Lance Robertson, ACL Administrator and Assistant Secretary for Aging

Lifting up Voices for World Elder Abuse Awareness Day

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WEAAD Logo

Tomorrow we join the world in speaking out against the abuse, neglect, and exploitation of older adults for World Elder Abuse Awareness Day (WEAAD). This day is about coming together to reaffirm that older adults are equal members of our communities, entitled to all the same dignity, rights, and security that each of us would expect at any age.

We salute those working to combat elder abuse, in the context of individual victims and individual perpetrators. There are many dedicated social services and law enforcement professionals across the country doing critical front-line work to advance elder justice on a case-by-case basis. ACL is proud to be supporting this work with a variety of grants and initiatives to enhance state Adult Protective Services, collect data on the scope and nature of adult maltreatment, and advance research on innovations and best practices.

At the same time, I want to challenge us to think bigger and commit to creating a society that is good, and just, for all its members. Thinking through this lens means considering our attitudes about aging; the community, social, and religious institutions that keep us connected to each other; and the services and supports that empower us to remain engaged in our communities as we age.

It also means acknowledging that elder abuse is not a problem for “someone else” to solve. Every one of us shapes the communities in which we live, therefore, every one of us has a role to play in advancing elder justice.

We can each work to challenge negative attitudes about aging, to reinforce the value of older adults and their contributions to society, and to promote a culture that looks out for each other. We can come together to ensure that our communities provide services such as meals and accessible transportation that help older adults stay in their own homes, participating fully in their communities.

Every community is different and there is no magic formula to creating this just community. But across the country, we see how these community-level approaches have benefited community members of all ages. After all, we all benefit from the voices, experiences, and wisdom of elders.

This year's WEAAD theme is lifting up voices.

Having a voice is, at its core, a matter of dignity. This theme was selected, in part, to highlight the shared values of the elder justice movement and the movement responding to violence against women, which has demonstrated the power of survivors’ voices.

It is a sad reality that older adults who face abuse, neglect, or exploitation often do so in silence. One study found that for every reported case of elder abuse, 23 cases go unreported. When we lift up the voices of survivors of elder abuse, we assert that they are entitled to dignity as opposed to stigma or shame. Victims should never feel embarrassed or feel that they are responsible for the abuse they experience.

Having a voice is also about having as much control over your life as possible. This is one reason why ACL is working with grantees — including the American Bar Association’s Commission on Law and Aging — to advance guardianship reforms, to prioritize ways of supporting decision-making of adults through a wide range of options, and to address abuse and financial exploitation by guardians and others. ACL also is funding a national resource center exploring one alternative to guardianship that considers the areas in which each individual does, and does not, need support.

Supporting the shift toward more tailored legal support arrangements is just one example of how ACL is incorporating person-centered thinking — which considers each individual's preferences, values, and strengths — across our programs.

Tomorrow, the whole world speaks as one against elder abuse and lifts up the voices of the millions of older adults who have experienced abuse, neglect, and exploitation. But building just communities — where people of all ages and abilities are included, equal, and safe — is year-round work. I am grateful that so many people of all ages are answering this call and I am honored to roll up my sleeves and join you in this effort.



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Older Americans Month: Connect, Create, Contribute

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Every day, all around us, older adults make a positive impact in our communities. As employees, volunteers, mentors, and advocates, they are an integral part of America’s social fabric. Their experience and insights enrich and strengthen our neighborhoods, workplaces, and families.

That’s why ACL takes time each May to honor their valuable contributions and celebrate Older Americans Month (OAM). People of all ages can celebrate OAM and help older adults thrive. With the 2019 theme, Connect, Create, and Contribute, ACL invites you to:

  • Connect with friends, family, and services that support participation
  • Create through activities that promote learning, health, and personal enrichment
  • Contribute time, talent, and life experience to benefit others

ACL offers information about resources to assist older adults, family members, care providers, organizations, and neighbors connect, create, and contribute. We have also put together a list of suggested activities to celebrate OAM.

We encourage you to Connect, Create, and Contribute for stronger communities this month and throughout the year. Visit acl.gov/oam for ways to get started and watch our blog for upcoming posts that explore ways to connect, create, and contribute in your communities.

Follow ACL on Twitter and Facebook, and join the conversation using #OAM19 and #ConnectCreateContribute.

