overcoming the 'silver tsunami' asa_admin Tue, 07/07/2020 - 07:00

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Generations Today

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Aging is a first-person experience.

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The phrase “silver tsunami” drives me nuts. It is a common expression used to describe the unprecedented increase in the number of older people in the world, and it is used even in the aging services sector. People employ this doomsday term as a way of demonstrating they are “in the know” about the demographics of aging.

Fact check: a tsunami is a large wave that results in vast destruction and mass casualties. A natural disaster of catastrophic proportions, it is planned for, mitigated against and feared.

Unfortunately, this phrase is fun to pronounce. Silver tsunami became embedded in our collective psyche because of its alliteration. And, to some, the phrase sounds clever.

Using silver tsunami to describe population aging was intentional as a shorthand description of the burden that will befall the country when millions of people grow old, get sick and need care. It is an economic term, based in calculations of increasing cost. On the nation’s balance sheet, the great silver tsunami rests squarely in the liability column. This drain on financing is coming. Be aware. Be warned. Plan ahead.

Re-Evaluating Impacts of Longevity and the Meaning of Aging

I am all for planning ahead. Increasing numbers of older people will strain our healthcare resources, place increased burden on caregivers and accelerate a workforce shortage. I do not take issue with cost concerns. My protest lies elsewhere.

The term silver tsunami fails to account for the asset of increasing numbers of older people, many of whom are reaping the benefits of better health and increased longevity. Its economic assumption presupposes a future of healthcare delivery that resembles the past. We are re-valuing how, and what, we pay for in healthcare and where we should invest in prevention. Even the delivery of long-term care will evolve in the future.

Also this phrase does not convey what it means to get old and be old. The swell of people in the wave are individuals, with lives of purpose, meaning, and, yes, difficulty. Aging is a first-person experience.

But our culture remains awash with negative images and stereotypes of older people. Ageism is used to diminish and devalue people and is a convenient way to divide adults into two categories: us and them. Ageism distracts from the fundamental truth that advanced age is a period of human development.

The FrameWorks Institute is the research partner for the Reframing Aging Project, an initiative sponsored by eight leading organizations in the field of aging. FrameWorks has developed strategies for changing the way we think and speak about aging. Consider this question, “What do older people need?” The answer to this question brings to mind an abstract group of old people who will need transportation, housing, care and so forth.

As an exercise, now ask the same thing differently, “What will I need when I get old?” The issues of aging are not about other people. The issues of aging are about everyone. Older people are individual glimpses of our future selves, given time.

People Live Longer but Better Lives

In 2017, a person reaching age 65 had an average life expectancy of 19 additional years. A child born in 2017 could expect to live more than 30 years longer than a child born in 1900. In the span of a life, where were those extra years added? Although the average life expectancy has increased, additional years weren’t tacked on at the end. Americans are enjoying more and better years before the declining years of advanced age.

In 2009, Harvard Professor Sara Lawrence-Lightfoot wrote a book called “The Third Chapter: Passion, Risk, and Adventure in the 25 Years After 50.” Professor Lawrence-Lightfoot’s research has led her to conclude that this third chapter is a stage of life when “many women and men are embracing new challenges and searching for greater meaning in life.”

Marc Freedman, CEO and founder of Encore.org, explores meaning and purpose in people older than age 50. Freedman is the creative force behind The Purpose Prize, an award given to “demonstrate that older people comprise an undiscovered, and still largely untapped, continent of solutions to an array of pressing societal challenges.” His organization works to innovate “new ideas and models to leverage the skills and talents of experienced adults to improve communities and the world.”

These are the assets I’m talking about. Experienced adults can improve the world. They are cherished members of their families and communities. Older people in the third chapter of life are finding additional purpose and exploring creativity. A true accounting of a future full of 95 million older people must be balanced, with an eye toward planning for both the burden of care and the benefit of contribution.

Personally, I prefer the term “age wave.” You can ride a wave, but it can capsize you. We must prepare for both. It is essential that we understand the impact on the U.S. economy when, in 2060, nearly 25 percent of the population will be older than age 65. Who will provide care when those individuals reach advanced age? How will it be paid for?

These challenging questions have already arrived with the front edge of this surge. In an August 2019 article, The Washington Post explored in detail the elder boom and worker shortage currently facing the state of Maine. The article predicts the issues confronting Maine are a preview of the nation’s future.

As we prepare for this wave, we also must plan to surf it. Millions of us will have time and experience to share. We need to be healthy enough to do so, mentally and physically. It is essential we devote additional time and more resources to healthy aging, as individuals who are growing older and as a nation concerned about health.

Kathy Greenlee, J.D., previously served as U.S. Assistant Secretary for Aging and Kansas Secretary for Aging. She is a member of the Board of Directors of the National Council on Aging, and member of the Generations Editorial Advisory Board.

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Tsunami

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Op-Ed
By Kathy Greenlee

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July-Aug 2020

Promoting Climate Change Activism Among Older People

Bob Blancato — Mon, 11 Jul 2022 14:35:28 +0000

Promoting Climate Change Activism Among Older People Bob Blancato Mon, 07/11/2022 - 16:35

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The barriers and opportunities facing older people who could be involved in climate change activism.

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Abstract:

Older adults are vulnerable to the effects of climate change, but they represent an enormous resource in efforts to prevent and mitigate its impact. This article summarizes the benefits and barriers associated with environmental activism by older adults. Benefits include enhancing older adults’ health, self-efficacy, and generativity, and providing volunteers for environmental organizations and communities. Barriers to widespread engagement of older adults include their lower levels of support for pro-environmental policies and less concern about climate change, and their systematic lack of access to environmental volunteer opportunities. It also outlines efforts to mobilize climate change activism targeted to elders, and addresses barriers grounded in ageism.

Key Words:

climate change, environment, activism, volunteerism

Table 1. Types of Older Adult Environmental Initiatives

Type	Description	Examples	Location	Website
Government Initiatives	Developed and funded by the government	Senior Environmental Employment Program is a federal governmental program that provides an opportunity for older adults to assist the U.S. Environmental Protection Agency on various federal, state, and local environmental projects.	United States	https://www.epa.gov/careers/senior-environmental-employment-see-program
		TAMAR Sea Turtle Conservation Program is a federal government initiative to preserve Brazil’s sea turtles in partnership with community members, including older adult fishermen employed to carry out turtle monitoring.	Brazil	http://www.tamar.org
		Green Climate Fund is an intergovernmental fund created by the UN Framework Convention on Climate Change to help developing countries fight climate change, with 150 projects in vulnerable societies and populations, including older adults.	International (Developing countries)	https://www.greenclimate.fund/
National Initiatives	Focused on national advocacy	Elders Climate Action is a project of the Elders Action Network, a nonprofit organization whose mission is to encourage elders to take action on social and environmental challenges like climate change.	United States	https://www.eldersclimateaction.org
		Sanctuary Nature Foundation’s Mud on Boots Project is a program to support on-ground conservationists in India with the goal of documenting traditional environmental knowledge held by indigenous communities and their elders.	India	https://www.sanctuarynaturefoundation.org/projects/mud-on-boots
		Grandparents for a Safe Earth is an association of older adults campaigning for environmental sustainability and disinvestment from fossil fuels.	United Kingdom	https://network23.org/gfase
International Initiatives	Focused on international advocacy	Climate and Development Knowledge Network is an international alliance that supports climate compatible development for those most vulnerable to climate change, including by combining traditional knowledge from elders with research and technology.	International (Africa, Asia, Latin America, Caribbean)	https://cdkn.org
		The Elders is an independent group of global leaders with a Climate Change program focused on ensuring a just transition to a low carbon economy and encouraging innovative solutions to tacking climate change.	International (Worldwide)	https://theelders.org/programmes/climate-change
		Elders for Climate Justice is a group of committed to leaving a more enduring and equitable world for future generations, which is part of the ManKind Project global organization.”	International (23 countries)	http://eldersclimatejustice.org/
Inter-generational Initiatives	Comprised of intergenerational activities with elders and youth	Green Belt Movement is a women-led indigenous nonprofit organization focused on environmental conservation with education and advocacy programs that link children and elders through community reforestation activities.	Kenya	http://www.greenbeltmovement.org/
		Indigenous Climate Action is an Indigenous-led nonprofit organization that relies on the knowledge of elders to help guide its activities and mentor younger activists fighting for climate justice.	Canada	https://www.indigenousclimateaction.com
		Habitat Intergenerational Program is a volunteer program of the nonprofit Habitat Education Center in Belmont, Massachusetts that unites younger and older people in environmental service projects and stewardship activities.	United States (Massachusetts)	https://www.massaudubon.org/get-outdoors/wildlife-sanctuaries/habitat/get-involved/hip-at-habitat
Local or Regional Initiatives	Focused on local or regional advocacy	Retirees in Service to the Environment is an environmental education and leadership training program for older adults that can run by any local environmental organization.	United States	http://citra-rise.human.cornell.edu
		Indigenous Guardians is project of the Indigenous Leadership Initiative to help Indigenous Nations honor the responsibility to care for lands and waters with a network of elders as the “eyes and ears” on traditional territories.	Canada (Indigenous Nations)	https://www.ilinationhood.ca/guardians
		Nebraska Elder Climate Legacy Initiative is a network of older climate activists striving to leave a positive legacy for the generations to come through statewide action in Nebraska.	United States (Nebraska)	https://www.elderclimatelegacy.org/
Citizen Science Initiatives	Engagement of citizens in generating scientific data	Earth Challenge 2020 is the world’s largest ever coordinated citizen science campaign to enable people around the world—including older adults—to collaboratively address the world’s most pressing environmental challenges through technology.	International (Worldwide)	https://www.earthday.org/campaign/earth-challenge-2020
		Animal Demography Unit is a unit of the University of Cape Town that provides citizen scientists—including older adults—the opportunity to collect valuable data for science and conservation.	South Africa	http://www.adu.uct.ac.za/adu/home
		Eyes of the Reef Hawai’i is a statewide reporting network that encourages Hawai’ian Island Ocean enthusiasts, fishers, and community members—including older adults—to assist in protecting local reefs.	United States (Hawaii)	https://eorhawaii.org/about-eyes-of-the-reef/
		Our Voice is an international initiative to empower community members to drive change in their local environments (e.g., community gardens, bike paths, trails, parks, clean-up), including projects that specifically recruit older adults as citizen scientists.	International (15 countries)	https://med.stanford.edu/ourvoice.html

Teaser Media

Housing

Byline

By Karl A. Pillemer, Julia Nolte, and Marie Tillema Cope

Issue

Test table

Bob Blancato — Fri, 08 Jul 2022 18:32:36 +0000

Test table Bob Blancato Fri, 07/08/2022 - 20:32

Channel

Teaser Text

The barriers and opportunities facing older people who could be involved in climate change activism.

Paragraphs

Abstract:

Table 1. Types of Older Adult Environmental Initiatives

Type	Description	Examples	Location	Website
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By Karl A. Pillemer, Julia Nolte, and Marie Tillema Cope

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Sat, 07/09/2022 - 12:00

Style, Reinvention and Leading a Full, Free Life

asa_admin — Mon, 17 Aug 2020 19:46:42 +0000

Style, Reinvention and Leading a Full, Free Life asa_admin Mon, 08/17/2020 - 21:46

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A new episode of Generations Bylines featuring Ari Seth Cohen and Judith Boyd

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Ageism comes in many forms—and is often far from obvious. Age-based social norms tell us how older people should look, act and engage with society. But despite such images and cues (subtle and explicit), there are no hard and fast rules to dictate how anyone must live, at any age. We need more representation of authentic lives to continue breaking down these norms.

In this episode of Generations Bylines, we talk with two people who are doing just that: Ari Seth Cohen, photographer, author of multiple books and creator of the Advanced Style blog, and Judith Boyd, model and author of the blog Style Crone. Listen as Ari and Judith talk about how they view aging, what they would like society to understand about being old, and how they counteract traditional norms about how older people should look.

Photo (top) courtesy of Ari Seth Cohen

Check Out Ari & Judith's Instagram

Ari Seth Cohen on Instagram: @advancedstyle

Judith Boyd on Instagram: @stylecrone

Links Referenced in the Episode

Advanced Style | By Ari Seth Cohen
Advanced Style: Older & Wiser | By Ari Seth Cohen
Advanced Love | By Ari Seth Cohen
Advanced Style | Blog by Ari Seth Cohen
Style Crone | Blog by Judith Boyd
Ninety-Nine, Straight Up, No Chaser | By Ilona Royce Smithkin

Key Quotes

On how Ari started Advanced Style

"I started to walk around New York and I saw really inspiring, creative, fashionable, vibrant, and vital older women walking down the streets who reminded me of my grandmother, and I started to photograph and interview them. And many of them became my close friends." -Ari Seth Cohen

On how Judith started Style Crone

"I blogged through cancer caregiving, through his death, which happened in April of 2011, through grief, and then my reinvention" -Judith Boyd

On the intersection of ageism and racism

"All the 'isms' I believe are related but ageism is the only ism that everyone, if we're lucky enough, experience. And I also see that ageism affects people of color and other marginalized groups more intensely, also women more intensely." -Judith Boyd

On the perception of aging and the impact of his work

"We're so we're bombarded by images and ideas about anti-aging and there's so much fear attached to getting older. My work kind of lessens that fear by showing people who are continuing to live really full lives and oftentimes a lot more free lives as they get older." -Ari Seth Cohen

On fashion as expression and art

"I really don't pay any attention to what the response is. It's like I have some kind of blinders on. So if it's negative, I wouldn't see it. But many times people will comment on my hat or my outfit, which feels good, but I dress for myself because it's a form of creative self expression. And I guess I would say, it's my art." -Judith Boyd

Episode Transcript

Leanne Clark-Shirley 0:47
Hello, and welcome to Generations Bylines, the podcast where we go beyond the pages and talk to authors that bring us aging related news research and books. I'm Leanne Clark-Shirley Vice President of Programs and Thought Leadership at the American Society on Aging, and also your host for today.

So we know ageism is pervasive throughout our society. It shows up in how we speak about how we portray and how we interact with older people. We usually think about ageism as negative stereotyping and discrimination against older adults. But there's another side to it too: being over accommodating, assuming someone needs help just because they look old, and using patronizing speech. These are forms of benevolent ageism, and they're also detrimental. This episode of Bylines features two people's work that is turning ageism on its head, and exploring the expression of beauty, fashion and friendships as we age.

Today I'm speaking with Ari Seth Cohen, who's the creator of Advanced Style. That's a blog that documents what you call "the fashion and wisdom of the senior set." Arii, you've written two books, I believe you have a documentary, you've shot some ad campaigns for fashion brands, and you've even published a coloring book featuring older characters. We also have Judas Boyd with us. Judith is a model that works with Ari. And Judith, you also publish Style Crone, which is a blog that celebrates the older woman in her most creative and authentic era. So Ari and Judith, welcome to Generations Bylines. It's so nice to talk with you both today.

Judith Boyd 2:26
Great to be here.

Leanne Clark-Shirley 2:30
Ari, we'll start with you. So for our listeners who are unfamiliar with your work briefly describe it for us.

Ari Seth Cohen 2:38
Sure, I started a blog in 2008 when I first moved to New York City, called Advanced Style. The purpose for the blog was for me to deal with the loss of my best friend who was my grandmother Bluma. I've always had an affinity for older people and wanted to connect to older people in a new city. So I started to walk around New York and I saw really inspiring, creative, fashionable, vibrant, and vital older women walking down the streets who reminded me of my grandmother, and I started to photograph and interview them. And many of them became my close friends. And later, I realized after I'd kind of collected a body of work, that a lot of my friends who were just beginning to enter their late 20s and 30s were already afraid of aging because of so much of what they'd seen in the media and the traditional view of aging. And I was seeing these women in their 80s and 90s, who were living these really rich, full lives. And I started the blog, which is now Instagram and Facebook and actually have three books. My latest book is called Advanced Love. I had made Advanced Style and then a follow up to that and so Advanced Love is the latest book. It's all about couples who are over 60 and different types of relationships as we get older.

Leanne Clark-Shirley 4:10
Yeah, I'm actually holding that one in my hand right now.

Ari Seth Cohen 4:15
The second one is Older and Wiser and that one is similar to the first book, except it has a lot of essays from some of the women. I think Judith wrote an essay for that.

Judith Boyd 4:26
I did.

Leanne Clark-Shirley 4:27
Well, I'll have to procure that one to complete my collection.

Ari Seth Cohen 4:34
Oh, thank you. It has really changed into a movement to really change people's perceptions on aging and get rid of that fear of getting older. I've been doing that for the past 12 years now. And Judith is one of my muses, and I have been following her blog for the longest time as well.

Leanne Clark-Shirley 5:02
So how did you meet Judith? What was that first encounter like?

Ari Seth Cohen 5:08
Well, Judith, is based in Denver, and I'm not even quite sure how I first saw her blog, the Style Crone, but for me, right away, I saw something really deep and meaningful. She can tell you the story of why she started her project. But I was really moved by her intention with what she was doing. And obviously I loved the way she dressed and I loved her attitude and her confidence and her style. She came to visit New York, because I think she had been following Advanced Style for the year or two before she started her project. And we met on upon that trip through our mutual friend Deborah Rapoport who's one of the women that I feature heavily in my books and also in my documentary. But it wasn't until recently, I mean, Judith and I have known each other for, Judith, how long now? Like maybe since 2010?

Judith Boyd 6:05
Yeah. 2010

Ari Seth Cohen 6:08
She's become one of my best friends. Which is also a huge part of this project -- connecting people of all ages and showing the power of intergenerational friendships. So, yeah, Judith and I met in New York City several years ago. And then we did a conference in Chicago recently and we really bonded. She's taught me so much in the in the last few months, so it's been a great friendship. Great.

