The White House Conference on Aging

Summary

Highlights

• Bernard Nash celebrated his participation in the 1961 conference, offering a historical perspective on senior advocacy. 🎉
• Valerie Jarrett highlighted key achievements under President Obama's administration, including the Affordable Care Act's impact on seniors. 🏛️
• Key speakers shared insights into the future of aging in America, focusing on redefining aging with dignity and inclusivity. 🌍
• Efforts to resist the privatization of social security were highlighted as crucial for senior security and stability. ⛔
• David Hyde Pierce moderated a panel on caregiving, emphasizing the importance of holistic support systems. 🎭
• Community-driven efforts like Dementia Friendly America were announced, aiming to enhance support networks for aging populations. 🏘️

Key Takeaways

• The White House Conference on Aging emphasized the importance of addressing challenges posed by an aging population and presented opportunities for innovation and growth. 🌟
• Bernard Nash, a seasoned advocate, shared his insights from past conferences, highlighting the continued progress needed for senior care. 🙌
• Valerie Jarrett and other speakers focused on key programs like Medicare and social security, promoting financial and healthcare security for all. 💡
• Speakers like Valerie Jarrett praised the Affordable Care Act for improving senior healthcare, especially concerning prescription drugs and preventative measures. 🏥
• The importance of caregiver support was underscored, with innovative programs and community efforts spotlighted as crucial for future strategies. 🤝
• Senior financial security and healthcare improvements are seen as pathways to longer, healthier lives post-retirement. 💪

Overview

Chapters

• 00:00 - 03:00: Introduction by Bernard Nash Bernard Nash opens the chapter by greeting the audience and acknowledging the significance of the gathering at the White House. He highlights the privilege they have to be part of the strategic planning for the nation’s future and stresses the importance of focusing their knowledge and experience on the tasks ahead.
• 05:30 - 11:30: Opening Remarks by Valerie Jarrett Valerie Jarrett discusses the significant challenges posed by increased longevity in society and expresses confidence in the ability to address these challenges. She references her experience as a delegate to the 1961 White House Conference, illustrating her long-standing involvement in public service.
• 11:30 - 16:00: Introduction of Panel by David Hyde Pierce The chapter discusses the introduction of a panel by David Hyde Pierce. It begins with an atmosphere of applause as the panel gets underway. There were over 3,000 delegates mentioned, indicating a large and significant gathering. The setting involved serving the White House, rather than being guests, highlighting a service-oriented perspective. The delegates were organized into 13 specific sectional areas, suggesting a structured approach to their tasks or discussions.
• 16:00 - 33:00: Panel Discussion: Caregiving and Aging The chapter titled 'Panel Discussion: Caregiving and Aging' involves intensive discussions among passionate delegates who were committed to resolving issues related to caregiving and aging. The discussions were thorough, examining every issue and proposal presented.
• 33:00 - 57:00: Question and Answer Session The chapter titled 'Question and Answer Session' focuses on a conference aimed at addressing various challenges highlighted during regional meetings across the country. The speaker emphasizes the need for energy and responsibility in tackling these issues, reflecting on past experiences, including a personal anecdote about being 38 years old in 1961.