Older Americans Month logo


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New Data Highlights the Long-Term Care Ombudsman Program’s Legacy of Service

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Today, ACL posted new data on the Long-Term Care Ombudsman program’s impact in fiscal year 2017. Looking through the data, I am struck by both the scope and the impact of the work that ombudsmen do every day.

As the Ombudsman program enters its 40th year as a mandatory program of the Older Americans Act, I want to take this opportunity to reflect on some of the data ACL has compiled, highlight some of the amazing work done by programs across the country, and discuss some important developments for the future of the program.

I would like to start with the story of just one of the more than 200,000 complaints Ombudsman programs resolve annually. The complaint came from a nursing home where residents had to walk along a busy road to access the surrounding neighborhood.

The absence of a sidewalk presented a daily hazard to residents and had already resulted in one resident being hit by a car. That resident reached out to the Long-Term Care Ombudsman office who worked with the resident, their local Ombudsman advisory council, and, eventually, city leaders to get a new safe sidewalk built outside the facility.  Now, residents can travel with greater freedom and safety.

Ombudsman programs respond to a wide variety of problems faced by residents of long-term care facilities, including discharge and eviction, inadequate care, violation of rights, and quality of life concerns. In fiscal year 2017, Ombudsman programs provided regular visits to 60% of all nursing homes and 30% of all other residential care communities in the country. They also provided over 400,000 instances of information and assistance on resident rights, care, and community options to residents and their loved ones and over 125,000 instances of information and assistance to facility staff on issues of discharge planning, care, rights, and abuse prevention.

The most common types of complaints Ombudsman programs received involved improper eviction or inadequate discharge planning, Ombudsman programs worked to resolve over 14,000 such complaints in fiscal year 2017.

In addition to addressing individual complaints, Ombudsman programs also advocate for resident interests in public policy arenas. In fact, the OAA requires Ombudsman programs to analyze, comment on, and recommend changes in laws, regulations, and government policies and actions to benefit residents. On the issue of inappropriate discharges, Ombudsman programs have developed task forces, proposed legislation, trained both hospital social workers and long-term care facility staff on relevant requirements, and trained residents and their families on their rights regarding discharge and transitioning out of a long-term care facility.

Staffing shortages are another prominent issue many Ombudsman programs are working to address through systems advocacy. Ombudsmen are working in partnership with both the long-term care provider industry and state agencies, including workforce commissions, to identify solutions to the workforce shortage, including wage increases, expanded benefits, additional direct care worker training, and the development of public awareness campaigns to elevate the profession. Ombudsman programs are also advocating for improved state laws or regulations to support adequate staffing and training facility staff on topics such as abuse prevention, person-centered care, and dementia care.

Many state Ombudsman programs utilize volunteers, designated as representatives of the Office, to work on behalf of the Ombudsman. Thousands of volunteers across the county donated their time, talents, and energy to visit residents, listen to their concerns, and take action to resolve problems. In addition to directly helping resolve complaints, volunteers help Ombudsman programs make the most of limited resources. In fiscal year 2017, volunteers contributed 591,363 hours, the estimated equivalent of over $14 million, to Ombudsman programs.

One volunteer’s story demonstrates the impact of this service. Several residents of a facility told this volunteer Ombudsman representative that they were not receiving enough food at meal times. The volunteer visited the facility and observed small portions that may have met the dietician's recommendations but left some residents still hungry. Through advocacy and persistence, she convinced the facility administrator to increase portion sizes so residents were no longer left hungry.

ACL is proud to support this critical work going forward. Here are three areas we are prioritizing as we think about the future of the Ombudsman program:

  • Implementing the Ombudsman Program Final Rule: ACL’s first-ever Final Rule on States’ LTC Ombudsman Programs took effect in July 2016. Among other things, the rule provides specific guidance related to LTC Ombudsman resolution of abuse-related complaints and abuse reporting and emphasizes the role of State Units on Aging in providing elder justice coordination and leadership. ACL continues to work with every state to ensure compliance with the rule and we have been encouraged by the progress we have seen in 2018, including changes to program policies and procedures, regulations, and even some legislative changes.
  • Ombudsman Program Evaluation: ACL is currently evaluating the program to understand service delivery models. This process evaluation will help ACL lay the foundation to evaluate program impact and efficiency and represents the first comprehensive, national evaluation of the Ombudsman program since 1995. ACL anticipates completion of the process evaluation this year and we are in the beginning phase of an outcome evaluation.
  • National Ombudsman Reporting System (NORS) Data Collection: All of the statistics above are from data collected through NORS. ACL is revising the data collection required of state Ombudsman programs. The new data collection will begin October 1, 2019; the changes were developed in coordination with state partners and Ombudsman programs and seek to reduce reporting burdens, improve data usability, enhance ACL’s understanding of program operations and resident experiences, and reflect developments in program operations and long-term services and supports systems.