Leanne Clark-Shirley 6:37
And Ari, how would you describe the majority of your subjects and how you choose someone to invite to be part of your work?

Ari Seth Cohen 6:47
Yeah, so a lot of people ask me if I style the people that I photograph, but everyone that I photograph, this is their particular unique, personal style. I walk around the streets of whatever city I happen to be in and I ask people if I can take their photographs. There's not one particular thing I'm looking for, but I do like to photograph people who have a really strong sense of themselves and a strong sense of personal style, to kind of encourage people that you can be who you want to be an express whatever you want to express, no matter what age you are. I have heard from a lot of older women, and I've seen through my work, that at a certain age people, especially women, start to be treated as if they're invisible. And also, there's a lot of shame around expressing yourself at an older age. I've gotten comments from people saying, "I would want to dress like these women, but my grandchildren and my son or whatever it is, tell me that I need to not be so loud that they find it embarrassing," which is also a huge part of ageism. So I tend to photograph people who are really bold and strong and confident in what they're trying to express. But it can be anyone who's a very colorful dresser like I tend to photograph a lot of women who love vintage because I also really care about sustainability and all different kinds of styles a diverse range. But I would say for most people, they would probably look at my work and think that the people who I'm photographing are pretty colorful and pretty vibrant.

Leanne Clark-Shirley 8:35
Including you, Judith. I've looked at your blog and noticed you have a particular affinity for hats.

Judith Boyd 8:43
I do. I'm a hat lover.

Leanne Clark-Shirley 8:46
So tell us about Style Crone and how you got started publishing it.

Judith Boyd 8:52
I started in 2010. I found Advanced Style prior to launching my blog, and Ari and his blog really gave me the courage to begin. Because I worked in healthcare all of my life. By license and by training, I'm a psychiatric nurse. And I wore street clothes to work. So I didn't wear a uniform. So I dressed up as much as I could during those days. But in 2010, my husband had been diagnosed with a very rare cancer and had been in treatment at the time that I launched my blog for almost six years. It was really Ari and my deceased husband Nelson, who encouraged me to just leap into the abyss, so to speak, because I knew nothing about blogging. As a it turned out my husband was my first photographer, and I would dress up and one of the regular series was, what to wear to chemo. And I would get dressed up and then in the exam room prior to Nelson's treatment, he would take my photo and then I would have my computer with me and blog about what was happening in our lives while he was receiving chemo. It really offered us a different way to communicate through the lens, and also to have something light in our life during a time that was devastating. He was dying. And so I blogged through cancer caregiving, through his death, which happened in April of 2011, through grief, and then my reinvention

Leanne Clark-Shirley 10:52
So talk a little bit about that reinvention. What have he past 10 years looked like for you as you've evolved?

Judith Boyd 11:02
Well, I think part of my evolution was influenced by Advanced Style and who I met on the internet, other older women that were blogging, and then later on on Instagram, and it gave me a lifeline of sorts. And so I started blogging a bit about ageism. And this was all of course, posted with an outfit because that's what I love to do, was put together ensembles. Mostly vintage, mixed sometimes with contemporary but almost always, I guess you would say, I shop secondhand first. I too, have an interest in climate change and sustainability.

So many things happen that I had no clue would have ever happened in my life because of what my blog brought to me. I grew my hair out from red to white. My hair person encouraged me and helped me get a modeling contract. Which, by the way, I seldom get jobs which I feel is somewhat related to my age. And then I was featured on sites that I would not have imagined would have happened such as BuzzFeed and of course featured on Advanced Style, which was always thrilling. I walked for a designer in New York Fashion Week and monetized my Instagram for a while.

But at this point, I'm more interested in activism around climate change and dismantling systemic racism, which I feel is related to ageism. So I've gone through many I guess you would say eras over the past decade.

Leanne Clark-Shirley 13:18
Yeah. Talk a little bit about more more about that connection you see between racism and ageism and maybe what you know your work or you know, your your actions can do to fight against those things.

Judith Boyd 13:34
All the "isms" I believe are related but ageism is the only ism that everyone, if we're lucky enough, experience. And I also see that ageism affects people of color and other marginalized groups more intensely, also women more intensely. And I think that what we do in terms of intervention and dismantling this discrimination is a similar process.

Leanne Clark-Shirley 14:24
Ari, how about how about you? What do you think your work is doing or can do to fight against ageism?

Ari Seth Cohen 14:34
That was an interesting question to think about. Because, for me, I've always thought of aging as a really positive thing because of my grandmother. And I've always had older friends my entire life and used to engage with older people for the longest time. And so early on, when I started my project, a lot of people were telling me, "Oh, this is revolutionary. This is radical." And I was just featuring older people who were vital and vibrant. And I didn't understand why that was revolutionary. If you show something that's alternative to what people think of as aging, which a lot of it has to do with decline and there's a lot of stereotypes that go with aging. And so even that seemed kind of like an internalized ageism. To limit our perspective on what aging could look like. Like, why was my work so different? Because I was just presenting the reality of aging, which is, people age in different ways. People take care of themselves in different ways people, have different genetic makeups. There's not one view of what aging is.

But if we accept the fact that there is this idea of age that my work is alternative to that, I try to present something that is very optimistic and positive. And something that might show people something a bit different. We're so we're bombarded by images and ideas about anti-aging and there's so much fear attached to getting older. My work kind of lessens that fear by showing people who are continuing to live really full lives and oftentimes a lot more free lives as they get older.

I hear all the time from people saying, "I'm no longer afraid to become 60 because I saw this woman on your Instagram who inspired me. If she can go out and do this, then I can do that too." So it's giving examples to people who may not have those reference points. And, you know, that's probably what my books and my film and Instagram do, is give people hope and show that you don't have to stop doing the things you love just because you get older and maybe you'll have some limitations here and there. Oftentimes I hear from people, especially my friend, Ilona Roy Smith--and she just wrote a book at 100 years old, about the process of turning from 99 to 100. And I would encourage everyone to buy it. It's called 99 Straight Up No Chaser. And she talks about how her mind is fully engaged with the world, and she has limitations with her body now, but it's such a beautiful book. And I think that in itself is getting rid of the fear of dying and death. It's a huge thing that we all have to kind of rethink in our culture, because I think that stops a lot of us from being able to enjoy the process of getting older and wiser.

Leanne Clark-Shirley 18:31
Judith, you mentioned picking up on this sort of permission to embrace aging and make aging look the way you want it to look. You mentioned going red to white. Can you talk more about that and what drove that decision and maybe why you were you afraid to go white before and what changed?

Judith Boyd 18:57
I dyed my hair red, or my hair stylists dyed my hair red, over my lunch hour and nobody recognized me when I went back to work when I was 50. And so it was around the time that I was in my 70s I think it's been about four years now. I just saw so many women on Advanced Style and other bloggers and Instagramers that had natural hair and I became enthralled with it and decided to do that as well. Go cold turkey, so to speak, and I just let my hair grow out. And it's white, and I wish I would have done it earlier because I think this is my favorite hair of my entire life. It's so easy. And it makes me feel more like myself and I feel like it also models for other people, perhaps younger people and other older people, that it's fun. It's fun to experiment fun to make changes, and it's part of aging, that aging can be experimental and we can stretch and grow for our entire lifespan.

Ari Seth Cohen 20:26
I have to say, and Judith I hope you don't get mad at me, but Judith, are you 77 now?

Ari Seth Cohen 20:33
Yeah, 77.

Ari Seth Cohen 20:35
And I just bought her from a dear friend of mine, a virtual burlesque class so she is definitely trying something new at 77 because she always loved dancing and has had an interest in vintage and so I'm so proud of her for doing that.

Judith Boyd 20:55
It's a generous gift and I'm thrilled about it because I think at any age we can add add to our dance moves.

Leanne Clark-Shirley 21:06
Indeed

Ari Seth Cohen 21:10
We call it advanced the dance.

Leanne Clark-Shirley 21:15
Brilliant. Online burlesque. These are the times we live in. That's fantastic. So, Judith, I'm curious, it sounds like fashion has been important to you your entire life.

Judith Boyd 21:30
Well, yes. I think going back to the 60s. when I was in my 20s. And then it escalated in my 30s in the 70s. I started going to estate sales and vintage shops. And as I said, I didn't have to wear a nursing uniform to work so I started wearing 40s dresses over-sized and belted with boots. I really don't know where it came from because nobody else was dressing like that. But it was almost like a drive of some kind to dress up. I can't really describe it as anything else. But I didn't know very many other people that were doing it. So when I saw Advanced Style, I guess maybe you could say, it was so refreshing and so encouraging and I could then realize that I wasn't nuts. Because sometimes when I would go places or even when I dress to go to work, I felt like I was different, but then that really didn't bother me that much, but it was very reassuring to know that there were other people in the world that like to do the same thing.

Leanne Clark-Shirley 22:56
You found your tribe. What does it feel like to walk down the street dressed in loud, bold, stylish clothing? How do you feel?

Judith Boyd 23:10
Well, I dress for myself and I don't have any education in or background in fashion. It wasn't my area of expertise, although I did have a hat shop in the 80s and I continued to work as a psych nurse during that time. When I feel like the outfit is complete when I walk out, it just feels good. And I really don't pay any attention to what the response is. It's like I have some kind of blinders on. So if it's negative, I wouldn't see it. But many times people will comment on my hat or my outfit, which feels good, but I dress for myself because it's a form of creative self expression. And I guess I would say, it's my art. And I have collections that I draw from, that I've been collecting since the 70s. And it's fun.

Leanne Clark-Shirley 24:16
Yeah. Sounds like it. It's beautiful. It makes for incredibly beautiful imagery. It's beautiful to look at and to hear about. Thank you. So, from each of you, what what do you think is most important for society to understand about aging?

Ari Seth Cohen 24:38
I think it's being open to different interpretations of aging. And, like I said earlier, to not accept what we're being told about growing older and all this anti-aging propaganda that we're fed. Companies make a lot of money. Ageism allows for the beauty industry and a lot of different industries, to really profit off of the fear. And I think that if we widen our perspectives, make friends with older people, as a younger person, and understand that it's not like a one dimensional idea of aging. And also concentrate on a lot of the positive aspects of getting older, because so many of the women that I speak to talk about how all of a sudden they have this new sense of freedom as they've gotten older because they no longer have to worry about what other people think, and they can truly be who they are. Hopefully, you can begin to do that even as a younger person, inspired by the women that I photograph, but I think as a society, we also really need to learn how to treat older people better. And think about how to create communities and go back to the days when we respected older people for their wisdom and what they can teach us and incorporate different generations into the idea of community. I really think that's the only way that we're going to be able to survive. A lot of cultures really do do that, even within the U.S. But on a broader level, we need to care for each other. We need to love each other.

Leanne Clark-Shirley 26:50
Yeah. I agree. Judith, what do you think is most important for society to understand?

Judith Boyd 26:59
I think it's important to understand that discrimination is bad for our health. And with aging, I feel that ageism is a prejudice against our future selves. And internalized ageism -- I have my own inner ageism that I have to always be aware of and counter and self talk. And one of the most important things I read about aging is a positive mindset regarding aging adds seven and a half years on to our lives. And there's been a lot of talk about vaccines recently, and it's kind of like this is a life saving, transition to go from shame and fear and self loathing to realizing that we can enjoy any era of our life. I think having a passion and a purpose really contributes to that. I also read somewhere that people are the happiest at the beginning and the end of their lives. I know Ari has featured women that are, as he just talked about, Alona are 100 years old. So there's still a lot of living to do if I can maintain my health an I'm certainly encouraging everybody to forget about age appropriate anything such as age appropriate clothing or age appropriate activities, burlesque classes that can be taken at any age, that we it's okay to be open to new experiences. It really helps us feel energized and alive.

Leanne Clark-Shirley 28:56
Yeah, that's great. Do you have any advice for those of us who work with older adults or on behalf of older adults? What do you want us to know?

Ari Seth Cohen 29:10
I think, to kind of let go of your prejudices and realize that each generation has something to teach one another. And I think there's a certain way of speaking or a patronizing way of talking to older people that occurs a lot of times. And I think you might have mentioned it before, but that idea of benevolent ageism is a huge one. I don't look at an older person any different than I would look at a friend of my own age. I mean, Judith is one of my best friends now. It's kind of letting go of everything you think about what an older person might think, or how they may feel, and just approaching that person as a human being. I don't know if that's good advice, but that's what I do. I do it with a lot of reverence. Because I do have a lot of respect for older people, but I was taught that by my grandmother, and in my family

Leanne Clark-Shirley 30:40
Judith, anything to add any advice for those of us working with older adults?

Judith Boyd 30:50
I believe that activism is important to change how older people are seen. It needs to evolve into policy changes, which will then change the lives of all older people in our country. Somehow it needs to be a national shift. I think is important, when we think about older people, what age do we think of? I know AARP, at the age of 50, everyone gets information it seems about that organization. But when you think of all the changes that occur from age 25, to age 50, that's 25 years. And then thinking about older people from the age of 50 to 75 is 25 years. And then 75 to 100 is another 25 years. So you really can't lump all of those ages together. There's so much that happens over that period of time and many, many changes. So advocating for someone at 50 is different. Well, I'm now in that last age group that I just described 75 to 100, that there's so many changes that occur and pushing back and educating ourselves around ageism and becoming more conscious and aware. I think that's all part of what I think needs to happen.

Ari Seth Cohen 32:39
It's interesting. When I was thinking about respect, I was also thinking about how within these different generations, there's different ideas that people have. Especially everything that's going on now in the world. Some of the women who are in their 60s who I photograph, they might have a very different perspective about politically what's happening in this country than someone in their 80s. And I think it's also important, you know, to be respectful, but you can't treat someone in a precious way just because they're older. Some of my friends who are in their 80s. I challenge a lot of their ideas about race and politics and we have discussions about it. And I think that that's okay to continue to have these dialogues with people of all ages. I do try to treat people with a lot of respect, but just because someone's older doesn't mean that you can't help to make them think differently about something that you have gained knowledge about. We're all complex individuals. And our ideas about aging are all differen. Be open minded have a sense of humor. I think that's a huge one.

Judith Boyd 34:16
For sure.

Ari Seth Cohen 34:18
Humor, I think is really important.

Judith Boyd 34:25
Well, I so appreciate Ari. Because as we've gotten to know each other, I love to be challenged, because it helps me grow. And that's one of the gifts that I have received from Ari, is to grow. To be challenged to grow.

Ari Seth Cohen 34:51
Thank you. Well, you've challenged me in a lot of ways too, to be a more eccentric person. To accept to my eccentricity, there are so many things in Judith wardrobe that I have my eye on. I want to borrow. I want to borrow some hats and capes.

Judith Boyd 35:15
We share a love of vintage. That's very much fun.

Leanne Clark-Shirley 35:18
Yeah, I can imagine. You're inspiring me to go out to our vintage shops around here and see what I can find.

Ari Seth Cohen 35:29
You should meet our friend Caprice if you're in Baltimore. Caprice Anne Jackson. She's on Instagram. Is she in her 60s Judith?

Judith Boyd 35:40
Yes, she is. And she's very into the fashion underground world. You can find her on Instagram. Look for her. She loves to dress in a futuristic way. It's very interesting thing.

Ari Seth Cohen 35:58
She's been talking a lot about sustainability and ageism. And so she's a good person to meet.

Leanne Clark-Shirley 36:08
I will look her up. Thank you for that. So, we can wrap up, but what I, you know, we've talked a lot about, you know, from 75 to 100, and sort of the next 25 years. So what are both of you most excited about or looking forward to for the next 25 years?

Ari Seth Cohen 36:29
It's such a strange time right now. I'm just looking forward to be able to give my mom a hug. For me, it's always my quality time with the people that I love. And hopefully, you know, I aspire to be as healthy and vital as Judith. I'm a vegan. I try to be quite healthy, but she does yoga every day. And so her her daughter, Camille, is a personal trainer. And so I just started working with her. And yeah, I hope to have as much energy as she did when I'm in. If I get to my 70s I hope I hope to have that.

Judith Boyd 37:14
Oh, you'll be great.

Ari Seth Cohen 37:16
I don't even have it now.

Judith Boyd 37:18
Yes, you do,

Ari Seth Cohen 37:19
Even in quarantine Judith is much busier than I am.

Judith Boyd 37:28
I think that for me right now, it's like the virus is directing us and I respond with my behavior. And I haven't been spending time with my grandchildren. Mostly just FaceTime. And so, you know, all these generations that are available to us enrich our lives. So health is my priority and getting through this period of time healthy is the number one goal.

Leanne Clark-Shirley 38:12
Well, this has been great. Is there anything that I didn't ask you that you wish I would have?

Ari Seth Cohen 38:18
No, I think, I think I think we've covered a lot. And I can't think of anything. Can you Judith?

Judith Boyd 38:27
No, no. It was really fun.

Ari Seth Cohen 38:31
Go out and play in your wardrobe. Have fun, to everyone who's listening. I think that it's important to remember that we should never stop having fun and playing. I think that as we get older, it's even more important to play. That's something sometimes we lose as you know, life becomes more serious. And I think it's a really vital way of of staying healthy and strong is continuing. To to be playful.

Leanne Clark-Shirley 39:03
Yeah, keeping that humor and seeing the fun and creating the fun.

Judith Boyd 39:12
Until I wear my last hat.

Leanne Clark-Shirley 39:15
Oh, that's a really good title for something.

Ari Seth Cohen 39:22
Judith, what what hat will that be?

Judith Boyd 39:24
Oh, you know, I don't know. Maybe I don't even have it yet. Always collecting. Why would I stop that?

Ari Seth Cohen 39:34
Yeah, we'll find it together hopefully.

Leanne Clark-Shirley 39:40
Thank you so much, Ari, and Judith for joining me today. To find more information and links to Ari and Judith's work please visit us at asaging.org and thank you so much for listening to this episode of Generations Bylines.