The Ombudsman program is rooted in a simple, yet powerful, principle -- that all older adults and people with disabilities are entitled to equal rights, dignity, and a life free of abuse no matter where they live. As I reflect on the accomplishments of the last 40 years, and the important work that lies ahead, I am grateful for the service of so many Ombudsman staff and volunteers who work to make this vision a reality every day.

Comments

Patty Ducayet - Thu, 03/07/2019 - 16:13

It is my great honor to serve as a long-term care ombudsman for over 15 years, and I deeply appreciate this post highlighting accomplishments of the Ombudsman Program. I am in awe of the work of thousands of dedicated and caring volunteers, and the tireless tenacity of staff ombudsmen across this country. It is a privilege to share our expertise with residents and their families as they navigate the complex world of long-term care! And, it is gratifying to read the respect and support that our Assistant Secretary lends us in this great program. Thank you!

Melanie McNeil - Fri, 03/08/2019 - 07:09

Thank you for highlighting the critical work and creative ways that Long-Term Care Ombudsman Representatives serve long-term care residents. We appreciate the support from ACL for the work we do, from empowering residents to speak for themselves to advocating with or for them at their facility to representing residents when we talk to policy makers, we know that ACL stands behind us in our work.



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EJCC: Advancing Elder Justice in Rural and Tribal Communities

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Assistant Secretary for Aging Lance Robertson greets Assistant Secretary for Health ADM Brett P. Giroir
Assistant Secretary for Aging Lance Robertson greets Assistant Secretary for Health ADM Brett P. Giroir

What is the point of offering the highest quality medical care or support services if they cannot be accessed by those who need them the most? 

This was the question posed by Dr. Jason Burnett of The University of Texas Health Science Center at Houston during today’s meeting of the Elder Justice Coordinating Council (EJCC), which I had the privilege of chairing. The EJCC brings together leaders from across the federal government to address issues of elder justice nationally. Council members include the leaders of federal departments, agencies, and entities administering programs related to elder abuse, neglect, and exploitation.

Today's meeting focused on the unique challenges to advancing elder justice in rural and tribal communities. Last month, I had the privilege of participating in the Department of Justice's Rural and Tribal Elder Justice Summit in Des Moines, IA which provided important context and information for today's discussion. Americans in rural communities often face greater risk of isolation and have access to fewer support services.

Dr. Burnett highlighted the emerging role of tele-health and tele-medicine in helping people in rural communities access medical and social support services. For example, the TEAM- Forensic Assessment Center Network allows Houston-based geriatric and elder abuse experts to connect with Adult Protective Services (APS) caseworkers and their clients across the state. One key to the program's success is the use of virtual in-home client assessments conducted via Apple's FaceTime service. The Department of Veterans Affairs is also taking advantage of technology to allow older veterans to access their Gerifit exercise program virtually.

The committee also received an update on the opioid crisis and its impact on older adults from HHS Assistant Secretary for Health ADM Brett P. Giroir. ADM Giroir described the opioid epidemic as "the most important and challenging public health crisis of our time" and noted that it effects Americans of all ages. ADM Giroir also reviewed the five point plan announced by Pres. Trump to combat opioid abuse, misuse, and overdoses and spoke about the importance of addressing inappropriate prescribing in a way that does not deny necessary medications to those experiencing pain.

The connection between elder justice and topics like the opioid epidemic and tele-medicine may not be obvious at first glance, but we know that the factors that contribute to elder abuse are complex, and our response to it must be multi-faceted. Over the coming weeks we will be asking you to share your thoughts on the EJCC’s priorities moving forward. I hope you will share your perspectives and experiences with us.

I am encouraged by the growing recognition of elder abuse as a problem we must all work together to end. On Friday, the front page of USA Today highlighted new data on elder abuse from ACL's National Adult Maltreatment Reporting System, and this summer, the Senior Safe Act became law. The new law encourages financial institutions to report suspected abuse to the proper state or federal law enforcement authorities with the promise of immunity for those who undergo training and report suspect elder financial exploitation in good faith.