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By Leanne Clark-Shirley, PhD

Lifelong Learning in the Age of COVID-19

asa_admin — Mon, 17 Aug 2020 19:31:56 +0000

Lifelong Learning in the Age of COVID-19 asa_admin Mon, 08/17/2020 - 21:31

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Lifelong Learning Reimagined—An Opportunity and Challenge

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Resources have been stretched thin during the COVID-19 pandemic. To save lives, the global community has been forced to make extreme short-term sacrifices: widespread closures, unprecedented unemployment, profound financial loss and physical distancing. What might be the psychological, emotional and physical toll as the population has grappled with living in isolation? Time will tell, but social isolation is an obvious outcome.

Prolonged loneliness brought on by social isolation is nothing new to a huge percentage of the population. Even before the pandemic, one in three Americans and 60 percent of older adults had already experienced the detrimental impact of loneliness. Clinical psychologist Onyedikachi Ekwerike expressed it most succinctly, stating bluntly, “We already had a pandemic before COVID-19.” Now more than ever it is critical to provide pathways for our most marginalized and vulnerable population members to remain socially engaged.

Lifelong Learning Reimagined—An Opportunity and Challenge

Lifelong learning is an important component to a physically, cognitively and socially healthy lifestyle. Research suggests that continuous learning provides numerous benefits for older adults with respect to cognitive functioning, health and well-being, civic participation, social inclusion and self-confidence. Defined here as organized learning opportunities for older adults, lifelong learning takes many forms, including educational travel programs as well as education in an academic setting or a cultural center. Traditionally, many lifelong learning providers offered educational opportunities in an in-person format, but with the pandemic, most providers have been forced to rethink delivery modes.

Lifelong Learning institutes (LLI) have had to change programs and delivery modes. Some of the smaller LLIs could not transition to online learning (for instance, due to lack of resources to purchase video presentation technologies) and postponed courses. Others have adapted to the new situation by moving courses online or providing members with recorded lectures.

Some LLIs found creative ways to combat social isolation. For example, OLLI at Arizona State University invented a continuous Zoom “Party Line,” in which OLLI members can meet each other virtually around the clock.

The Center for Life and Learning (CLL) at Chicago’s Fourth Presbyterian Church offers courses and lectures for older adults in the arts, humanities, fitness and health. CLL also has migrated to online learning, but because a significant number of its members do not use the Internet, these classes are out of reach for them. CLL is tracking attendance more rigorously to determine which of its community members have slipped through the digital cracks. But there is no easy solution for rectifying the inequity.

Not all organizations had programming amenable to moving online. Road Scholar, for example, each year offers more than 5,000 educational travel opportunities and learning adventures for mature adults. Due to the pandemic, the organization has temporarily been forced to suspend its educational travel programs. Nevertheless, to keep the community engaged and to provide learning resources during shelter-in-place orders, Road Scholar offers a series of free and live interactive online lectures with instructors from around the world. Lectures are recorded and published online so that people who couldn’t tune into the live event can watch later.

Benefits and Shortcomings of Online Learning

The benefit of online learning is that it is easily accessible for digitally connected homebound elders and those living in remote places. It provides the ability to broaden one’s personal perspective by learning from instructors across the globe and exploring new technical skills, which also can be applied in other contexts, such as bringing family together, virtually. Asynchronous forms of instruction that don’t occur in real time allow the learner to structure their learning schedule in a way that’s works for them.

But online learning has its shortcomings. For example, video conferencing tools require tech-savviness from participants and instructors. They are vulnerable to digital fraud, unwanted disruption, and often require updates, which can be deterrents for less tech-savvy individuals. Furthermore, many online programs that were developed in haste during the pandemic do not include accessibility options, such as captions or audio description, which puts individuals with hearing or vision loss at a disadvantage.

Also, virtual classrooms can make learning less personal due to fewer opportunities for direct interaction with the instructor and classmates. Research generally indicates that lifelong learners prefer in-person over online learning, and that discussions with others as well as an intimate learning atmosphere are key components of a positive learning experience for older adults.

The Digital Divide

Most significantly, online learning disproportionately disadvantages those who do not have access to the required technology. Generally, Internet usage among older adults has increased, yet still only 28 percent of Americans ages 80 and older report having home broadband, according to 2017 Pew Research Center data. In addition to age, the data reveal substantial inequities in digital access based on socioeconomic status, educational attainment, disability and racial and ethnic identity.

Public libraries play an important role to enable access to digital resources, in particular for African Americans (42 percent of African American library users say they use their libraries’ computers and Internet connections). The closure of public libraries during the pandemic, however, further marginalizes this segment of the population.

Telephone-based lifelong learning services can be an effective way to overcome the digital divide. Mather’s Telephone Topics and Covia’s Well Connected are phone- and video-based social connection and learning resources for older adults. While both services accommodate digital connectivity, many participants continue to join by phone. Providing an extra level of accessibility, Covia’s conferencing system can automatically call and connect registered participants. While many of the discussions and lectures offered by both services are perfectly suited to an audio-only experience, some topics, such as the visual arts, rely on the distribution of course packets to telephone participants in advance. The situation during the height of the pandemic compelled Mather to suspend mailings and, to maintain equitable access for their telephone participants, temporarily halt all visuals for Telephone Topics. This turn of events, however, has required little adaptation on the part of presenters, who are already accustomed to describing visuals, because both Telephone Topics and Well Connected attract many older adults who are blind or have low vision.

Disability and Alzheimer’s Disease

For people living with Alzheimer’s disease and dementia, the widespread distancing measures as a result of COVID-19 are in many cases proving nothing short of catastrophic. The closure of adult day centers and challenging conditions in memory care units deprive this highly vulnerable population of vital socialization and cognitive stimulation, which can lead to a drastic progression of symptoms.

Creative engagement and arts-based programs can have a demonstrable positive impact on the well-being of those living with Alzheimer’s and dementia. In response to the crisis, some community arts organizations are leveraging the power of art in creative ways. New York’s Arts & Minds activates the city’s museums through creative gallery conversations and studio workshops for people with dementia. With the closure of museums during the pandemic, Arts & Minds quickly pivoted to hosting its programs online using video-conferencing technology.

Despite technological and pedagogical learning curves, Arts & Minds is successfully running online programs five times per week in English and in Spanish. Despite the exceptions, the explosion of online learning and cultural engagement in the United States during the COVID-19 pandemic has strongly privileged technologically-able, English-fluent, cognitively-typical, able-bodied, and literate individuals. Rather than trying to take older adults online, some arts organizations are developing novel offline solutions to continue their valuable missions. La BROCHA offers supportive, social, and expressive art-making workshops to Spanish-speaking members of Chicago’s older Latinx community, especially those with Alzheimer’s, Parkinson’s or dementia. To address the needs and desires of their community, La BROCHA developed a bilingual coloring book, which, along with coloring pencils, they have mailed to older adults in Chicago who were previously served by La BROCHA and continue to send, upon request, to those in need.

Conclusion

Whenever society might settle on its new normal, it is not unreasonable to imagine that some organizations will have evolved a hybridized approach of lifelong learning. In large part, though, the direction of lifelong learning providers will be motivated by audience demand. The COVID-19 pandemic is forcing many older adults to adopt technology not only for their own entertainment, social connectivity and daily well-being, but for telehealth and workforce relevance. As consumers become comfortable with video-conferencing and virtual classrooms, there may be an uptick in demand for online learning.

But systemic inequities in access to the digital realm will remain. It is the responsibility of our nation’s lifelong learning providers to ensure equitable access to the resources they provide. This requires the difficult work of prioritizing, as well as partnering with marginalized populations, such as older people of color, LGBTQ+ individuals and people with disabilities.

Sandra von Doetinchem, MEd (Dipl. Päd), is a program specialist at the University of Hawaii at Manoa.

Lucas Livingston, MA, has worked for 20 years in arts, aging and accessibility at the Art Institute of Chicago.

Teaser Media

Lifelong Learning

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By Sandra von Doetinchem and Lucas Livingston

Reimagining Housing for Aging in Place, or Infrastructure for Flattening the Next Curve

asa_admin — Mon, 17 Aug 2020 19:12:03 +0000

Reimagining Housing for Aging in Place, or Infrastructure for Flattening the Next Curve asa_admin Mon, 08/17/2020 - 21:12

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We need to ensure that added years can be lived joyfully and with dignity, and in a way that does not bankrupt individuals, families and society, while overwhelming our healthcare system.

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As the COVID-19 crisis unfolded, Americans became familiar with the concept of “flattening the curve.” As a society, at first we took voluntary and legal steps to increase our personal safety to avoid the need for acute care that could have overwhelmed hospitals and the healthcare system. The steps did not eliminate the crisis but for a time made it more manageable, saving lives and reducing additional economic hardship.

But far-sighted Americans have long been worried about another curve that has the potential to threaten our healthcare resources and individual, state and national financial security. That curve involves the demographic bulge of aging baby boomers where it meets the high costs of American healthcare.

As noted by Federal Reserve Chair Jerome Powell in July, 2018: “Longer term, it is widely understood that the United States is on an unsustainable fiscal path, largely due to the interaction between an aging population and a healthcare system that delivers pretty average healthcare at a cost that is much higher than that of any other advanced economy.”

While we have developed medical miracles that add years to lives, we also need to ensure that those added years can be lived joyfully and with dignity, and in a way that does not bankrupt individuals, families and society, while overwhelming our healthcare system.

One Strategy: Aging in Place. In the case of COVID, flattening the curve requires sheltering in place. In the case of aging baby boomers facing high healthcare costs, flattening the curve requires aging in place. Aging in place is the most economical, and by far the preferred housing option for the increasing number of older Americans who reap the benefits of longevity but also face the challenges posed by declining health and fixed incomes.

The Key Tactic: Updating Homes to Facilitate Aging in Place. Investing in housing updates is a commonsense means to ensure an effective platform for delivering healthcare and other support services in the home and reducing health costs to individuals, families, the healthcare system and the country. Updating the nation’s housing infrastructure will increase resiliency to meet the needs of an older population. In this sense, the most important infrastructure for the country to upgrade is the housing stock of older adults.

Demographic and Financial Realities

Policy Debates Gloss Over Costs and Needs of Older Adult Health. Though healthcare is a dominant issue in the news and in political campaigns, public debates generally ignore a key fact: the oldest old—people ages 85 or older—are the fastest growing segment of the U.S. population and use the most healthcare resources. Improving the conditions of aging can significantly reduce healthcare spending.

But our current system causes people to fear the cost of a cancer more than the diagnosis. Sixty-six and a half percent of all bankruptcies are tied to medical issues. According to a study published by Health Affairs, by 2029, 54 percent of the 14.4 million middle-income older adults ages 75 and older will not have sufficient resources to cover the costs of the housing and services they are projected to need. Those needs are growing. Sixty percent of those middle-income older adults ages 75 and older will have mobility limitations, and 20 percent will have high healthcare and functional needs.

Our Current System Does Not Cover Long Term Care. There is no national system to provide or pay for long-term care. Our existing aging programs, Social Security and Medicare, were conceived before the significant increase in longevity and won’t cover the costs that longevity creates. There is a widespread and persistent misunderstanding that Medicare covers long-term care costs. This means that for all but the poorest Americans, who are covered by Medicaid, or for the relatively few who have sufficient long-term care insurance, individuals and families pay long-term care costs out of pocket.

Home is the Preferred Option for Older Adults and a Better Option for Healthcare. Even when they need assistance, more than 80 percent of Americans prefer to remain in their homes. In fact, fewer than 10 percent of older people ever live in senior housing of any type. As longevity increases there is growing recognition that homecare delivers better clinical quality at lower cost, even for those with multiple chronic illnesses, and enables consumers to maintain their preference to remain in their homes.

Homes Can Also be the Source of Funds for Necessary Upgrades. For most Americans, their home is their single greatest investment. The highest rates of home ownership in the United States are found among adults older than age 65, at 78 percent. In addition, people older than age 55 account for half of the remodeling spending in this country, to the tune of $130 billion.

However, few Americans proactively make accessibility modifications. They need incentives to motivate them to update their homes to enable aging in place. Still, the funds are available to make the necessary improvements. People older than age 50 hold 83 percent of U.S. wealth, with $17 trillion in retirement savings. This is their own money, already earmarked for retirement. Allowing use of those funds could transform liquid assets into a capital improvement, making their home a better tool for retirement.

The Obstacles and Opportunities in Upgrading Housing to Facilitate Aging in Place

There is a growing recognition that more medical care is capable of being delivered in the home and that reducing functional limitations in the home for older adults can improve health outcomes. For example, the Johns Hopkins CAPABLE study found that “older adults with functional limitations use a vastly higher percentage of healthcare resources than those without functional limitations,” but that 79 percent of those enrolled in the experimental program were able to reduce those limitations through interventions that included various home repairs and modifications.

Studies like this have led to enhancing Medicaid waiver programs subsidizing such improvements throughout the states, and to the 2019 Senate Special Committee on Aging Report on Falls Prevention. A significant indicator of the importance of home updates, in 2020, for the first time, CMS decided to allow structural modifications to the home as a supplemental Medicare Advantage benefit. This has significant cost implications. A before and after comparison of the amount of care provided revealed that home modifications reduced hours of care by 42 percent per week.

As researchers at the Joint Center for Housing Studies at Harvard University (JCHS) wrote, “The costs of providing long-term care in the home are generally much less than in institutions. The Senate, in its deliberations on the Patient Protection and Affordable Care Act, noted that the costs to Medicaid of supporting three older adults with home and community- based services are roughly the same as those for nursing home care for one individual.”

Tech Upgrades Enable Innovations in Care. Technological trends will vastly improve the ability to monitor, diagnose and treat people in their homes. The advent of faster wireless systems, such as Wi-Fi 6 and 5G wireless, inexpensive cameras, sensors and higher resolution video will enable innovative care delivery models. As we have seen in the current crisis, telehealth provides significant opportunities to support home care at the same time it reduces cost and transportation and logistical headaches. Even once the pandemic is under control, now that Medicare has begun to pay benefits for telehealth, it will remain an important, if not key, element in supporting the delivery of care to the home. This is another strong indicator that aging in place is on the way.

As JCHS wrote, “New technology is also enabling older adults to remain safely in their homes. Sensors are available to provide alerts in the case of falls, tools and robotics provide support for those with difficulty performing ADLs, and automated systems monitor activities in the home. Medical consultations via video-conferencing also help to support those living independently. For instance, the Health Buddy program at the Michael F. Blakely VA Medical Center in Houston uses technology to manage patients’ care in their homes, helping to reduce hospitalizations.”

Traditional Upgrades Also Necessary. To take advantage of the good news, we need to stimulate a broad upgrading of older adults’ homes, likely involving the technology noted above. But such changes also involve more traditional upgrades. According to JCHS, “By 2035, 17 million households will include a person for whom stairs, traditional bathrooms, and narrow doors pose challenges...Yet only 3.5% of US housing offer [accessibility features].”.

This presents a host of practical questions: How can long-term care needs for older adults be met if they can’t get in and out of their front door for medical appointments or social activities, or they can’t shower and use the bathroom without fear of falling? As we have seen the rapid approval and deployment of telehealth and other high-tech monitoring during the pandemic, we also see that the basic safety of the physical environment is a foundation for aging in place.

Economic Case Is Compelling. The benefits of home updates are compelling. For example, hospitalization for an average fall costs $30,000. Falls are a leading cause of disability and death. Avoiding one fall equals the outlay for 100 grab bars at $300 each. Similarly, avoiding one month in a nursing home is equivalent to spending $10,000 on home updates. Upgrades can generally do much more.

Policy Recommendations

The United States should adopt public policies and industry incentives that encourage home preparedness and self-sufficiency to optimize use of personal and taxpayer resources. Updating homes will make aging in place easier and less expensive. Financial incentives will motivate people to update the “age-friendly way” whenever they remodel, regardless of health or age, starting new trends in remodeling. State and local programs to encourage home updates (subsidies, property or other tax incentives) also can help stem people trickling down into Medicaid. Further, aging in place presents opportunities for business growth and innovation.

For states, we recommend lending programs that provide incentives and the means for upgrades. For example, the Maryland Department of Housing and Community Development offers a program that provides 0 percent interest deferred loans for a term of 30 years, or grants to finance accessibility improvements. These improvements may include, among others, the installation of grab bars and railings, widening of doorways and installation of ramps. The maximum loan amount will be up to 110 percent of the value of the property, taking into account any superior mortgages. The loans are to be repaid upon sale, transfer or refinance of the property, with all closing costs will be included in the loan. The state can finance such an initiative through direct appropriations or through specially structure bonds, with the repayment of the loans providing funds to repay the bonds over time.

For states and the federal government, we recommend penalty-free and tax-free withdrawal from retirement savings to use 401K, IRA, TSP and other workplace pensions and retirement savings accounts to update homes. Reduced health costs, along with increased productivity and innovation in business sectors serving older Americans, will more than balance the cost of incentives. Caps based on percentage of savings used, or lifetime caps, may also merit consideration.

For the federal government, we recommend that Congress consider expanding the use of the earned income tax credit to provide another source of funding for aging in place upgrades.

And we recommend normalizing incentives across the aging population that occupies individually and privately owned condos, single family homes and rowhouses. If home updates are limited to those who are very ill or living with significant disability, we will miss the opportunity for far-reaching falls prevention benefits and supporting-self-sufficiency, self-reliance and well-being for our older population.

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Housing

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By Louis Tenenbaum and Susan Kimmel

U.S. Masters Swimming is for Everyone

asa_admin — Mon, 17 Aug 2020 19:06:32 +0000

U.S. Masters Swimming is for Everyone asa_admin Mon, 08/17/2020 - 21:06

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US Masters Swimming thinks swimming is for everyone. And they're working to make that a reality for older adults across the country.

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The health benefits of swimming are widely known. For older adults it's a great way to exercise without impact, improving strength and fitness without pain. But not everyone had the opportunity to learn to swim as a child, and may feel intimidated. On top of that, swimming pools have not always been safe for BIPOC.

We recently spoke with Bill Brenner, COO of U.S. Masters Swimming (USMS) about this and about USMS efforts to ensure that everyone has the opportunity to learn to swim. He explains that, with members whose ages range from 18 to 100 and older, coaches train with a focus on safety and diversity and inclusion. And community-led efforts like their Adult Learn to Swim Program are helping to change the tide and make pools and swimming available for everyone to enjoy throughout their lives.

Watch this video to learn more:

Want to learn more and find a USMS club near you? Visit the Club Finder feature on their website.

Connect with U.S. Masters Swimming on Instagram: @mastersswimming

Swimming and COVID-19

Considerations for Public Pools, Hot Tubs, and Water Playgrounds During COVID-19 via the CDC

Coronavirus and Swimming: What You Need to Know (Updated July 2020) via USMS

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USMS swimming

The promise of technology for older adults: ephemeral or essential?

asa_admin — Mon, 17 Aug 2020 18:16:38 +0000

The promise of technology for older adults: ephemeral or essential? asa_admin Mon, 08/17/2020 - 20:16

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Generations Today

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‘The high expectations we have held out for technology simply have not been met.’

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Technology and technology-enabled interventions have become central to the lives of older adults, family caregivers and the workforce supporting older adults. Although often an unseen element, for many elders, smart phones and apps, electronic health records, tech-driven schedules or smart homes and the Internet of Things are woven into the fabric of their lives.

Yet, based on decade-old pronouncements by technologists and futurists, it is clear that technology has not achieved all the goals and promises that had been presented to policy makers or to the gerontological workforce—much less to older adults. Technology falls short of its promise because it can be overly complex; in other cases market and economic forces have stalled progress; and all too often it is due to resistance around adopting something new and different.

However, just as often, the high expectations we have held out for technology simply have not been met. The promise of breakthrough technologies such as autonomous vehicles, robotics, the Internet of Things and even predictive analytics still has not made as significant an impact on the world of older adults as had been promised.

Presidential Promises

Four years ago in Aging Today I summarized a report, “Independence, Technology, and Connection in Older Age,” submitted to President Obama by the President’s Council of Advisors in Science and Technology. Not so ironically, many key recommendations and anticipated technology innovations highlighted in that article remain as important, but just as unfulfilled today as they were in 2016. Key among such recommendations are the following:

Improve education and training in online technologies for older adults to ensure access to online services and protection from scams and fraud—all tailored to the learning needs of older adults.
Develop a technology-enabled system to support vulnerable older adults in disaster and emergency situations.
Support banking and financial services sector efforts in developing technology-enabled programs to protect older adults from fraud and exploitation.
Improve regulation and payment to reflect the benefits of telehealth innovation.

Support enhancing regulations and financing to improve home design that will sustain independence.

Again, in some cases it is the technology that has not been able to keep up with expectations, but more often than not there are policy and regulatory constraints, limitations in funding and even a lack of basic information about the benefits of a specific technology that has kept technology advances at bay and from reaching older adults. The implications of limited access to technologies are many, resulting in poorer health and safety, restricted information and services, less engagement and greater social isolation, and ultimately, a poorer quality of life for many older adults.

Promises Undelivered—Promises to Come

Ways in which older adults could use technology are easy to see; technology can improve health, safety, knowledge and education, provide access to information and to each other. But there are several key barriers that need to be overcome. Older adults, as well as their families and providers, have not been quick to adopt many technologies. Often this stems from a lack of digital literacy or even fundamental training in how to use technology. And there may be limitations in the “user interface”—or how easy or difficult it is to operate a technology-enabled device or product.

Yet these challenges can be overcome: incentives can induce adoption, digital device training can be made universally available and barriers from poor design can be tackled through applying human-centered design and co-design principles.

Rather than viewing the promise of technology as a glass half empty, we can see it as a glass half full, especially as the potential benefits become clearer and more pronounced. Analysts have predicted that within the next few years, voice will be the primary way in which we interface with digital devices and the world around us, reducing a major barrier for older adults who have difficulty operating new products.

The digital literacy of the workforce, as well as that of older adults, is steadily increasing.

The onset of the COVID-19 pandemic has reinforced the need for all individuals in society, not just older adults, to have access to broadband for immediate access to information. Similarly, telehealth has expanded exponentially, dramatically changing healthcare delivery. The Internet of Things, which connects digital devices, will exceed 50 billion connected devices this year alone. The use of embedded sensors and wearables is becoming far more common, providing more information on our health status and controlling our environment. And the rapid emergence of 5G and Artificial Intelligence (AI) and Machine Learning will exponentially increase the speed and power of data analytics to anticipate our needs or actions.

Even the digital literacy of the workforce, much less older adults, is increasing as each generation becomes more facile with the use of technology. Finally, there are new imperatives to using technology to respond to the challenges brought on by a pandemic and recession: technology-enabled solutions offer a rapid, efficient, cost-effective means to address the safety and well-being of older adults, persons with disabilities and other vulnerable populations. Technology can improve the means by which providers and family caregivers alike can protect and support at-risk populations in response to COVID-19.

Continuing Challenges

Whether potentially game-changing technology solutions offer immediate assistance or promise future gratification, there remain significant barriers to obtaining their full benefits. First and foremost, disparity in access to technology remains the central challenge. Many of our most vulnerable older adults do not have access to even the most basic of technologies, such as connection to the Internet and smart phones. Second, when older adults have access, there is frequently an equity issue in that while some older adults have ready access to sophisticated technologies, many other older adults cannot afford the most basic technology.

Yet in an era where older adults are being buffeted by a pandemic and a recession, new technology solutions, whether in the form of advances in personal protective equipment, enhanced communications to reduce social isolation or data analytics to improve the efficiency of services, can be vitally important as a partial solution to addressing these added challenges.

As I posited four years ago, “employed to its fullest, technology has the potential to improve the quality of life of older adults while concurrently improving access to care, efficiency of care and reducing costs of care.”

Yet for these new technology options to be truly efficacious, it still comes back to the human element: from how we design new products to whether we adopt new forms of support, it is the person who uses technology-enabled products and interventions who ultimately determines if they are beneficial. As we see new technology advances come about with increasing frequency, it is critical to ensure that the person who will use a specific technology-enabled solution drives which technologies we need. Older adults will act as the barometer of whether the promise of technology is ephemeral or beneficial.

David Lindeman, Ph.D., is director of Health, Center for Information Technology Research in the Interest of Society (CITRIS) and the Banatao Institute, University of California, Berkeley, and director of the Center for Technology and Aging.

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In Focus
By David Lindeman

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July-Aug 2020

Kevin Prindiville: Have a clear sense of your values and social-emotional intelligence

asa_admin — Sat, 15 Aug 2020 20:34:58 +0000

Kevin Prindiville: Have a clear sense of your values and social-emotional intelligence asa_admin Sat, 08/15/2020 - 22:34

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"We need passionate, innovative, strong, committed leaders in this space. .... If you are a helper, solver, advocate or changemaker, there is not a better place for you to be using your talents today." -Kevin Prindiville

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Editor’s note: This past January, ASA surveyed its members about what it takes to be a leader in the field of aging, what members would like to learn about how to develop leadership knowledge, skills and abilities, and who best personifies leadership. ASA members identified respected leaders in aging—many of whom are well known to the ASA community and to the field at large. This following Q&A with Kevin Prindiville is one in a series of leadership profiles we will feature on Generations Now blog in the coming months.

Kevin Prindiville, Executive Director of Justice in Aging (JIA)

Kevin Prindiville is Executive Director of Justice in Aging (JIA). A nationally recognized expert on Medicare and Medicaid policy, he has served as counsel in several class action lawsuits protecting low-income older adults’ access to public benefits. He frequently testifies before legislators, presents at national conferences and works with federal and state regulatory agencies. Prindiville serves on ASA’s Board of Directors and has served on its Generations Editorial Advisory Board.

JIA uses the order of law to fight senior poverty and advocate for broad systemic reforms that will improve elders’ access to affordable healthcare, ensure economic security and access to the courts for older adults with limited resources. The nonprofit also conducts lots of legal training for the aging network, and uses that training to advocate for big changes.

“Our work increasingly is focused on issues of equity, racism, sexism, homophobia and xenophobia,” said Prindiville. “We are centering our advocacy in the experience of older women, people of color, immigrants and LGBTQ elders to ensure they can age with dignity, regardless of financial circumstances.”

Generations Now: How might you describe the way leadership in the field of aging differs from leadership in other fields?

Kevin Prindiville: Leadership in aging is interesting in that it fits at the intersection of so many issues. Aging touches all of our lives, but impacts people’s lives so differently, dependent upon one’s experiences. It requires a great ability to understand your own experiences and how they might relate to the people you work with. It requires an openness—you have to have empathy and the ability to listen, and to build connections and bridges.

Aging adds a complexity to leadership as it touches everything, but is pushed aside. As a leader you see the connections between aging and everything else, but you also notice that others tend not to see those same connections. You need to have this awareness while bringing others along to see how whatever topic you’re addressing impacts aging.

GN: How did you use networking to progress in the field of aging?

KP: Networking is incredibly important, as there is nothing you can do alone, especially in policy work. Policy advocacy really requires partnerships, and the way to build partnerships starts with personal connections. Connecting is really valuable to me, and the best way to build those connections is through having a shared mission. Finding things you care about that others care about too, and finding opportunities to work together. Really getting to know people as people, and then doing important work together.

For me, personally, networking has also led to connecting with great mentors. People who have been champions for me, and gave me opportunities to take on new challenges and responsibilities. I see how valuable that has been for me, and look to do the same for others. Finally, in building networks, it is important to always be thinking about diversity and inclusion. Create networks that include people who come from different backgrounds and experiences to create more opportunities for learning from diverse perspectives.

GN: What sort of education did you find most helpful?

KP: Well I’m lawyer by training, and legal education is very helpful in thinking critically about how to solve problems. I learn by doing, so having the opportunity to roll up my sleeves up and solve specific problems—in policy or in helping to run an organization. Getting opportunities to figure things out and move forward.

I also look for opportunities that require me to play a role different than the one I normally play in my “day job.” For example, serving on the Board of Directors at ASA has taught me a lot about running Justice in Aging. And serving on a government advisory committee where I am asked to help set policy priorities has taught me a lot about how to be a more effective advocate with policymakers.

GN: What do you think is the most critical skill to have as a leader?

KP: There are two. One is having a moral clarity about what you think is the right thing. The second is social-emotional skills. The ability to let people know what your sense of right is, and to understand how others may be experiencing things, being attuned to how what you’re doing impacts others.

GN: Can you speak to one leadership challenge encountered on the job and how you met it?

KP: These last almost four years been a constant challenge. We’ve been working in a really difficult policy environment. It is hard to make positive change while also dealing with constant threats to healthcare and the economic security of older people. Because so many of the attacks on healthcare and other programs have been identity-centered (often targeting people based on their race, gender, age, disability, LGBTQ identity, immigration status), the work has felt personal in a new and different way. This has been stressful for our staff and partners in this work.

Responding to this challenge has required an intentional effort to really communicate the impact we’re having as an organization, to help my colleagues see that we are making a difference in the work we are doing. We also work to create a culture where everyone at Justice in Aging can bring their whole self to the work. Creating a diverse, inclusive and equitable organization is critical.

GN: What might you say to inspire younger potential leaders in the aging sector?

KP: Get ready to work! We need passionate, innovative, strong, committed leaders in this space. Aging is not a sexy issue in our society, and to me that means the work we are doing must be important. As leaders in this space you have the potential to make significant and lasting change that will benefit our families, communities and the entire country. If you are a helper, solver, advocate or changemaker, there is not a better place for you to be using your talents today.

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Young leader

Voices on Caregiving: John Poole

asa_admin — Sat, 15 Aug 2020 00:34:33 +0000

Voices on Caregiving: John Poole asa_admin Sat, 08/15/2020 - 02:34

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Millennials aren't always the first generation to come to mind when we think about caregiving. In 2014, John Poole became his parents’ primary caregiver at age 30.

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ASA is excited to announce a new series, Voices on Caregiving, as part of its commitment to uplifting the experiences of BIPOC community members. In this series, we hear from a diverse group of family caregivers about their caregiving journeys, how caregiving affects the rest of their lives and what happens when they are no longer caregivers. Some are from the Sandwich Generation, some are Millennials, some are older adults—but all of their stories are relevant to ASA members and beyond.

Millennials aren’t generally the first generation that comes to mind when we think about caregiving. In 2014, John Poole became his parents’ primary caregiver at age 30. He cared for his mother and father for six years. Through his story we learn about the isolation he felt from his peers, his struggle to maintain a personal identity while performing his caregiving role, and the challenges he faced in learning to navigate care systems.

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Providing the Value They Have Earned: Addressing Direct Care Worker Needs Through Pay, Training, Innovation and Legislation

asa_admin — Sat, 15 Aug 2020 00:20:42 +0000

Providing the Value They Have Earned: Addressing Direct Care Worker Needs Through Pay, Training, Innovation and Legislation asa_admin Sat, 08/15/2020 - 02:20

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The future of long-term care for older adults has never been more essential, yet never more precarious

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During the past five months, COVID-19 has devastated our nation, claiming the lives of close to 115,000 older adults (approximately eight out of every ten deaths, according to the Centers for Disease Control and Prevention).

Given the disease’s transmissibility and novel nature, those who care for America’s elders are placing themselves at dire risk for infection and death. Direct care workers, in particular, have been on the front lines, tending to older Americans’ essential healthcare needs in the community. An estimated 70 percent of adults ages 65 and older develop a significant need for long term care services, and the majority of that care (82 percent) is provided in home- and community-based settings.

The value direct care workers provide to these more than 28 million older adults is repaid by challenging work conditions, including meager pay, limited training, personal protective equipment (PPE) shortages, few benefits, minimal upward mobility, high rates of job-related injury and high levels of physical and emotional stress. The COVID-19 pandemic has only intensified these unfair and undesirable conditions.

The future of long-term care for older adults has never been more essential, yet never more precarious. More long-term care workers are leaving the industry than entering it. If this trend isn’t reversed, we won’t have enough direct care workers to care for our nation’s older adults. Here are some steps we should take to prevent that scenario.

Increase Pay

Direct care work is demanding and requires a specific set of skills. The minimal pay and limited benefits offered, however, reflect the low value our society places on this critically important workforce. An analysis of published data shows that in 2018, the median hourly direct care worker wage in the United States was $12.47—only 1.5 percent higher than it was in 2008. Meanwhile, the cumulative rate of inflation between 2008 and 2018 was 16.6 percent. Approximately 15 percent of direct care workers live in poverty.

Invest in Training

The majority of direct care workers are women (86 percent), people of color (59 percent) and immigrants (25 percent). Despite the essential care they provide, they often feel undervalued and insignificant. And the labels applied to this work don’t help, often falsely referred to as “unskilled,” “non-skilled,” or “low-skilled.” Training can help remedy this situation.

Minimum training requirements for direct care workers are often inadequate or nonexistent and vary from state to state. This contributes to a lack of career mobility, provides justification for low wages and exacerbates feelings of disrespect. The availability of low- or no-cost flexible training is key.

Many of the skills direct care workers rely upon to perform their duties are those they bring naturally to the job, such as adaptability, decision making and interpersonal skills. Providing person-centered, culturally competent trainings to develop practical skills and competencies will increase not only the quality of care delivered, but respect and job satisfaction. A better prepared and more respected workforce is more likely to remain and grow in the field.

Innovate

Traditional training alone won’t be a panacea for the varied needs of our nation’s direct care workforce. Technological interventions offer the potential to supplement care preparation and delivery. The pandemic has illustrated the potential for simple-to-use technology to facilitate information transfer between the right people at the right time. Integrating the direct care worker into a connected health infrastructure can deliver education, and support collaboration between the worker, the patient, the family caregiver and connected teams.

Telehealth, for example, can support visual, audio or textual well-visits and may even help guide a worker toward appropriate support for bio-psycho-social or spiritual stressors. Built-in algorithms can enable learning, and also deliver protocols for given situations. Improving communication flow might be as simple as triggering a system flag to alert a remote team member and/or informal caregiver of a potential issue. Such remote intervention has the potential to contribute to a system of safety, success, and well-being for the workforce.

In order to fulfill the potential such technology holds, however, it is also important to ensure that our direct care workforce is properly educated and equipped to keep pace with these advancements, and also that older adults have sufficient access to technology, broadband and training.

Legislate

COVID-19 legislation has provided a start to solve these issues. The HEROES Act (Health and Economic Recovery Omnibus Emergency Solutions Act) contains extensive measures that have the potential to positively impact direct care workers, such as increased compensation, enhanced training and recruitment, additional PPE and testing and workplace safety guidelines. The Centers for Medicare & Medicaid Services has temporarily issued waivers regarding telehealth coverage, and many groups are pushing to permanently extend these changes.

As the pandemic rages on, our nation’s direct care workers remain vulnerable, while our older adult population continues to grow. These are challenging times that require focused and bold solutions. As the nation navigates unprecedented waters, policymakers must stand up. It is time to take care of our direct care workers, so that they can care for our country’s older adults.

Alison Hernandez, PhD, RN, is a residential 2019–2020 Health and Aging Policy fellow in Washington, DC. Cinnamon St. John, MPA, MA, is the associate director of the Hartford Institute for Geriatric Nursing at NYU Rory Meyers. Laural Traylor, MSW, FNAP, works in the Department of Veterans Affairs, Veterans Health Administration, Office of Academic Affiliations, in Washington, DC. Lieke van Heumen, PhD, is a clinical assistant professor at the Department of Disability and Human Development at the University of Illinois at Chicago.