I am heartened by the work that my colleagues across the federal government, and so many dedicated front-line professionals, are doing to advance elder justice. Thank you for standing up for the right of all Americans to live with dignity at any age.



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Commemorating October 1st 2018 - International Day of Older Persons

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IDOP 2018

Today, on the International Day of Older Persons, the United States joins communities around the world to pause and reflect upon the contributions of older people globally, and also to encourage all nations to thoughtfully consider and address the challenges faced by older people.

 

This day has been recognized annually since 1990, when the United Nations first designated October 1st as the International Day of Older Persons. In the intervening 28 years, the world’s population demographics have changed dramatically. The share of the world’s population that is 60 years or older has grown dramatically, and continues to do so. Nearly a billion people living today are 60 or older, and by 2050, there will be more than 2 billion older adults in the world. Here in the U.S., 10,000 adults turn 65 every day.

 

Despite their growing ranks, older adults are far too frequently victims of discrimination, exploitation, abuse, and neglect. Older adults commonly face discrimination in work settings, healthcare environments, and settings of law and justice.  Discrimination against older persons is unique, because when you discriminate against an older person, you are simply discriminating against your future self. We all aim to reach a healthy old age, and yet we allow ageist discrimination to persist.

 

As the Assistant Secretary for Aging and Administrator for Community Living (ACL), it is my honor to lead the agency in the federal government dedicated to promoting the rights of older persons, including supporting their independence, health, and well-being. This also means recognizing older adults’ many contributions to our society. They are grandparents, parents, great aunts and uncles; they are friends and mentors; they are community leaders and volunteers; they are also elected officials, and critical contributors in the workforce. Clearly, our communities are stronger when everyone has the opportunity to contribute their talents.

 

We must all work together: in our communities, across the nation, and in partnership with other countries, to promote policies that recognize and make use of the experience and capabilities of this growing population. This is particularly true as people are living longer and staying healthier for more of those years. The theme for this year’s International Day of Older Persons is “Celebrating Older Human Rights Champions.” I am proud to say that ACL supports the efforts of local and national leaders who champion the rights of older adults every day.

On this year’s International Day of Older Persons, and every day going forward, let’s make a committed effort to ensure that every person has the opportunity fully participate in their communities, throughout their lives.

Comments

Colette Cordova - Fri, 10/05/2018 - 20:13

Thank you for you advocacy ! We are lucky to have someone with empathy and cares about older persons at the helm of acl; as a we know aging begins at birth. Glad you made a visit to Toledo for our Opiod Town Hall. As you see I am doing the homework you assigned: searching the acl.gov website
PS ironically this day has double meaning for me as it was the day I was diagnosed with breast cancer . I too am celebrating 28 years on October 1st!! I was told I had 6 months to live. Well I am still here and fighting for seniors every day! Onward and upward on behalf of older adults.

Kiggundu Samuel - Tue, 04/09/2019 - 21:07

Thanks so much for the older persons advocacy in the world. We are doing it in Uganda www.bagonvuelders.org and https://www.facebook.com/Bagonvu/

We are open for any partnership in organizing 2019 year of older persons



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Celebrating 50 Years of the Architectural Barriers Act

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Lance Robertson, ACL Administrator and Assistant Secretary for Aging

Access Board ABA Anniversary Event PanelAs chair of the U.S. Access Board, I had the privilege of participating in an event today celebrating the anniversary of the Architectural Barriers Act (ABA) of 1968 and the fifty years of progress it helped spark.

Before the ABA was passed, accessibility standards were often inconsistent -- and just as often ignored. The American National Standards Institute developed the first accessibility standards in 1961 with the help of Easter Seals and the research of the University of Illinois. Many states used these early standards to develop accessibility requirements in their building codes. However, other states adopted access requirements that ranged from lax to nearly nonexistent. This resulted in great discrepancies in accessible design requirements from state to state, and in some cases, from city to city.

This had real life impacts. It meant that a wheelchair user could easily go to the post office in one town but not in a nearby state or community. The same problem existed with respect to sidewalks, entrances, bathroom stalls, paths of travel, signage, and everything else that makes a building accessible.