All authors are 2019–2020 Health and Aging Policy Fellows.

This article is part of a series to appear in Generations Now and Generations Today, by the 2019-2020 Health and Aging Policy Fellows.

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By Alison Hernandez, Cinnamon St. John, Laural Traylor and Lieke van Heumen

We Need to Start Thinking Seriously About Social Security

asa_admin — Fri, 14 Aug 2020 23:23:03 +0000

We Need to Start Thinking Seriously About Social Security asa_admin Sat, 08/15/2020 - 01:23

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The truth is this: the Social Security Old Age and Survivors Trust Fund is forecasted to be exhausted by 2034. This is real, and it’s a problem we need to address.

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Last Fall I attended a meeting that featured a discussion with our County Executive, the leader of our County’s executive branch. Among the topics he addressed were his long term planning efforts for the County. After he finished I raised my hand and asked whether he was considering the effects the exhaustion of the Social Security Trust Fund may have on our economy and on County programs. He brushed me off. He responded that the so called depletion of the Trust Fund is a political ploy, that it’s not going to happen, and that guaranteeing its continued existence is just a matter of a simple economic fix. This, from the leader of our County. I realized then that it is time we get the word out about what is really going on with Social Security.*

The truth is this: the Social Security Old Age and Survivors Trust Fund is forecasted to be exhausted by 2034. This is real, and it’s a problem we need to address.

What the Trustees Report Shows

First a little background: every year the Board of Trustees of the Federal Old Age and Survivors Insurance and Federal Disability Insurance Trust Funds issues a report that presents the current and projected financial status of the Trust Funds. There are six Trustees, four of whom serve by virtue of their positions in the Federal government: the Secretary of the Treasury, the Secretary of Labor, the Secretary of Health and Human Services, and the Commissioner of Social Security. The other two Trustees are public representatives appointed by the President, subject to confirmation by the Senate. The two Public Trustee positions have been vacant since July 2015. The actuarial opinion is given by Stephen C. Goss, Chief Actuary of the Social Security Administration.

The 2020 Trustees Report indicates that the Old Age and Survivors Insurance Trust Fund, which pays Social Security retirement and survivors benefits, will only be able to pay scheduled benefits on a timely basis until 2034.**

Does that mean that no Social Security Old Age and Survivors benefits will be paid after 2034? No. It means that, when the Fund is depleted, payroll taxes for the program will be sufficient to pay only 76 percent of scheduled benefits.

There is No Easy Solution

Most of the 130+ proposals to reform Social Security Old Age and Survivors benefits that have been “scored” by the Social Security Administration attempt to eliminate at least a portion of the shortfall in Social Security’s long range actuarial balance. The solutions that have been proposed are grouped into categories with provisions affecting: the annual cost of living adjustment; the level of monthly benefits; the retirement age; family member benefits; payroll taxes; the coverage of employment or earnings, or inclusion of other sources of revenue; and the taxation of benefits.

Most experts agree that, to reform the program, taxes will have to be increased, or Social Security benefits will have to be reduced, or, more probably, some of both.

What Solutions are Likely to be Implemented?

The “fix” for Social Security will depend on who has control of Congress and the White House when the problem is finally dealt with. The answer also obviously depends on whether action is taken prior to the date the Trust Fund is predicted to be exhausted.

What the Depletion of the Trust Fund Means with Regard to Our Economy

Although Social Security Old Age and Survivors benefits represent a large part (sometimes the entire part) of some households’ retirement income, most families will also have retirement funds accumulated during their working years from defined contribution plans (including 401(k) plans), IRAs, defined benefit plans, and/or housing equity. The full impact of the exhaustion of the Social Security Old Age and Survivors Trust Fund, of course, will be much more damaging to retirees of lower income.

We will probably see an increase in the number of “at risk” households; how they will be borne by society remains to be seen. There may be increases in the number of individuals who apply for Federal means tested programs such as SSI. Other individuals may get additional resources from State and local government programs. And yet others may have to rely on support from children and other family members.

When We Should Start Taking Action

Lawmakers have many policy options that would reduce or eliminate the long term financing shortfalls in Social Security and they 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.

Finally, it may be instructive to remember that the Trust Fund experienced a similar situation in 1983 when it was only months away from being exhausted. At that time, the bi-partisan Greenspan Commission developed a set of recommendations that Congress hurriedly enacted. So, it has been shown that it is possible for politicians to work together to arrive at a solution. Advocacy organizations for older adults such as the American Society on Aging should start pushing them harder to address this very serious issue as soon as possible.

*This article only addresses issues with the Old Age and Survivors Insurance Trust Fund and does not discuss the Disability Insurance or Medicare Trust Funds.

**The 2020 Trustees Report notes that the projections and analysis in the Report “do not reflect the potential effects of the COVID-19 pandemic on the Social Security program. Given the uncertainty associated with these impacts, the Trustees believe that it is not possible to adjust their estimates accurately at this time.”

Beverly Rollins spent her career working for the Social Security Administration and later its oversight organization, the Social Security Advisory Board, where she served as Executive Officer for nearly 17 years. In retirement she volunteers with many organizations and currently serves as a member of her local Commission on Aging and is also a member of the ASA Public Policy Committee.

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By Beverly Rollins

Older Women, Older Black Workers Overrepresented in High-Risk Jobs

asa_admin — Thu, 13 Aug 2020 22:27:56 +0000

Older Women, Older Black Workers Overrepresented in High-Risk Jobs asa_admin Fri, 08/14/2020 - 00:27

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More than 24 percent of Black older workers are in frontline jobs, making them overrepresented in jobs with high exposure to the virus. This is especially true in the personal care and home health aide industry, where 21 percent of workers older than age 50 are Black, while only 10 percent of all older workers are Black.

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The economic downturn in the wake of the COVID-19 pandemic has changed the risks of working, exacerbating existing labor market inequalities. In an earlier article for AgeBlog, we categorized different occupations based on their job loss and health risks.

In short, jobs can be categorized as: Sideline Jobs: occupations facing high risk of unemployment, such as retail salespersons, food servers and machine assemblers. Frontline Jobs: essential jobs, as defined by federal guidelines, that are mostly low-paid and expose workers to higher health risk, such as janitors, truck drivers and personal care and home health aide workers. And lastly, Safe Jobs: occupations where workers face less risk of unemployment or falling ill, such as corporate executives, information technology managers, financial analysts, accountants and insurance underwriters.

Although all workers face heightened health and unemployment risks due to the pandemic, sizeable inequalities exist within the older workforce. New research shows that older women workers and older Black workers are underrepresented in safe jobs and overrepresented in jobs at risk for job loss and illness. Older women are overrepresented in sideline jobs more vulnerable to job loss, while older Black workers are more likely to work in frontline jobs with high health risks.

Sick Leave Critical but Uncommon in Essential Jobs

Black older workers on the front lines are more likely than all Black workers to lack paid sick leave. On average, 40 percent of older Black frontline workers did not have paid sick leave before the outbreak. This overrepresentation and lack of paid sick days are serious causes for concern because Black Americans nationwide are significantly more likely to contract and die from the coronavirus. The overall COVID-19 mortality rate for Black Americans is 2.3 times as high as the rate for whites.

Older Women Are Overrepresented in Jobs with High Risk of Unemployment

During the pandemic, employment opportunities declined most in non-essential occupations, especially in jobs at the bottom of the income distribution that cannot be performed remotely. Because older women constitute the majority of workers in many of these low-paid jobs, especially in the service industry, they are overrepresented in sideline jobs. More than 56 percent (9.2 million) of older women (out of 21 million older women workers) are at high risk of unemployment and losing employer-based health insurance.

In many ways, older women and older Black workers were already excluded from the growth that characterized years of economic expansion and recovery preceding the COVID-19 crisis, amplifying systemic inequalities. In 2018, even after almost a decade of economic expansion following the Great Recession, older Black workers faced a higher unemployment rate compared to their white counterparts, while older women’s wage growth lagged behind that of prime-age men.

Unemployment Benefits Must Be Extended and Expanded

The virus likely will increase these labor market inequalities, disproportionately hurting low-income workers and communities of color. Hence, extending and expanding unemployment benefits is critical to ensure marginalized older workers’ well-being while unemployed and to ensure they have a choice to refuse unhealthy, low-paying jobs.

Additionally, for many workers unemployment means the loss of health insurance. Reducing the age at which one qualifies for Medicare to 50 and making it older workers’ primary insurance will protect these workers and facilitate their employment by lowering insurance costs for employers.

Forced retirement will rise as a result of the continuing health crisis and recession. Because Blacks and women have lower retirement balances than do white men, they are more likely to claim Social Security benefits at an earlier age, further diminishing their retirement income. Social Security benefits should be increased to offset the effects of COVID-19 recession.

Recessions reduce employment opportunities, decrease earnings and increase poverty at older ages. Older workers, especially older women and older non-white workers, are often hit hard by recessions, but the COVID-19 recession hit older people even harder than did past recessions. This is due both to the COVID-19 recession having a larger impact on the well-being of the economy, but also because the pandemic creates additional health and economic risks for older workers that magnify existing inequities.

Aida Farmand is a doctoral student in Economics at The New School for Social Research in New York City.

Photo above by frankie cordoba on Unsplash

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By Aida Farmand

Future Proof: Racial Disparities and Racist Reactions to COVID-19, Plus Aiming for Equity in the Navajo Nation

asa_admin — Thu, 13 Aug 2020 22:24:44 +0000

Future Proof: Racial Disparities and Racist Reactions to COVID-19, Plus Aiming for Equity in the Navajo Nation asa_admin Fri, 08/14/2020 - 00:24

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Future Proof with Larry Curley

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In this episode of Future Proof, Peter and Larry discuss issues of equity and justice and how they intersect with Larry's work with older adults in the Navajo Nation.

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Larry Curley is the Executive Director of the National Indian Council on Aging (NICOA) in Albuquerque, New Mexico. Curley, who along with members of the National Tribal Chairmen’s Association founded NICOA in 1976, was named a 2019 Influencer in Aging by NextAvenue. In this episode of Future Proof, Peter and Larry will discuss issues of equity and justice and how they intersect with Larry's work with older adults in the Navajo Nation and how recently there have been resurgences in racism against members of the Navajo Nation in New Mexico due to COVID-19.

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Key Quotes

On the impact of COVID-19

"In terms of the infrastructure of the Navajo Nation, I think it has just glaringly brought out those inequities and the disparities."

"We're talking right now you're in Florida and I'm in Albuquerque, New Mexico, we can cover the span of distance very easily. But in Indian Country, it is very, very difficult because in some areas of Indian Country, there is no broadband. There is no access to the internet. So you can't implement telehealth out there in Indian Country."

On nation-wide protests for racial justice and against police brutality

"I was part of the late 1960s and 1970s movement...But the young people today, they're even more committed. They've already inspired a massive cultural and a perspective change in our society. And I applaud them. I hope they continue. And I strongly support what they're doing."

"...mostly what I have heard is, 'That's what we've been going through for decades.' That the the brutality is there, the discrimination is there. The length of time people are sentenced to be incarcerated is much longer than the rest of the population, the non Indian population."

On Indegeous rights and identity

"One of the things that I have been saying for many, many years is we are American Indians and Alaska Natives. But we're part of a group of people that are recognized by the United States Government in the Constitution of the United States, Article One, Section Eight. We are a political body. We are members of a political body, and we're not a racial group in that sense. And I think that there are some people forget that there are 573 sovereign governments that have the right to determine who they are, what they are, where they're going, and be able to practice their religion, their traditions, their customs."

On aging and older adults

"I started counting one time, all of those elders that I knew and how old they were when I knew them. And you know, I counted their ages up....2000 years of what they taught me. 2000 years of experience and wisdom. I think that's how we should value our elders. To learn from them what they went through, and become just as resilient because we have a responsibility to the next generation behind us, and the one behind them. And I think we think too often in short term. What's tomorrow? next week? From our own almost a selfish perspective. We need to think about those young people that are coming up."

Transcript

Peter Kaldes 0:04
Hi there, everyone. My name is Peter Kaldes. I'm the CEO of the American Society on Aging. Welcome to another episode of Future Proof. Today on Future Proof we're going to be continuing our conversation this season around equity and justice. And I'm really delighted with our guest today. His name is Larry Curley. He's the Executive Director of the National Indian Council on Aging in Albuquerque, New Mexico, is a member of the Navajo Nation and, along with members of the National Tribal Chairman's Association, founded the NICOA in 1976. And last year, he was named a 2019 influencer in Aging by Next Avenue. Today we'll be addressing the issues of equity and justice, and how they intersect with Larry's important work with older adults in the Navajo Nation. So Larry, thank you very much for joining us on Future Proof. Welcome!

Larry Curley 0:59
Thank you very much. Pleasure to be here.

Peter Kaldes 1:03
Larry, I want to start off our conversation today with something very recent that happened. The Supreme Court's recent decision involving Indian law and Oklahoma. If you could share with us the impact of that particular case on some other matters that impact the civil rights of indigenous older adults.

Larry Curley 1:33
Well, I have been very interested in what's going on in Oklahoma and with the recent court decision regarding the jurisdiction of Indian tribes over what used to be Indian Country in Eastern Oklahoma. I been mulling through what will be the impact of that particular Supreme Court decision not only in the area of criminal law but also in civil law. In terms of where they are now, my understanding is that the five tribal leaders, or the five civilized tribes, had been working on an agreement with the Attorney General for the state of Oklahoma. And they had all agreed at some point of how they're going to divvy up the jurisdictional issues. But as of yesterday, I read that two of the tribal leaders backed out of that agreement, and so it puts everything into disarray.

But I think looking at it from the aging perspective and elderly perspective, I think that part of the questions that I look at is, we currently have across this country, nursing home ombudsman funded by the Older Americans Act, and those nursing home ombudsmen have jurisdiction and they exercise their jurisdiction over an looking at nursing homes, doing inspections and making sure they follow up on complaints. And the question is, will those ombudsmen now have jurisdiction over Indian Country nursing homes in Indian Country like in Tulsa in other parts of the state of Oklahoma? I don't know. And I think that that's something that will probably have to be worked out. But it does fall into the issue of how are we going to be treated equally? And with justice in terms of following up on complaints, are the tribes going to allow the non-tribal nursing home ombudsman into their Indian country to look at nursing homes, etc. So it brings up a lot of these kinds of issues. And I also wonder, for example, whether under the Older Americans Act, we have the title three programs, you know, we have Area Agencies on Aging. For these Area Agencies that were created by the state of Oklahoma, will the tribes now have jurisdiction over those Area Agencies and determine where those Area Agencies will be placed? So it creates a lot of, I think, uncertainty. And we don't need any more uncertainty in what's going on today in this world. So, but that's just a short answer, just kind of reflecting what's going on out there.

Peter Kaldes 4:21
It's a fascinating case. I know it was heralded by many who practice Indian Law. But you can easily see how that kind of inconsistent application could have some pretty devastating effects. Particularly, as we want to talk about today, in areas of the country and with members of the Navajo Nation who are struggling with the COVID-19 pandemic, and how that has exacerbated racial disparities within the Nation and within nursing homes and other areas. So I'm wondering if you could talk a little bit about how COVID-19 has really shown those racial disparities.

Larry Curley 5:11
In terms of the infrastructure of the Navajo Nation, I think it has just glaringly brought out those inequities and the disparities. I know because I used to be the Executive Director of the Department of Health for the Navajo Nation. And in my department, I have 14 major programs and having been out there and going out and seeing my elders out there on Navajo Country. Water, obviously, there's lack of water, there's no running water going into homes. And that exacerbates the problems, the health issues out there. Roads, in the wintertime or in even summertime when it rains, roads are impassable. So if an elderly person is in an emergency situation, some of those roads are impassable. And that creates a health issue. And overall having been involved in the area of Indian health for quite some time, and specifically looking at it through the lens of how is it going to affect our elders in this country. Indian Health Service is a major health care provider out in Indian Country. And for years and years, and I've been one of the ones yelling and screaming at the top of my lungs just say, we are underfunded. We need to be able to have the amount of funding that is commensurate with what's happening elsewhere.

I was listening in on a meeting yesterday with a group called a T-TAG. That's the Tribal, Technical and Advisory Group, an advisory group to CMS. And there was an individual there who said that the per person allocation of funds for Indian people is $3,900 compared to $11,000 for the non-Indian population. So, right there is a discrepancy and an inequitable distribution of resources. And when we talked about providers, for example, when I was out there in Indian Country working with the tribes it was difficult to recruit doctors, nurses because most of those tribes are located out in the middle of nowhere and they don't want to go to those kinds of facilities. And so it's very difficult and if you do have one willing to come out, you have to pay them at a higher price to recruit them out to those facilities. And so just the proportion of providers out there is severely lacking.

Peter Kaldes 8:13
In addition to access to doctors, what other issues have come up as a result of the pandemic that you've seen as executive director of the NICOA?

Larry Curley 8:27
Well, one of the things that has come up, every Friday, we were having discussions with all 273 title six directors around the country and every one of them were talking about what's missing out there. PPE for example. Face masks are lacking out there. So these are just some of the problems that they're dealing with and having to deal with them. For example, there were saying, "We have people out here who need dialysis," and since some of the tribes have locked down their reservations, they're not allowed to go off-reservation. And so is it creating that kind of a problem. And in talking about health care, the delivery of health care, in the rest of the country, telehealth is easily available. We're talking right now you're in Florida and I'm in Albuquerque, New Mexico, we can cover the span of distance very easily. But in Indian Country, it is very, very difficult because in some areas of Indian Country, there is no broadband. There is no access to the internet. So you can't implement telehealth out there in Indian Country. And so that that exacerbates the problem even more than just the issue that we're just discussing.

Peter Kaldes 9:55
I want to talk a little bit about what's going on in our country today, besides the pandemic. Can we reflect a little bit on the recent protests against racism and police brutality? I'm wondering if you could reflect a little bit about the reaction of your members to these protests?

Larry Curley 10:13
Well, I have not heard anyone say, "The police are doing fine. They're protecting us. They're taking care of us." I have not heard anybody say anything of that sort. But mostly what I have heard is, "That's what we've been going through for decades." That the brutality is there, the discrimination is there. The length of time people are sentenced to be incarcerated is much longer than the rest of the population, the non-Indian population. And so that's what I've been hearing and seeing. For example, just recently, about a year ago, there was a young Lady in Winslow, Arizona, who happens to be a member of my tribe. She went to a Circle K gas station store, a convenient store, and the store manager accused her of shoplifting. The cops showed up and they shot her five times. And the people there who looked at the investigator said he was a justified homicide. Five times she was shot. And they said that she was carrying scissors and that made her dangerous. It was one of the paper cutting scissors, one of those small school type. So, you know, things are happening and we don't find it surprising that this is happening. Even from my own personal experience. When I'm driving down the road and all of a sudden I see a police car come up behind me, automatically, the hair on the back of my neck stands up, "Don't do anything crazy, drive careful, don't look suspicious." It's what comes with the territory. And I think that a lot of Indian people in this country have gotten to that point where they feel that way as well. There's a different perspective.

Peter Kaldes 12:30
Yeah, there are a lot of similarities with what we're hearing from folks who are just frustrated at these kinds of day-in and day-out aggressions. I'm wondering what you have to say to the young protesters, how do your members and how do you feel about seeing a real movement emerge?

Larry Curley 12:55
Well, I was part of the late 1960s and 1970s movement. I was part of that generation. And I think that it's powerful. I think we, my generation who were part of that movement back in the late 60s, early 70s, I think we blew it. I think we missed an opportunity to change the face of this country. But the young people today, they're even more committed. They've already inspired a massive cultural and a perspective change in our society. And I applaud them. I hope they continue. And I strongly support what they're doing.

Peter Kaldes 13:44
I think there'll be a lot of protesters would never suggest that your generation blew it at all. In fact, to the contrary, they couldn't be protesting like this, but for your work, so I hope you don't, you don't really think that.

I want to talk to you about some other things that the protests have forced us to rethink and that is our history and our approach to history, our approach to who we commemorate and why. And one issue that has taken a bit more of our attention now is the naming of military bases. And I know the Navajo Nation played such a key role. Members of the Navajo Nation played such a key role in fighting most of our wars in the United States. So I'm wondering, can you talk about a movement or the effort to rename some of the military bases after those who fought on behalf of our country but who were from the Navajo Nation?

Larry Curley 14:45
I think it'd be appropriate, quite frankly. I read somewhere a few years back that American Indians in this country, proportionally more of them have served in the military and fought on behalf of this country. My tribe, the Navajo Nation, lent its language, to win a war. And those are the Navajo Code Talkers. I think the Navy recently named a whole new class of ships for the Navajo Nation. Navajo class, I think it was called, Navajo class destroyers. But I think it's starting. I think we need to be remembered, That there were Indian people from across the country who fought bravely on our behalf. We have, for example, right now in the Navajo Nation, one of the code talkers, his name is Peter McDonald. He's a former chairman of the Navajo Nation and he's one of the original code talkers. And I think that those are the people that need to be honored. It's not only just Navajos, I think I heard that the Creeks also had some and the Crows also were a part of that code talking group during World War II. But we have American Indians who are also generals. Who have attained the rank of Generals. And they think that when their time ends, that we ought to honor those generals as well. I have a lot of respect for our veterans for what they've done and what they fought for. For that possibility that one day I would be able to sit down and talk with you in the language that you can understand. That was what they fought for. And I am honored to be a part of that legacy.

Peter Kaldes 16:51
I'm wondering if you could also share with us what you think we can do as a country to be more inclusive around Native Americans and be more all-encompassing when we talk about race. In other words, it's not just about Black Lives Matter. It is about our general treatment of minorities in this country. I'm wondering, what would you recommend to our ASA members to be more inclusive? How could they be more inclusive?

Larry Curley 17:25
One of the things that I have been saying for many, many years is we are American Indians and Alaska Natives. But we're part of a group of people that are recognized by the United States Government in the Constitution of the United States, Article One, Section Eight. We are a political body. We are members of a political body, and we're not a racial group in that sense. And I think that there are some people forget that there are 573 sovereign governments that have the right to determine who they are, what they are, where they're going, and be able to practice their religion, their traditions, their customs. And when I think about them, I think about, at least from my own personal perspective, we look at everything on this planet as equal. We are equal beings. The mountains are equal. Some of those mountains are very sacred to us, because they hold certain meanings. And when I see the non-Indian population going up to one of our sacred mountains and putting up a ski resort up on there and then using artificial reclaimed water to make fake snow. And reclaimed water is made up of, you know, processed human stuff. It would be like me going to the Mormon Tabernacle and urinating on it. It is not something we would do, because we respect them. And I wish the larger population would understand that all of these places that they see and walk upon, from our perspective, is very sacred because it contains the dust of the ashes of our ancestors. It's sacred land, and that's who we are.

And when we talk about history books, please add in there the fact that Chief Joseph of the Nez Percé Tribe was a fantastic military strategist. Crazy Horse what he did. Chief Manuelito of the Navajo Nation. All of those were powerful people, and they have wisdom that a lot of the larger population could use now.

Peter Kaldes 20:13
Larry, I'm wondering if you could share with us how you think older adults from various Indian Nations can help not just inform our ASA members, providers, health care providers, etc, but could really play a role in better understanding just how different and how unique every single older adult is in America. What sorts of things should we be doing?

Larry Curley 20:46
I really think that they need to take the time to sit down and talk with them. Sit down and talk. And those elderly people are more than willing to share what they know and how they perceive the world. What their role was in the world that we created. They're fantastic storytellers. And I think that's where the interaction needs to occur.

You know I run across people here in New Mexico who have lived here in New Mexico all their lives, and still know very little about the Indian Tribes here in New Mexico. And they ask questions, like, "Are we permitted to go on the reservation?" Yes, you're permitted. We're not going to kick you off the Rez. Come in. It's not like a private Country Club where you got to be a member to go in. The Indian reservations are not a country club. You're invited, come visit us. Please come and see where we live and you will have a better understanding. And I think that one of the things that you'll note in Indian Country among our elders is they're resilient. They are very strong people. And for those who make it to the age of 70 80, 90, they were probably the cream of the crop in terms of the strongest, the fittest, the wisest, and the most resilient, and they have much to teach us.

Even at my age, I think back to the time when I was working with all kinds of elders -- Asian people, African Americans, Jewish population, the regular white population, other Indian tribes -- and I started counting one time, all of those elders that I knew and how old they were when I knew them. And you know, I counted their ages up. Like, like Esther Tang in Tucson. She was 78 years old when I knew her. I added all ages up. 2000 years of what they taught me. 2000 years of experience and wisdom. I think that's how we should value our elders. To learn from them what they went through, and become just as resilient because we have a responsibility to the next generation behind us, and the one behind them. And I think we think too often in the short term. What's tomorrow? next week? From our own almost a selfish perspective. We need to think about those young people that are coming up.

Peter Kaldes 23:31
Larry, I couldn't agree with you more. I think, like we're seeing with racism, ageism devalues human life, and we really need to do so much more to remind ourselves that we do have value as we age. I know at the ASA, we're gonna be doing a lot more of that work to demonstrate that and I'm so grateful for all the work that you're doing. We're nearly out of time, Larry, but I want to ask you one question that I've been asking all our guests here on season two of Future Proof. And that is, why do you think that you've pursued a career where you are advocating for equity and justice?

Larry Curley 24:15
Well, I think that one of the things is just the way I was raised. My father was a medicine man. He was not educated in the formal sense, but he knew the world. And one of the things that he said was, "You're no better nor worse than anybody in this on this planet, including the bugs, the birds, the animals. You're no better and you're no worse. You're all equal, treat everybody equally." And so when I take a look at the world, and I say, "Our elders need to be treated equally. Our people need to be treated equally and respected in that particular fashion." I think that working with elderly populations has provided me with a platform to be able to do that.

Peter Kaldes 25:01
And I'm glad that you are and I know you're going to continue to do as much as possible to advocate for all our seniors. So thank you so much for the work that you're doing and for your contributions to ASA. We're very, very grateful.

And that wraps it up. Larry, thank you for joining us. And thank you for joining us as well. We hope you've enjoyed this episode. And if you want to log in and view more episodes, visit our website, and stay tuned for more Future Proof.

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Future Proof: Where Research Meets Reality: On African American Elders, Equality, Equity, Health, Environment, Alzheimer’s and the Pandemic

asa_admin — Thu, 13 Aug 2020 22:20:54 +0000

Future Proof: Where Research Meets Reality: On African American Elders, Equality, Equity, Health, Environment, Alzheimer’s and the Pandemic asa_admin Fri, 08/14/2020 - 00:20

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Future Proof with Karen Lincoln

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Peter Kaldes and Karen Lincoln explore where her research on social and economic inequality and equity intersects with her community practice work with older African Americans who have Alzheimer’s and other mental health conditions, as well as the impact of the coronavirus on this same population.

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In this episode of Future Proof, Peter Kaldes, President and CEO of ASA, talks with Karen Lincoln, associate professor of Social Work and senior scientist at the University of Southern California Suzanne Dworak-Peck School of Social Work. Karen explores where her research on social and economic inequality and equity intersects with her community practice work with older African Americans who have Alzheimer’s and other mental health conditions, as well as the impact of the coronavirus on this same population.

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Karen's work

Key Quotes

On the impact of protests for racial justice on Karen's work

"With this heightened awareness of a lot of people in this country and around the world, we're now experiencing a very interesting time in our lives, which comes with hope. It comes with trauma and being re-traumatized. The opportunity for change. All of that is encompassed in the work that I do."

"We have now been able to see that many of our young people are activists. They're they're advocates. They're looking for something to make sense of the world. And I think the marches and the protests and all of these conversations have provided something for them to hold on to and to focus on. It's been wonderful to see more young people and more diverse, racially and ethnically diverse young people, out marching and protesting and lending their voices to this particular cause."

On research around risks for Alzheimer's Disease and African American communities

"Because we've had 400 plus clinical trials and no cure, many funding agencies are turning their dollars to support brain health prevention or risk reduction efforts and looking at ways that we can reduce risk and linking those strategies with where people live. And so pollution has been linked to higher risk. We know that social isolation is a factor. We basically know that where people live is associated with their risk for Alzheimer's disease. We're now looking at poverty and financial strain as a risk factor for Alzheimer's Disease, where before it was all neurological or biological. But we can now see these more external social factors that are increasing the risk for Alzheimer's."

On the impact of additional resources related to the pandemic in the communities Karen serves

"For those who might get a benefit, it's so small, particularly when you have seniors and their families who are already in debt or already in need of funds to buy food and to keep the lights on. So if you receive $400, there's already a big hole that you have to fill with it, so it doesn't really go far. I think that the needs are just so much greater for people who are already under-resourced."

Transcript

Peter Kaldes 0:02
Hi, everyone. I'm Peter Keldes, the CEO of the American Society on Aging and welcome to another episode of Future Proof. In this season we're talking about equity and justice. And I'm just absolutely delighted that we have a special guest here with us today who comes from a university that's been a strong partner of ours here at ASA, the University of Southern California. We are here with Karen Lincoln. She's an associate professor of social work at USC's Dworak Peck School of Social Work. She also directs the USC Hartford Center of Excellence in Geriatric Social Work. And today, we'll be addressing the issues of equity and justice, and how they intersect with Karen's important work, researching and designing programming around Black mental health across the life course. Karen, welcome to Future Proof.

Karen Lincoln 0:53
Thank you. I'm so glad to be here.

Peter Kaldes 0:56
I want to get started with what's been going on in our country these last few weeks. Especially coming on the heels of long months of continuing to shelter in place in California because of COVID. I'm wondering if you could just share a little bit about how the recent protests have impacted your work in Los Angeles?

Karen Lincoln 1:19
Sure. Well, obviously the protests around racial injustice and police brutality have affected all of us. It has definitely raised awareness about racial injustice. And interestingly enough, when I talk about this topic to people, I have to prepare them to understand how many African Americans might respond to this because none of this is new for us. This is a battle that we have been fighting since the beginning of time. With this heightened awareness of a lot of people in this country and around the world, we're now experiencing a very interesting time in our lives, which comes with hope. It comes with trauma and being re-traumatized. The opportunity for change. All of that is encompassed in the work that I do. And honestly, the major impact that it's had is that, with the protests, we have to find different ways of getting around the city. And because we serve under-resourced communities, we are used to doing a lot with a little. It's just a matter of planning our movements and engaging in social distancing and all of the public health mitigating standards that we're all trying to abide by. I think just in terms of the conversations and working with older adults, particularly African American older adults who have lived through many of these types of experiences, it is impacting them in different ways. And so we are partnering with our community partners who are focused on mental health issues more than we have before. Substance abuse issues more than we have before. We are seeing some emerging health concerns with older adults, with the biggest being isolation. Because we have these connections in the community, it's allowed us to reengage with these partnerships in a new way to serve the population that we serve.

Peter Kaldes 3:39
Let's talk about some of the the issues that you're seeing with the population that you, under normal circumstances would be studying, with what's come about as a result of the pandemic and the protests. I'm wondering if you are shaking your head saying, "Yes, we know isolation impacts one's health. Yes, we know this. It's just that the pandemic and some of these protests have exacerbated those issues." Or, what other issues have come out to the forefront now as a result of where we are right now.

Karen Lincoln 4:14
I think that yes, you're right. There has been an exacerbation of issues that have been prevalent in our community. So I haven't seen anything new. I have seen something that we haven't seen in a while and that is fear and anxiety, around the pandemic in particular. Because engaging in social distancing, for example, can be very difficult for many African Americans, which is the population that I primarily serve. It has a lot to do with where people live and who they live with. The anxiety around living in congregant housing, for example, has increased the level of fear, which is impacting physical health conditions as well as mental health conditions. So I think it's really testing our coping skills and stretching them to the to the boundaries. And I think there's confusion in terms of the messaging. Specifically, how do you do these things? How do you quarantine when you have multiple generations in your home? How do you engage in social distancing when you have people who have essential jobs who are coming in and out? Not being able to have information about how to do these really important things has increased the level of anxiety and fear of getting infected.

Peter Kaldes 5:45
You talked at the beginning, about how many of the issues we're seeing today are nothing new. In fact, two years ago, you wrote about this. You guest edited an issue of Generations on economic and social inequality in America. And I was hoping you could share any change in the status of these populations who find themselves in poverty. What have you found in just the last few years?

Karen Lincoln 6:17
One of the things that we found is that, as we talked about, some of these issues of economic inequality have been exacerbated among a lot of different populations. But with the impact of the pandemic, particularly with African Americans and Latinos, we are seeing increased rates of unemployment. A couple of days ago, there was a conversation around the increase in unemployment across Americans, but it is significantly higher among African Americans. And I think the fact that economic insecurity has been a prevalent problem and continues to be a problem, it's a bigger problem, particularly when housing is unstable. And then the pandemic hits. Employment is unstable, and then the pandemic hits. Schools are closed. And so when children are already in schools that are under resourced, there are going to be significant impacts of that. And so I think that although all of us have been impacted in some way, there are some communities that might not recover. One of my biggest concerns is that many African Americans who have been hardest hit by this pandemic, some will be able to recover, but many will not.

Peter Kaldes 7:41
I think the pandemic, while it has exacerbated inequalities, I feel as though it's also raised awareness in a positive way. I feel like it's raised awareness around the root causes of economic inequality and you have more and more people, particularly people who look like me, talking about these issues. And I'm wondering, how do you feel about the evolution? Do you find the same awareness has been elevated?

Karen Lincoln 8:12
I do. I absolutely do. And that is definitely one positive thing that has come out of this. Many of these conversations that have been happening in communities for decades are more prevalent. Not just in the United States. They're happening all over the world. And I think that is really helpful platform when you have this conversation here and it's beyond the local level and it's beyond one incident. There's a persistence of momentum. Oftentimes, you have some of these awful traumatic incidences and you have some reaction, and then it kind of fades away. People forget. But this is one that is long-lasting and the spread is much wider. And so it's very difficult for the conversation to lul. Because the impact has been so much bigger. So that has definitely been a positive that has come out of this.

Peter Kaldes 9:10
Can you talk a little bit about why you think that's the case? Why do you think it hasn't waned?

Karen Lincoln 9:17
Yeah, it's interesting. I have to think about that. I think part of it has to do with Millennials and younger people who are growing up in a different time. Who are more racially diverse, who are more biracial and multiracial are interacting more. And then of course, you have social media that spreads news very, very quickly. And we have now been able to see that many of our young people are activists. They're they're advocates. They're looking for something to make sense of the world. And I think the marches and the protests and all of these conversations have provided something for them to hold on to and to focus on. It's been wonderful to see more young people and more diverse, racially and ethnically diverse young people, out marching and protesting and lending their voices to this particular cause.

Peter Kaldes 10:25
It's almost become a pop-cultural phenomenon. When you have major corporations, major brands, also finally stepping up and challenging their own versions of what they see as the status quo too. What do you think of that movement?