The Architectural Barriers Act helped solve this problem by creating a mechanism for developing and setting clear and consistent nationwide accessibility guidelines for the federal government. It literally began to open the doors of government to Americans with disabilities like never before by requiring buildings constructed or renovated with federal funds, as well as those owned or leased by the federal government, to be accessible and usable by people with disabilities. For the first time, schools, housing, offices, courts, hospitals, stadiums, post offices, and countless other facilities were available to people with disabilities.

This did far more than eliminate physical barriers. It helped level the playing field by promoting greater access and equal opportunity to public education, colleges and universities, community living, employment, health care, and more. In this way, the ABA helped pave the way for the last five decades of civil rights advances for Americans of all ages with disabilities.

One of the law’s lasting legacies is the innovation in design and technology it helped spur across the private, public, and nonprofit sectors. Over the years, the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) and the Access Board – together with many other federal agencies – have invested significant resources, time, ingenuity, and rigor in generating and effectively sharing new knowledge to improve the opportunity and ability of individuals with disabilities to access the built environment, technology, and the digital world.  The quest continues and so does the return on investment.

We at ACL are especially proud of the important role the Access Board and NIDILRR have played in advancing the science, discipline, and esthetic of what we now call universal design. Universal design uses a broad-spectrum of ideas and methods to design and develop buildings, products, and environments that are inherently accessible to all people of all ages and abilities.

As he was signing the landmark Americans with Disabilities Act into law in 1990, President George H.W. Bush said the law would take a sledgehammer to the shameful wall of exclusion that has prevented far too many with disabilities from exercising their full rights and responsibilities. It is important to recognize and celebrate that the first blow against this wall was struck by the Architectural Barriers Act and those that made it possible. 

We are a better nation and a better people because of it, and we remain committed to advancing the principles behind it.



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Centers for Independent Living Make Community Living Possible

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Lance Robertson, ACL Administrator and Assistant Secretary for Aging

At ACL, our goal is to make community living possible for everyone. We believe community living should always be the expectation, and that older adults and people with disabilities should be able to live alongside people of all ages, with and without disabilities, with the same opportunities to learn, work, and play. One of the ways we are working to make that principle a reality is by funding services, support, and training to help older adults and people with disabilities achieve and maintain independence. These programs are primarily provided by community-based organizations, such as centers for independent living (CILs).

On Wednesday, Deputy Secretary Eric Hargan and I had the pleasure of visiting with staff and consumers from three D.C.-area CILs:  the Endependence Center of Northern Virginia (ECNV), Independence Now (MD), and the DC Center for Independent Living (DC CIL).

Centers for Independent Living are community-based, cross-disability nonprofit agencies that provide services and opportunities that enable people with disabilities live independently. The defining feature that makes CILs effective is that they are consumer-controlled, meaning they are run by and for people with disabilities. Several people mentioned how meaningful it was to them that the people offering services, training, and support have faced and addressed similar barriers. They share similar hopes and aspirations. For CIL consumers, CIL staff become trusted peers, mentors, and role models.

As ECNV Executive Director James Garrett put it, “the beauty of CILs is that it is a very holistic approach.”

Here are a few of the people we met:

  • Tyree is a talented young artist who experienced a spinal cord injury while in college. She was told to expect to spend the rest of her life in a nursing home. Independence Now helped her transition out of a nursing home, ride a bus for the first time since her accident, find accessible housing, and get tuition assistance and accommodations to complete her degree at the Corcoran School of Art. Though she primarily drew with her right hand before her accident, she learned to draw with her left hand and she shared with us two beautiful portraits she recently completed.
  • Josephine’s mother had been her primary caregiver since she had a childhood stroke. When her mother became ill, Josephine decided it was time to become more independent. ECNV helped her move into a room of her own in a group home, learn to use public transit, and get six hours of personal care assistance a week through a Medicaid waiver. The combination of skills and support are helping her experience a new level of independence and work towards her goal of getting a job in the community,
  • Lynn worked with the DC CIL after losing her vision. The CIL connected her with orientation and mobility training and peer counseling to help her move around her community with ease and end her homelessness, securing a place that she moved into just this week. Lynn is now a disability advocate and facilitates a peer group for other people with disabilities.
  • Cali sustained a severe TBI and other injuries in a car accident when she was in middle school. Initially undiagnosed, the TBI caused cognitive processing and memory gaps. A straight-A student who had participated in her school’s gifted and talented program and won awards for writing, art and photography before her accident, Cali’s began to struggle, and her school system recommended she be moved to another school. ECNV helped Cali’s mother fight for the accommodations she needed to succeed, and continue to support Cali and her mother as they advocated for her to be able to participate in honors courses and school activities. Cali told us, "I had people put in my life, through grace, that helped me learn how to be myself but also how to tell people what I needed." Cali graduated high school at the top of her class and now organizes trainings on supporting students with disabilities for professors at her college.
  • Dianna spent years in a nursing home after an accident. “I never thought I was going to be able to get into the community again because I didn’t know how,” she said. With support from “the angels” at ECNV, she was able to find the housing and supports she needed to live in the community. “They helped me so much…I feel very blessed.” Dianna is an artist and a musician; painting was an important part of her life before her accident. Before her accident, she painted on large canvases hung on the wall, using a ladder. With the help of ECNV, she has adapted her technique to accommodate her disability, painting with the canvas on the floor. 