Karen Lincoln 10:42
I think that's interesting. I think that it is positive in that there is this raised awareness. I also think that if you find yourself heading or being in the top administrative level of any company or agency where you have a diverse workforce, you really must respond to this diversity because it's a conversation that's happening all over the world. The other thing that I'm thinking about is because we have such diversity and because this is a global phenomenon, I think there's some level of responsibility by people who are heading some of these companies to address it. Because so many people across generations, across race, ethnicity, gender identity age, are invested and involved. And if you are heading a company and you don't respond to this in some way, there will be economic ramifications. I think that it's a financial decision that some people might want to make to engage in this conversation or to respond in some way. Because we've witnessed what happens when people don't issue a response or don't respond in some way. So it's a very interesting reaction. And I'm not sure you know, who's responding for what reasons, I'm just glad that people are actually responding.

Peter Kaldes 12:26
Well, it is amazing, to your point earlier about where all the new advocates have come from, whether it's the younger generation or the corporate boardroom. But at least they've come out and they're really trying to push a thoughtful agenda. Speaking of advocates, though, I want to touch a little bit on your work with the Advocates for African American Elders and what the group's docket now is, particularly in response to this latest awareness setting around racial equity.

Karen Lincoln 13:03
One of the things that we've done is very practical. When the pandemic hit and we safer at home order here in California. And so when that order was passed and we had to stay at home, we were really concerned about the older adults that we serve, because many of them are served by senior centers. They get their meals, they have a lot of their social interaction from the senior centers. And some of the senior centers do provide some very critical care for many of our seniors, particularly in low-income communities. And so we contacted many of the directors of these centers and said, "What do you need? What can we do?" And they indicated that it wasn't food. That seemed to be the more prevalent obvious need for many low-income people and it's still true, but it wasn't food. It was hygiene products. Disinfectants like Clorox wipes and masks and gloves. And so we took whatever funds we had and we asked for donations. And we prepared hygiene kits for seniors. Two hundred of them. We distributed them to the senior centers and they were able to identify those seniors who were most in need to get those hygiene kits. That's one of the things we did. We were also hearing that many of the seniors that we work with, once they realized that they needed to stock up on certain things and they needed to get disinfectants and things to clean their homes, they'd go to the stores and those products were gone. We're serving seniors who live in food deserts. So there aren't a lot of grocery stores to begin with. So we knew that there was going to be a high need and we started to collect these items to distribute to seniors in the community.

Peter Kaldes 15:01
Given the emergency investments that were made by the federal government and a lot of additional dollars trickle down in response to the pandemic, do you see it trickling into communities that you serve? Or do they continue to be forgotten?

Karen Lincoln 15:23
They continue to be forgotten. It's not trickling down to really poor and low-income communities. And also for those who might get a benefit, it's so small, particularly when you have seniors and their families who are already in debt or already in need of funds to buy food and to keep the lights on. So if you receive $400, there's already a big hole that you have to fill with it, so it doesn't really go far. I think that the needs are just so much greater for people who are already under-resourced. Any additional resources that people get, it's just not enough to lift them up out of these poor levels of socioeconomic status.

Peter Kaldes 16:15
Yeah. And the needs are also greater for those who may have comorbidities or Alzheimer's. I wanted to touch a little bit on Alzheimer's disease and your research. I know that the rates of Alzheimer's in the Black community are higher than in other communities, but I wonder, why is that the case?

Karen Lincoln 16:39
What's been reported is that because Alzheimer's is associated with a host of risk factors that are related to chronic health conditions and that the higher prevalence of hypertension, diabetes, and heart disease, are higher in African Americans, that we then have a higher risk for Alzheimer's disease. That's true, but also things that haven't been talked about much, that are just now beginning to be published in journals and getting research funding for, are the social determinants of health. Because we've had 400 plus clinical trials and no cure, many funding agencies are turning their dollars to support brain health prevention or risk reduction efforts and looking at ways that we can reduce risk and linking those strategies with where people live. And so pollution has been linked to higher risk. We know that social isolation is a factor. We basically know that where people live is associated with their risk for Alzheimer's disease. We're now looking at poverty and financial strain as a risk factor for Alzheimer's Disease, where before it was all neurological or biological. But we can now see these more external social factors that are increasing the risk for Alzheimer's.

Peter Kaldes 18:18
I'm wondering if some of these studies or this new effort will also touch on stigma, and how we need to fight it, because it exists in so many different communities that are disproportionately impacted by Alzheimer's. I'm wondering if you could share your work on that.

Karen Lincoln 18:36
Sure. At Advocates for African American Elders, we serve seniors in the community. I'm a researcher but I also have this community based program and one of the things that we focus on is health education. Although we get calls from people who need help with a variety of resources, I started to notice a much higher volume of calls associated with Alzheimer's Disease. Whether it was someone who was concerned about their memory or an adult child who had some concerns about their parent. Because the volume of calls that were primarily associated with Alzheimer's disease was so high, we started to provide education in the community about Alzheimer's Disease. And what we found is that many African Americans have very low Alzheimer's Disease literacy. We don't know what it is. We don't recognize the signs and the symptoms. And if you can't recognize the signs and the symptoms, then you don't seek help. Back to your earlier question, one of the reasons that many African Americans have such a high prevalence rate is because we don't know we have it. We don't recognize when something's wrong. And we have our own cultural beliefs around memory loss. And so we created an educational program called Brain Works to educate African Americans about Alzheimer's Disease. We use a very innovative creative format--a talk show. We use culturally tailored text messages to reinforce the strategies and tips around reducing risk for Alzheimer's Disease. And so far, it's been very effective for increasing Alzheimer's Disease literacy for African Americans.

Peter Kaldes 20:29
I love that idea. And I love using technology, even if it's the most basic form in the form of texting. I think that's wonderful. I'm wondering, have you used technology in any other way?

Karen Lincoln 20:42
Right now we're just using it for Brain Works. However, I am working on a project to submit to the National Institutes of Health to use an app for relaxation training to address hypertension and stress in African Americans. Particularly those who are living in senior housing, in congregate housing. That app is phone based, but it also has a virtual reality component to it. So we're going to test it out to see how we can do it. With cell phones, that's tricky. It seems low tech, but for many African Americans its high tech. We have people in our research project that didn't have phones. We had people who had phones, but not smartphones. So it's not something that's widely available, but it is one of the most widely available pieces of technology among African Americans. So that's why we use cell phones.

Peter Kaldes 21:41
I love that approach. And that application. Good luck on that application. But I'm wondering, if I were the NIH, I'd want to know how you are going to bridge that digital divide to be able to provide access to them. I'm sure you've given that thought.

Karen Lincoln 21:55
I have. One of the things we learned with Brain Works is that most African Americans had a cell phone. And the reason that I chose the cell phone is because the research indicates that broadband access is very low among African Americans. And it's extremely low among older African Americans with only 38% having access to the internet. But most have have access to cell phones. And it was the only device and piece of technology where African Americans had a higher rate of using their cell phones to search for health related information than whites. And I thought that's it, we have to use the cell phone. Our research participants are used to using the cell phone now. We were able to train those who didn't have a cell phone to use a cell phone and to text. We now know that if provided with the phone, people will know how to use it. So I think with with that evidence, I'm pretty confident if we're able to put the phone in the hands of someone that we'll be able to train them to use it.

Peter Kaldes 21:57
I think that's right. I think there's a real willingness to learn if you are able to be patient and respectful in how you deploy training for folks. I think it's a powerful tool. And I think we're just the start of it deploying technology for all sorts of good here in this space. I want to I want to talk to you a little bit about one question that I've asked all my guests here. As we we wind down our conversation, I want to ask you why you're in this space, specifically now during this time. I'm wondering if you could just share with us why you've chosen to remain such a strong advocate and researcher in equity and justice for older adults.

Karen Lincoln 24:00
I don't know if it's part of my nature or my legacy, but I think about my grandmother, particularly when we focus on older adults. I supported myself through school. I didn't have parents who could pay for that. And when I was at UC Berkeley as an undergraduate, I was actually working full time and going to Berkeley full time as well. I slept for two and a half hours a day, until I finished. I worked graveyard shift on the Golden Gate Bridge. And I had a conversation with my grandmother because one of our assignments in a class was to was to interview an African American female role model. I was scratching my head trying to figure out, well who will this person be? And I thought my grandmother. So I interviewed my grandmother who had a third grade education. She grew up in the South. She had 11 children, including my mother. And she worked so hard. My grandfather was a sharecropper. She was a maid. She spent all day taking care of someone else's family. And then she walked home to take care of her own family. And she told me that all she wanted for her children was for them to graduate from high school. That was her biggest wish. And they all did. And here I am, an undergraduate at UC Berkeley talking to my grandmother about her raising these 11 children, washing all of thier clothes by hand, cooking all of this food and I said, "Grandmother, how did you do it?" And she said, "I worked until my heart slept." And it forever impacted me. Forever. I will never forget that moment. And I don't know if it just propelled me forward to do more, but I couldn't stop at a bachelor's degree. I had to continue on this journey to go as far as I could to do as much as I could. For people like my grandmother.

Peter Kaldes 26:21
I'm sure she's extraordinarily proud and probably was at that moment when you asked her to be the subject of your interview on who a role model was. I think that's wonderful. Thank you for sharing that story, Karen. That's a great, great way to end the conversation. Very powerful. Thank you. You've left me speechless. I really enjoyed our conversations today, Karen. And I hope you come back because we can talk some more.

Karen Lincoln 26:48
Oh, absolutely. I'd love to.

Peter Kaldes 26:50
Thank you very much for joining us on future proof and we hope you join us for another episode. Till next time

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Future Proof: How to Ally with Older Adults Facing Systemic Discrimination & Marginalization

asa_admin — Thu, 13 Aug 2020 22:16:46 +0000

Future Proof: How to Ally with Older Adults Facing Systemic Discrimination & Marginalization asa_admin Fri, 08/14/2020 - 00:16

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Future Proof with Denny Chan

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In this episode of Future Proof, Denny Chan, senior staff attorney at Justice in Aging, addresses civil rights for older adults and how the heterogeneity of this population means paying attention to the intersection between age and other protected identities. Chan and Kaldes also discuss how COVID-19 has exposed disparities in our racist healthcare system, LGBTQ protections and underreporting in healthcare discrimination and the importance of educating oneself about civil rights protections in order to help others.

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Key Quotes

On thinking about how civil rights apply to older adults

"It's important to think about civil rights in a much broader context. We often think about civil rights for people of color or for women, or for people with disabilities, but we don't think about older adults in those communities. And the civil rights that protect those communities protect older adults, because they're a part of those communities, too."

On section 1557 of the Affordable Care Act, the ACA is nondiscrimination provision.

A law like section 1557 is so important to older adults. And in particular, what we're seeing under this Administration, unfortunately, is a real effort to curve back some of those protections. To end the regulations and enforcement. To take some teeth out of what were really strong laws

On racism, civil rights protections, policy brutality, and older adults

"I would argue that there's racism behind police brutality and what has ignited demands for justice. That's the same racism that causes disparate outcomes in nursing facilities for nursing facility residents of color. It's the same system. They have different manifestations, different symptoms, but it goes back to the same notion. At Justice in Aging, we're taking really seriously this notion because this is really crystallized how important civil rights protections are for older adults, for other communities, older adults who live at the intersection with different identities."

On the role that ASA members can play in fighting racism

"I'm hoping that the moment that we're living in will offer and support a reimagined boldness and newness to how aggressive we can be in ensuring that our systems are fair for everyone. That's where I see ASA members doing that internal evaluation. Are our staff matching the communities that we serve? How do we go about recruitment and retention? All those things are part of building a sector that will work better for the older adults that we serve."

Recent Work from Denny and Justice in Aging

Transcript:

Peter Kaldes 0:03
Hi there, my name is Peter Kaldes. I'm the CEO of the American Society on Aging, and I want to welcome you to another episode of Future Proof. In this season of Future Proof, we're looking at equity and justice. And today on Future Proof, we have Denny Chan. He's a senior staff attorney at Justice in Aging, a national organization that uses the power of law to fight senior poverty. And today we'll be addressing the issues of equity and justice and how they intersect with Denny's important work advocating for health care reform and people eligible for both Medicare and Medicaid. So Denny, welcome to the show.

Denny Chan 0:43
Thank you so much for inviting me and I really appreciate the opportunity, Peter.

Peter Kaldes 0:47
So Denny, I want to thank you for your contributions to ASA. In particular to some of the articles that you've recently written around fighting for the civil rights of older adults. Could we step back and start with, what does civil rights mean in the in the context of working with older adults?

Denny Chan 1:11
Sure, absolutely. Thank you for the question. You know, the first thing that I think people think about in terms of civil rights as they apply to older adults is age discrimination. And that should be first and foremost in your mind. And so that's kind of where it starts. But I think it's also important in thinking about our diverse country and where older adults live and the communities that they live in, to think about civil rights much more broadly. It starts with something like age discrimination, but that's really not where it ends. Because we all know that the older adults that we're serving are not a monolithic community. They don't all look the same. They don't all eat the same food. They don't all have the same needs. So really, what I hope to see is increased attention in looking at the intersection of age with a bunch of other identities. So how do we think about older adults who might be limited English proficient? How do we think about older women? How do we think about LGBTQ seniors? All of them are going to have different lived experiences. And it's really the focus on that intersection and the fact that many of those groups have faced historical oppression and discrimination and continue to face challenges today. It's important to think about civil rights in a much broader context. We often think about civil rights for people of color or for women, or for people with disabilities, but we don't think about older adults in those communities. And the civil rights that protect those communities protect older adults, because they're a part of those communities, too.

Peter Kaldes 2:36
That's a great point. And it's so interesting, particularly as you know, there's conversations about reopening schools that sometimes people forget that in that context, for example, you have older adults who are teachers, who are custodians, who are professors, who are principals. And even in those contexts, people forget about the implication of their work on older adults. So it's great to link up how civil rights work isn't limited to folks who aren't older. It may surprise some, but it's it doesn't surprise us.

Denny Chan 3:14
Older adults aren't just hanging out the senior center. In the context of reopening schools, so many of our school-aged kids live with older adults. So we think about the risks of reopening, and we can talk more about that at some other time, but older adults are embedded in our communities. And it's important that we think about how broad and how non-monolithic, they are when we're thinking about older adult advocacy.

Peter Kaldes 3:43
So Denny, indulge me a little bit here. As I mentioned to you, I'm an attorney. I'm a recovering attorney. So I'd love to geek out with you a little bit here on some cases that you've worked on, related to the civil rights of older adults. Can you share some examples?

Denny Chan 3:58
Sure, absolutely. We might too get too geeky, I hope people stay engaged. One example is a case that Justice in Aging brought several years ago. This was a case during the Obama era against the Social Security Administration because they had discriminated against same-sex couples who were receiving Supplemental Income Benefits. SSI.

So, there was such a hodgepodge in the marriage equality decisions and how states were going about it, that there was a period of time before the last marriage equality decision, where depending on what state you lived in whether the state would recognize that marriage. And whether, for purposes of SSI benefits, you'd be recognized. There were couples in marriage recognition states that the Social Security Administration claimed they had overpaid. Because, as you might know, the couple's rate for SSI is lower than two times the individual rate. So technically, for purposes of SSI payments and benefits, there were same-sex couples who had been overpaid. And so the Social Security Administration actually tried to seek overpayment from this population. To try to collect money from these people who, by definition, because they're on SSI, are poor. Because they are same-sex couples, they have higher health disparities. There were all sorts of reasons why this didn't make sense.

We along with some partners went to court and tried to stop the Administration from seeking overpayment. Ultimately, we're able to settle with the Administration and get everything that we wanted. They stopped collecting overpayment for those couples. It's a really good example of how changes in the law can have unintended impacts on people's benefits and people's living situations.

Another couple of cases that we've been working on is challenging what's known as the public charge immigration rule. And that's a rule under federal immigration law that allows immigration officers to deny admission to people who might use a bunch of resources. And, under the Trump administration, unfortunately, they've expanded how they consider that and who might count as someone who will use a lot of resources. And that has a disparate impact on older adults who are immigrants, in particular. What they said was using things like Medicaid, even accessing health care coverage could count against you. And technically speaking, there weren't a ton of people for whom the rule would necessarily apply to, but it was enough to scare people. In California, where I do a lot of work, we noticed a significant drop in Medicaid applications. People were worried that using Medicaid would mean that they were somehow going to have immigration-related consequences, even if the rule didn't apply to them, because it's so wonky. So we were involved in filing a series of amicus briefs, which are a friend of the court briefs, in a number of the lawsuits that were challenging the public charge rule.

Peter Kaldes 7:18
It is amazing how sometimes there are perverse results from changes in laws that arguably, even with the best of intentions, end up having a disproportionate effect on a number of populations, and in this case, older adults. So I'm wondering if you could talk a little bit about some laws that currently exist to protect older adults and maybe are in danger of being perhaps applied inappropriately?

Denny Chan 7:52
The good news is that there is a strong bedrock of federal civil rights laws that apply to older adults. Obviously, we can start with the Age Discrimination Act. And that's really important, particularly during the pandemic. We know that there are hospitals and health systems out there, as we go through surges in different states--your state of Florida, my state of California, both are states where there are huge surges--and there's a real risk that we run out of hospital beds that we run out of ventilators. So things like the Age Discrimination Act protect older adults from being discriminated against. From a doctor saying, "Well, you're 85 and you're probably going to die anyway, pretty soon, right? So I'm going to give the ventilator 35-year-old." So that's a really important law, especially right now, in this context.

There's a bunch of other federal civil rights laws like title six, section 504, and the Americans with Disabilities Act. And sex discrimination provisions that also would apply to older adults as well.

You were talking about earlier about potentially, some laws that we should be looking out for that might be weakening: A newer law known as section 1557 of the Affordable Care Act, which is the ACA is nondiscrimination provision. That basically strengthened nondiscrimination protections specifically in health care, because it recognized that healthcare is kind of a different beast and that we really want to make sure there are strong nondiscrimination protections in that specific context. Even though section 1557 is not specific to older adults, we all know how important health care is for older adults. In particular, as we age, as a community ages, being able to access prescription drugs, being able to access home and community-based services -- that's fundamental to being happy and staying at home. A law like section 1557 is so important to older adults. And in particular, what we're seeing under this Administration, unfortunately, is a real effort to curve back some of those protections. To end the regulations and enforcement. To take some teeth out of what were really strong laws. I know a number of lawsuits have been filed. We are working on advocacy to try and maintain parts of the nondiscrimination rule. And we'll ultimately see where it goes.