All of these people are living their lives on their own terms, because of their hard work and thanks to the help of their CILs. We’re proud of the work that CILs do to make it possible for people with disabilities to live independently, in their communities, alongside people without disabilities. Watch a video of our visit.

Learn more about Centers for Independent Living or find a local CIL. Download a graphic about how Centers for Independent Living make community living possible.

CIL consumers discussing their experiences
Top left: ACL Administrator Lance Robertson and HHS Deputy Secretary Eric Hargan look at Tyree's art. Top Center: One of Tyree's drawings. Top Right: Josephine speaking. Middle: group photo of meeting participants. Bottom Left: Lynn speaking. Bottom Center: Cali speaking. Bottom Right: Dianna speaking.



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Five Ways to Fight Elder Abuse, Neglect, and Financial Exploitation

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On the eve of World Elder Abuse Awareness Day, the Social Security Matters blog is featuring a guest post by ACL Administrator Lance Robertson offering practical tips to join the fight for elder justice.

As Americans, we believe that people of all ages and abilities deserve to be treated fairly and equally and to live free from abuse, neglect, or financial exploitation. Tomorrow, on World Elder Abuse Awareness Day, we join the world in recognizing the importance of elders to our communities and standing up for their rights. Here are five ways you can join this fight.

1. Break Down Isolation

We cannot talk about elder abuse without talking about social isolation. Elders without strong social networks face a greater risk of abuse, neglect, or exploitation. It is up to all of us to ensure that our communities are supporting and engaging older adults. One simple way to do this is by staying in touch with the older adults in your community. So go ahead and knock on your neighbor’s door just to say “hi” or start an intergenerational book club or movie night. You can also support community efforts to empower elders and fight isolation; act by volunteering to deliver meals or serve as a long-term care ombudsman.

2. Learn to Spot “Red Flags”

There are a number of “red flags” that could suggest the presence of elder abuse. Examples include:

  • Isolation (especially by a caregiver);

  • Unpaid bills or utilities that have been turned off;

  • Unusual or quick changes in a will or other financial documents;

  • Missing medications; and

  • Bruises or welts (especially on the face).

Even if you are not certain abuse is taking place, you can report any suspicions of abuse so a professional can investigate.

Read the full blog post and share this and other elder justice resources on social  media using #WEAAD.



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EJCC News: Opioids and Other Elder Justice Challenges

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Lance Robertson, ACL Administrator and Assistant Secretary for Aging
Dr. Mosqueda and members of the EJCC
Dr. Laura Mosqueda, Director of the National Center on Elder Abuse and Dean of the Keck School of Medicine at USC, describes how the opioid crisis is impacting older adults and answers questions from HHS Secretary Azar and Attorney General Sessions at the spring meeting of the Elder Justice Coordinating Council.

In nine days, we will join the world in commemorating World Elder Abuse Awareness Day (WEAAD). Elder abuse is, by definition, abuse that affects older adults, and yet every year on WEAAD I see people of all ages coming together to take a stand against elder abuse. This is because elder abuse doesn't just affect the person being targeted. Friends, family members, and neighbors all feel the effects. It affects anyone who is, or hopes one day to be, an elder living in a community where they are treated fairly and equally. And ultimately, it affects all of us, because at elder abuse strikes at our core values, which are predicated on human dignity and the right of all people to live their lives without fear of harm.

Similarly, opioid addiction doesn't just affect the person experiencing addiction. It affects everyone around them, and as we are seeing across the country, it can have devastating effects for the entire community.