Peter Kaldes 10:27
You mentioned the implications of these laws on older adults who need healthcare, but also, increasingly, more and more older adults are reentering, or forced to stay in the in the workforce, and are looking for jobs right now, particularly during a pandemic. Can you talk a little bit about the age discrimination cases specifically? I understand that it's quite difficult to succeed at such a case. I know, through some of our new efforts here at ASA where we're going to be providing some summary of up-to-the-minute legislative initiatives on the Hill around matters related to older adults, there are a couple of proposals that are looking to tweak the amount of evidence you need to win on a case. And I'm wondering is that because the case laws, the burdens pretty high?

Denny Chan 11:27
Absolutely. You're spot on in identifying and sort of crystallizing how difficult it is. There's a separate federal statute known as the Age Employment Discrimination Act that governs and protects against employment discrimination, specifically for people who are over 40 years old. And the way that the Supreme Court has interpreted that statute, unfortunately, has meant that people have to show that the reason they were fired was because of their age, the exact reason. It's a concept in legal jargon known as 'but-for causation.' So you have to show that it was this and no other factor that influenced the adverse employment decision.

The way that discrimination works is that especially in 2020, it's subtle, it's implicit. It's not spoken. It's so hard already to make a strong case with solid evidence even without that kind of evidentiary standard. But because the standard is so high for private-sector employees, that's why these sort of legislative efforts are so important, because it's really modernizing discrimination law. There are very few circumstances where people are going to run up in a situation and the prospective employer will say, "I'm not hiring you because your too old," and that person gets it on tape and therefore rushes to court. That's not how this stuff works. It's much more subtle. It's much more implicit. And so hopefully legislative changes will make a difference because my opinion is that the statute has been interpreted to be impossible to win on these kinds of age employment discrimination claims.

Peter Kaldes 13:20
Yeah. One thing you said there that the standard is higher for employees in the private sector, that implies that it's different for employees of the public sector?

Denny Chan 13:30
That's right. Interestingly enough, the Supreme Court earlier this year issued an opinion that was specific to how the Age Employment Discrimination Act works with respect to federal government employees. And there it is not a 'but for causation' standard. They don't have as high of an evidentiary standard to meet. It was a very strong opinion, eight to one. It's a really good opinion, it probably should be what should be applied more broadly to private-sector employees as well. But that's ultimately why we have a split right now. And means that, at least with respect to federal employees, they have in theory with respect to the way the Supreme Court has interpreted the case law, an easier standard to meet.

Peter Kaldes 14:23
Wow, I could continue geeking out on that difference, but I don't want to bore our listeners who aren't lawyers. But it's an important distinction, particularly if you're a federal employee who's an older worker. That's a really critical distinction. So thank you for raising that and bringing that to our attention.

I want to turn a little bit to what's going on right now in our country. We're at a time of civil unrest. So I want to talk and ask you, from your perspective and the work that you're doing at Justice in Aging, how have the issues around police brutality changed your work in any way?

Denny Chan 15:01
Peter, I think that's a really timely question and one that I don't take lightly and that we at Justice in Aging and don't take lightly. If we think about our work at Justice in Aging, our mission to fight senior poverty, poverty and race in this country are inextricably linked. You can't undo the two. And so our work already has to recognize that we are working within systems that are inherently racist and implicitly racist. And what we're seeing with all the efforts around grappling with the COVID-19 pandemic, is that communities of color are much harder hit. We know that. And we know, in particular, for ASA members, older adults in communities of color, older adults in nursing facilities are extremely hard hit. And so we see the effects of racism. And what I would argue is that there's racism behind police brutality and that what has ignited demands for justice. That's the same racism that causes disparate outcomes in nursing facilities for nursing facility residents of color. It's the same system. They have different manifestations, different symptoms, but it goes back to the same notion. At Justice in Aging, we're taking really seriously this notion because this is really crystallized how important civil rights protections are for older adults, for other communities, older adults who live at the intersection with different identities. And it's really a moment where we have to think critically about that. And not just think critically about it, but think about the ways in which our own practices and systems might be contributing, or implicitly contributing to that kind of work.

Peter Kaldes 16:57
I want to talk about one specific area of your work. And that is around healthcare. When it comes to discrimination against older adults in a healthcare context, can you speak to how that really happens in practice? And what safeguards there are against it?

Denny Chan 17:13
It comes up, depending on the older adult, in so many different ways. You could have an older adult who is denied admission to a nursing facility because they're LGBTQ. Or you have an older adult who is limited English proficient and they don't get an interpreter. And then they don't understand what's happening and they get a bill. All of that is discrimination at work in the healthcare setting. And what's fortunate is that, as I was saying before, we have a lot of strong federal civil rights laws that protect against that kind of discrimination and one that's specific to health care, section 1557 of the Affordable Care Act. Unfortunately, this administration under President Trump is really trying to gut parts of the regulations implementing that statute. Ultimately, you can't change the law. President Trump can't single-handedly change the law. And so the law is still there, discrimination is still unlawful. So if people aren't being welcome in congregate living settings because of their LGBTQ identification, or if they're not getting an interpreter or whatever the case might be, that's still unlawful, regardless of what the administration is trying to do in terms of tweaking around the edges and weakening certain protections.

Peter Kaldes 18:38
You know, as you were talking, it occurs to me that there's an awful lot of work to be done at the intersection of race and age, or sexual orientation and age. And I'm wondering, how do these types of cases play out? And how might our ASA members, for example, help to guard against such discrimination?

Denny Chan 19:00
Those are really important questions. I have older adults in my life and I know that based on who they are, that life isn't always easy or fair for them. And I also know that there's huge cultural pressure, depending on what community you are in, to make do with what you have, and to not speak up. And so one big problem for advocates is a severe underreporting of civil rights and discrimination issues. Older adults are not looking to make a fuss, they're not looking to rock the boat or make a big deal out of things. But we have all these systems set up to handle reports, to handle complaints. And I will give the Administration some credit. The Office of Civil Rights under the Department of Health and Human Services is investigating COVID-related age discrimination and disability discrimination very closely. They have closed a number of investigations in states across the country, shutting down guidance that could be problematic for older adults. So, in some areas, they have shown a commitment to try and make sure that states are getting it right during the pandemic. But all of that is reliant on people reporting cases and issues. I don't want to put the burden entirely on older adults. But the other piece here is how can ASA members, massage that right? How can you encourage people to speak up? How can you encourage the older adults that you're working with to file those complaints?

Even if it's not filing a complaint, because that could sound really scary and foreign and who knows what those consequences are, at least have an honest conversation with them about things like this. About civil rights violations or potential civil rights violations. That might sound so severe, but you might want to frame it as something unfair that happened to you. And just venting about it and talking about it. And from there advocates can sort of figure out obviously in partnership with the older adult, is, is it something to file a complaint about? But I think the hardest part is trying to push for change when sometimes these agencies will say, "Well, we don't get complaints," or, "We don't get requests." And we know empirically that the need is out there, but people get by with everything else that they have. They're not looking to make a big deal out of things. And that's one sort of mentality that I hope ASA members really help massage and really help shift in terms of older adults in this country.

Peter Kaldes 21:37
That's a great point. I'd love to flesh that out more, but you said something also about HHS actually investigating certain discriminatory actions. Which I think is great. It demonstrates a real commitment to those sorts of laws. But I'm wondering if you could comment on civil rights across the board with this Administration. It feels as though things have gotten a little tenuous. And there's an inconsistent application of these laws. Can you speak to specifically your observation on that and what we might expect in the future?

Denny Chan 22:17
This administration has not championed civil rights. They have not championed civil rights for older adults, they have not championed civil rights for older adults of color, LGBTQ older adults. What we've seen them do with trying to weaken the protections in healthcare against discrimination is a real gutting of some very strong protections that existed before. Generous language would say, they're, at least on the face, inconsistent, to be really enforcing rules and civil rights protections in COVID settings, as it pertains to crisis care standards. But then also to be gutting important civil rights laws on the other side at the same time. Literally in the same month. I think we will continue to see that kind of weakening. And I also think it's important to point out that this Administration, I talked earlier about the public charge rule and scaring immigrants from using public benefits. They've done a number of things around DACA. They've done a number of things around transgender individuals in the military. This exists in a much larger strategy to shake the very strong foundation of civil rights in this country. And they're going to continue to shake it until they're out of office. Until they think their work is done. I think that's a really important thing to keep in mind. These are not individual, isolated incidents. This is part of a long-term strategy. And fortunately, only recently we've seen some checks come in on the power of the Executive from the Supreme Court. But I think it's really important and shows you just how critical civil rights protections are in this moment.

Peter Kaldes 24:11
And just to geek out with you again, I think some of those Supreme Court checks are really more about process than substance. Right? It's simple administrative law that was basically ignored in some of those cases. I want to share your optimism about the Supreme Court, but it was just some simpler rules following with respect to administrative law I suspect. But I let's let's go back to something you said earlier, about how ASA members can help identify and report on cases that they may see. Can you just sort of give us a primer, if you will, on how to best support older adults who have faced discrimination?

Denny Chan 24:52
Sure. I think part of it is down to that one-on-one interaction with the trusted social worker of a trusted face for that older adult. You asked earlier about the moment that we're living and police brutality. And I think that there's a role for ASA members too. To be thinking critically about, what are our internal practices? How do we get cases? How do we choose which older adults to support and which older adults not to support? Where are we spending resources? All those are organizational questions that ASA members have the ability to change. We're not talking about huge structures here. You can look at the data and look at who you're serving, how you're serving them, what the utility utilization rates are, the outcomes, all of that is a knowable universe. And I think that's where we want to start, you know, having some internal dialogue and conversations. I'm hoping that the moment that we're living in will offer and support a reimagined boldness and newness to how aggressive we can be in ensuring that our systems are fair for everyone. That's where I see ASA members doing that internal evaluation. Are our staff matching the communities that we serve? How do we go about recruitment and retention? All those things are part of building a sector that will work better for the older adults that we serve.

Peter Kaldes 26:31
I think that's right. I also think that a lot of our ASA members have such wonderful community resources at their fingertips. Whether it's a pro bono legal aid type of organization or even young Attorneys at Law Firms love to take on interesting pro bono matters. These types of cases would be so juicy and interesting for that kind of litigator who's interested in civil rights work and this is very much the civil rights work of our time right now. So those are great tips, Denny

Peter Kaldes 27:05
I want to end on one question that I've been asking all our guests here on the second season of Future Proof. This is has been focused on equity and justice and I'm just curious, from a personal perspective, what attracted you to this work? Why are you doing this work?

Denny Chan 27:25
I will try to give you the primer version, not the long version. Civil rights work and thinking about older adults and equity is something that's near and dear to my heart. I think largely influenced by the value that older adults in my life have. Specifically, my maternal grandmother who is still alive and I think about a lot in doing the work that I do. She is an 87-year-old immigrant from China and barely speaks any English, lives by herself because my paternal grandfather passed really early. And I think about all the struggles that she endures to get prescription drugs or to have someone come and help her with activities of daily living. And I think about whether and how the system is either set up for her or sometimes not set up for her. That's really what keeps me in the fight and keeps me grounded. Because there's, as you were saying before, there's been an assault, and as I said before, there's a shaking of the civil rights bedrock that our country exists on. And so I think about her a lot, and I think about other older adults who have led the civil rights movement in important ways by serving as plaintiffs in important civil rights lawsuits, like in some of the marriage equality decisions. All of that is where I draw my inspiration and where I continue to get my fight.

Peter Kaldes 28:59
I'm glad you do, because we need more fighters like you fighting on behalf of older adults because there's a lot to fight about. So, Denny, thank you so much for joining us and for all the good work that you're doing at Justice in Aging. And I want to invite you back because I think there's a lot of great stuff we can talk about if you're willing to.

Denny Chan 29:22
Of course, thank you so much for having me today.

Peter Kaldes 29:25
And thank you, everyone, for joining us on this episode of Future Proof. Remember to visit our website to find out about new episodes coming up in this season on equity and justice. Thank you, everyone.

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School Openings: Let's think about the WHOLE community - Multigenerational Families

asa_admin — Thu, 13 Aug 2020 22:07:29 +0000

School Openings: Let's think about the WHOLE community - Multigenerational Families asa_admin Fri, 08/14/2020 - 00:07

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As schools and communities around the country grapple with the question of whether or not to open for in-person learning in the fall, we thought we’d check in with a family, and recently spoke with members of a multigenerational household in North Carolina. Camerina Nava Gutierrez has lived with her daughter, Kimberly Nava Eggett, and her family for eight years. Kimberly, a teacher, has two children in elementary school.

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In this video Camerina and Kimberly discuss how they talk to the kids, who are ages 8 and 5, about staying safe, their concerns about returning to the classroom and how they are managing during the pandemic.

As school districts weigh the risks of in-person learning, the American Society on Aging urges everyone to keep our diverse, multigenerational communities in mind. We know that older adults, particularly those with comorbidities or compromised immune systems, are vulnerable to COVID-19.

Some statistics to keep in mind:

64 million people live in multigenerational households in the U.S.–that’s 1 in 5 Americans
18 percent of teachers are older than age 65
27 percent of principals are older than age 65
2.7 million grandparents are raising grandchildren nationwide
16.8 percent of American adults are providing care for someone older than age 50. This means that about every sixth school employee is caring for an older adult at home

Raise Awareness on social media by downloading and sharing these images

School Openings: Let's think about the whole community. 2.7 million grandparents are raising grandchildren nationwide

School Openings: Let's think about the whole community. 64 million people live in multigenerational households in the U.S.

School Openings: Let's think about the whole community. 18% of teachers and 27% of principals are older than 65

Video Transcript

Kimberly Nava Eggett 0:14
My name is Kimberly Nava agate and I live in Asheville, North Carolina with my lovely mom.

Camerina Nava Gutierrez 0:20
My name is Camerina Nava Gutierrez, thiers. And she's my daughter, my oldest daughter.

Kimberly Nava Eggett 0:31
It's funny, like, someone asked me in my 20s if I would have my mom lived with me. I would be like what? My mom lived with me. That's not what we do. But it is what we do in certain cultures, right? But there are other cultures. So my American side of me was having a hard time understanding that but my Mexican side was like, "Oh, wait, but that's how I grew up too." My grandmother was in my household.

And so having to navigate being in a pandemic, but also having to ensure that my kids are still getting some learning done was a struggle. My role at our elementary school is digital lead teacher. So I'm also the point person of support for technology. So, as you can imagine, my days were filled with people just trying to figure out how to do Google Meet and what that look like with their classrooms.

Camerina Nava Gutierrez 1:27
I just tried to keep him busy doing some activity or playing with them. And and I just tried to do what I can, you know, maybe cooking, cleaning, you know, so she can focus on whatever is most important for her, you know.

Kimberly Nava Eggett 1:50
We had to be okay with the fact that my kids weren't getting what they needed to educationally because they're getting other things that we wouldn't have gotten. They wouldn't have that time with their grandma to be able to just sit and paint.

As of right now for the district I work with we're looking at starting off with a staggered start. So when kid goes in for one week, and then they have a full week off, and at that "off" supposed to be at home learning. And that is a source of stress for me as a teacher, because I still have to report to work every day.

Camerina Nava Gutierrez 2:30
My concern is when they go... the truth is a lot of families, they don't take care of themselves. So when they send their kids to school, it's gonna be a different picture. I'm just concerned that it's gonna be kinda

Kimberly Nava Eggett 2:52
Families with different expectations or rules.

Camerina Nava Gutierrez 2:56
Yeah, so I really cannot even picture it because it's just so hard either way. Yeah. So hopefully w'ell be okay.

Kimberly Nava Eggett 3:10
You know, at our at home we've built some really good habits where every time they come in from outside even if it's just by themselves, they come in and wash their hands. That's just been a routine for them. They know every time we leave the house we have our face masks on. So for my kids putting on a face mask has been as I can is a habit.

Camerina Nava Gutierrez
Like a a routine.

Kimberly Nava Eggett
It's really weird to hear a five year old say, "6 feet 6 feet!" you know, yelling at a friend but it's something that they're hearing. Whether or not they actually know what six feet looks like, that is a different story. But it's that messaging that we're trying to help.

I know we have older teachers and I know there was one teacher that said I'm so glad I retired last year so I don't have to worry about this because her brother's auto immune compromised. We had a teacher, she's a younger teacher, but she takes care of her mother who has health issues. And she went ahead and resigned last week and found another job as a remote learning teacher with some sort of national program. And so folks are having to make decisions and we're losing staff.

I can't even imagine how I would feel if she were not in our home during the pandemic, at least I know, health wise, how she's doing. I there wouldn't have to be this distance between us because I know there's some families who haven't been able to see their grandparents because they're not living with them or because of their health situation. So I am pretty grateful. Even pre pandemic, just the economic downturn has also causedfamilies to become more intergenerational and that being more of something that we're seeing in families because safety nets are there like they used to be. And so it's worked out for us and so we, when we encourage other people,

Camerina Nava Gutierrez 5:21
Yeah, I'd like to say, I never thought I was gonna be here with them. I'd say no, they need to have this, you know, space but sometimes life turn around. Like she said, I am so grateful to be with them and to see the grandkids every day.

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Kimberly and Camerina

Voices on Caregiving: Cynthia Banks

asa_admin — Thu, 13 Aug 2020 22:02:49 +0000

Voices on Caregiving: Cynthia Banks asa_admin Fri, 08/14/2020 - 00:02

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