And when these two issues overlap, the results can be heartbreaking.

Yesterday at the spring meeting of the Elder Justice Coordinating Council (EJCC), Dr. Laura Mosqueda shared the story of a hospice patient she treated many years ago. The patient was in great pain and Dr. Mosqueda, who now serves as Dean of the Keck School of Medicine at USC and Director of the National Center on Elder Abuse, was doing everything she could to help. She was baffled because increasing dosages of morphine weren’t helping with her pain. The answer came from a blood test -- the patient had no morphine in her system. She was in pain because someone else was stealing her medication.

Sadly, while the connection between substance abuse and the abuse of older adults has been known for decades, stories like this one have become more common in recent years as our country confronts a crisis of opioid addiction. The overlap was the primary focus of today’s EJCC meeting.

Attorney General Sessions and HHS Secretary Azar
Attorney General Jeff Sessions and HHS Secretary Alex Azar at the Elder Justice Coordinating Council Meeting. "Fraud targeting seniors is so common that no victim should feel ashamed to come forward and report it," Sessions told the group.

The meeting brought together leaders from a dozen federal departments and agencies to coordinate efforts to combat elder abuse and discuss the latest developments from the field. I was honored to be joined at the meeting by U.S. Secretary of Health and Human Services Alex Azar, U.S. Attorney General Jeff Sessions, and our gracious host Jay Clayton, Chairman of the U.S. Securities and Exchange Commission.

"We know that some older adults abuse opioids themselves and that many others also experience abuse, neglect, and exploitation by others as a result of opioid addiction," said Azar. "Across HHS, we're looking at approaches to help communities across our country that are suffering from addiction, including ways to support (Adult Protective Services) as they develop effective ways to prevent, detect and remediate the harm caused by opioid abuse"

“We will continue to prosecute the fraudsters, the crooked doctors, and the traffickers who are doing so much damage across this country and across all age groups,” Sessions noted. “I am confident that together we can put an end to this epidemic and ensure that every senior has the safety and peace of mind that they deserve.”

It is clear that the elder justice community needs to be prepared to address the increased cases of elder abuse resulting from the opioid crisis. It is also clear that the needs of older adults must be considered in any community response to the opioid crisis. The opioid epidemic is putting new pressure on social service programs like state Adult Protective Services and they often lack the preparation or resources to fully address the increased demand.

The EJCC meeting also was an opportunity to reflect on the progress we have made in the nine years since the body was established and look to the future.

There was great excitement about the improvements we have made, and continue to make, in cross-agency collaboration on elder justice research, information dissemination, and data collection. In February, the Department of Justice brought the largest elder fraud enforcement action in American history against over 200 defendants who are accused of stealing more than half a billion dollars from more than a million older Americans. Two new laws approved by Congress and signed by President Trump over the last year, the Elder Abuse Prevention and Prosecution Act and the Strengthening Protections for Social Security Beneficiaries Act of 2018, are offering new opportunities to protect and empower elders. We look forward to sharing more on the laws soon. These are just a few examples of developments we touched on at the meeting.

The Elder Justice Coordinating Council is a potent illustration of how much we can accomplish working together.  But you certainly don’t have to be in government to be part of the elder justice movement. Anyone can work across disciplines and generations to make a difference, here are 12 ideas.

Please join us in observing World Elder Abuse Awareness Day on June 15, as we reflect on how far we have come and look ahead with renewed energy and clarity on what remains to be done to ensure justice for all Americans. Find an event near you or tools to plan your own commemoration.

Elder abuse affects all of us, and we all have to work together to end this human rights tragedy. Can I count on you to join the movement?



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Supporting nutrition, supporting health and independence

Date

We all know that good nutrition is the foundation of good health. Healthy eating can help people achieve and maintain a healthy weight, prevent the onset of chronic diseases, reduce inflammation, and speed recovery from injuries. On the other hand, poor nutrition is connected to a variety of health problems. 

Earlier this month, I had lunch with Vice Admiral Jerome Adams, the U.S. Surgeon General. I shared some of the things ACL was working on during National Nutrition Month, and we talked about how important nutrition is for the people ACL serves. 

VADM Adams gets it. “People who don’t have enough healthy food are more likely to be hospitalized, tend to experience longer hospital stays, and are more likely to be readmitted after discharge.  Good nutrition is important to everyone, but it is even more critical for those at risk for being food insecure, such as older adults and people with disabilities, many of whom already are already at increased risk of hospitalization.”

Unfortunately, a variety of factors can make it harder for older adults and people with disabilities to get the nutrition they need. 

As we age, our bodies generally become less able metabolize food, and many people with disabilities have unique nutrition needs. If people do not fully understand those needs, it can be very difficult to make informed choices that lead to better health. In addition, both older adults and people with disabilities can face barriers to eating well. For example, a lack of public transportation could limit access to fresh groceries, and some people need the support of a caregiver to prepare or eat meals.

ACL is working with the aging and disability networks to help address these issues.

The Older Americans Act (OAA), passed in 1965 and reauthorized in 2016, acknowledged the importance of good nutrition for older adults by creating two important meal programs.

The Congregate Meal Program brings people together for meals in group settings such as senior centers, while the Home-Delivered Meal Program provides meals for frail, homebound, or isolated individuals. Both programs serve people age 60 and over, and, in some cases, their caregivers, spouses, and people with disabilities.

Both programs offer nutrition-related services and other important benefits, in addition to the meal. Congregate meals provide companionship, access to other health activities, and wellness programs — nearly two-thirds of providers of congregate meals also offer health promotion programming. Home-delivered meals provide an opportunity for social interaction and informal safety checks. In fact, sometimes the person delivering the meal is the only person the older adult sees regularly; without the meal delivery, the older adult could be completely isolated.

The impact of these programs cannot be overstated. First, they play a key role in preventing senior hunger and food insecurity. They also help seniors remain independent. In a recent survey, 63 percent of congregate meal recipients and 93 percent of home-delivered meal recipients reported that the meals allowed them to continue living in their own homes.

Similarly, many of the ACL services and supports that help people with disabilities avoid isolation and remain active in their communities help increase access to nutrition. ACL also supports programs to help people with disabilities understand and manage their individual nutrition needs, while other ACL initiatives aim to increase the nutrition knowledge of the professionals who provide services and medical care for people with disabilities.

For example, ACL’s National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) has funded projects studying nutrition interventions for a variety of populations, including people with psychiatric disabilities and spinal cord injuries. In addition, many ACL-funded University Centers for Excellence in Developmental Disabilities (UCEDDs) have professionals on staff with expertise in disability and nutrition.

UCEDDs in five states are partnering with the Association of University Centers on Disabilities (AUCD) and the Walmart Foundation on the “Nutrition is for Everyone” program. The program provides nutrition education, including direct training, for people with disability and community members. In my home state of Oklahoma, the program is supporting nutrition education training, in English and Spanish, for families with children with disabilities. The training is taught by two parents of children with disabilities. The program is also working with the Oklahoma Self-Advocacy Network to offer training to people with disabilities on fitness, healthy eating, and interacting with their health care team.

Many State Councils on Developmental Disabilities are also taking an active role in promoting nutrition. For example, South Carolina is funding a “Fit for Life” program that promotes health and wellness for young adults and adults with disabilities. They do this by pairing fitness classes with nutritional support and trips to the grocery store.

Food is an important part of everyone’s day. And for older adults and people with disabilities, it is vital to be well nourished — not just fed — to live the healthiest possible life.  At ACL, we are committed to our continued work the aging and disability networks and other partners to support good nutrition as key part of helping people live independently.  And while National Nutrition Month is coming to an end, we will keep spreading the word about eating well and living well – I hope you will join us!

Comments

Mehtab - Thu, 04/19/2018 - 13:21

Very Good Blog, Keep Sharing More, Thanks

Nutrition Facts

Christy Samuels - Tue, 05/08/2018 - 15:40

In reply to by Anonymous

Thank you for your feedback. ACL was created around the fundamental principle that all people, regardless of age or disability, should be able to live independently and fully participate in their communities. Good nutrition for older adults and people with disabilities is important.



By clicking “save,” I acknowledge that all fields marked with an asterisk are required. We ask for your email address so we can contact you for additional information if necessary. Your email address will not be published on the public site. Your name and your comment may remain published on this site indefinitely. We will delete any comments that include vulgar language, hate speech or personal attacks, or which do not pertain to the topic at hand. We also may delete comments that include personal information about another person. If a comment is received that contains non-publishable material, we reserve the right to either edit the comment to remove these elements or to delete the comment.

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