The White House Conference on Aging Transcription

• 00:00 - 00:30 Bernard Nash: Thank you. Good morning everyone. Multiple Speakers: Good morning. Bernard Nash: From the smiles that I'm seeing on your faces here you share the awe that this day presents. We are privileged. We are a privileged few who are not only at the White House, the very center of the planning strategically for our nation's future, but we are also those who have been chosen to focus our knowledge and our experience
• 00:30 - 01:00 on the challenges that longevity has presented itself in our nation's future. That is quit the dramatic challenge you all aware of that. But I'm convinced that we are all up to the test before us that we have today. I served a delegate to the 1961 White House Conference.
• 01:00 - 01:30 (applause) That's why I'm hanging on to the rest. There were over 3,000 delegates at that time. We weren't privileged to be in the White House. We were serving the White House. We were divided into 13 specific sectional areas and
• 01:30 - 02:00 we had great discussions. As a matter of fact, although the convictions strong -- maybe that's not the word I should say -- they were passionate. The delegates were committed to resolving the issues for which we were there. We examined every issue and every proposal presented and
• 02:00 - 02:30 you know the results of that conference. That's what we're hoping to achieve at this conference. So we are called upon to expend the energy and the sense of responsibility in addressing the challenges that are presented -- that have been presented at the regional meetings that we've had around the country in preparation for this. I was 38 years of age in 1961.
• 02:30 - 03:00 I'll be 93 in two months. (laughter) (applause) And I'm just as excited as I was then. The future is with us in this room and we are going to be a strategic part of it. The profile of our society is changing. You all know that. But rejoice.
• 03:00 - 03:30 Rejoice. We have the opportunity to shape that profile and to provide opportunities for the seniors who are yet to come -- our children, our grandchildren, great grandchildren -- so we take on a very difficult task this day and we are going to be responsible and happy when we see the results of that.
• 03:30 - 04:00 I'm told there are over 600 watch parties today observing our activities and our deliberations. In 1961 I never would have imagined that in one year -- this past year -- much education and information sharing could be so accomplished. Not only the U.S. but throughout the world because I've been heard --
• 04:00 - 04:30 we have been heard. This 2015 conference on aging has maximized the opportunity for interaction between the professionals in our programs and the people that we are hoping to be increasingly more involved and active. And certainly the younger generations -- the thousands
• 04:30 - 05:00 and thousands of baby boomers who are going to be coming into our age group and are going to be looking to us to have shaped a period of time in their lives that they will be proud to participate in. Well, that's enough information, just the background. (laughter) You know far more than I what's going on today.
• 05:00 - 05:30 It's time that we get to work. So, it's my honor -- distinct honor today -- to introduce the senior advisor to the President Barrack Obama, Valerie Jarrett. (applause) Valerie Jarrett: Thank you so much. So I think we're going to have you get down. Bernard Nash: I'm really not this bad off.
• 05:30 - 06:00 (laughter) Valerie Jarrett: Hardly, hardly. Good morning everyone. Multiple Speakers: Good morning. Valerie Jarrett: What a pleasure it is to welcome you to the White House and thank you Bernie Nash, for that terrific opening. Your leadership and your dedication and your spirit at the ripe young age of 93 is something we should all emulate so thank you. Another round of applause for Bernie Nash.
• 06:00 - 06:30 (applause) You have and continue to inspire generations. I am thrilled to look around and see so many friends in the audience. Of course I have to recognize Congressman Dingle and Congresswoman Dingle who are here today. Thank you so much. (applause) True champions, both of them for the issues that we're going to be discussing. And to all of you, who are here today, welcome to the
• 06:30 - 07:00 White House. You're joining us during a pretty exciting year I have to say. We've already made a great deal of progress in 2015 but as we know, this is also a year of some rather important landmarks. Medicare and Medicaid are 50 years old. A round of applause for them. (applause) And social security just turned 80. Another important landmark. These three programs truly symbolize who we are and
• 07:00 - 07:30 they reflect our country's values. They reflect the fact that we are our brother's keeper. We are our sister's keeper and we understand that we're all in this together and that we, importantly, have a responsibility to each other. And because of our steadfast commitment to these programs America is leading longer and healthier lives. And as we recognize that Americans are regularly living 20-30 years beyond the traditional retirement
• 07:30 - 08:00 age we must reshape what it means to age in America. And we need to view our changing demographics as an opportunity and not a burden. Older Americans, like all of us, want to be defined by our abilities and not by our disabilities. That's why President Obama and his entire administration have consistently worked to ensure all Americans are able to look forward to
• 08:00 - 08:30 healthy, secure, and fulfilling lives after they retire. Thanks to the Affordable Care act, seniors are saving a fortune on prescription drugs. They're taking advantage of free preventative benefits in higher numbers than ever before and we're prohibiting insurance companies from denying coverage to people because of pre-existing conditions. And thanks to the United States Supreme Court ACA is here to stay. (applause)
• 08:30 - 09:00 President Obama's also working to strengthen older Americans financial security and to reinforce the basic American compact that hard work should be rewarded with dignity and stability in retirement or the case of disability. We're also working to protect social security and reject all calls to privatize it.
• 09:00 - 09:30 Amen. Amen. (applause) The future of hardworking Americans should not be dependent upon the fluctuation of the stock market. Today we look forward to exploring with you future strategies for how we best empower all Americans as our population ages and as older Americans continue to live fuller, healthier, and more vibrant lives as Bernie demonstrates. Today's conference provides a vital opportunity for
• 09:30 - 10:00 leaders and advocates and experts from around the country to share best practices and identify both individual and collective goals for the next 10 years. I learned first-hand from my mother, Barbara Bowman, a vibrant and independent 86-year-old mom -- who has no plans to stop working anytime soon by the way -- the potential of our elders if we provide them the support they need to lead full and productive lives.
• 10:00 - 10:30 This is a very important day for the administration and for all of you and for the future of our country and we hope that this conversation will move our country forward and the older generation upon whose shoulders we stand will be able to look towards a brighter future. This year's conference is the most exclusive in history and inclusive in history. We're beginning to join -- we're going to be joined today as Bernie mentioned -- by 600 watch parties around
• 10:30 - 11:00 the country watching online and engaging with us and we want to have a broad engagement because we want everyone to participate on what are the solutions and suggestions we have that we can put in place both immediately, over the medium and the long term. So we welcome all of you who are here today and everybody who's tuning in online. Your voices will be heard as well. And we hope that today will be a productive, energetic session as Bernie also said. So thank you very much for being with us.
• 11:00 - 11:30 Thank you for everything that you've done that's led us up to today, but more importantly, thank you for the very hard work that we will engage in together going forward. And so now, I'd like to turn over our first panel to a tremendous acting talent and an advocate, David Pierce, who will moderate our first panel. David Hyde Pierce, come on up. (applause)
• 11:30 - 12:00 David Pierce: Good morning. I am honored to be in this building and on this panel. I am 56 years old and to be asked to be part of a
• 12:00 - 12:30 conference on aging is slightly bracing but on the other hand I was in Leesburg, Virginia two days ago buying a bottle of wine and for the first time in over 20 years I was carded. So, the Lord giveth and the Lord taketh away. But it made me think about how we define ourselves and how some of these words that we use become fixed and calcified including words like aging and caregiving.
• 12:30 - 13:00 I think we need to shake up some of these definitions and something that's been happening in this country I feel is that we've been able to recognize and see beyond and in some cases take down the barriers and the divisions that we have sometimes artificially created between ourselves. I think these words aging and caregiving are two of those words that they almost come wearing cozy sweaters and leaning on a walker and I think we all have had very
• 13:00 - 13:30 different experiences of those words. My family's experience with caregiving came under the shadow of my grandfather and my dad's Alzheimer's and dementia and they were both diagnosed in their 80s but the burden and the honor of caring for them was shared by many generations -- my grandparents, my parents my siblings, and even their children. And even the role of caregiver -- my grandmother
• 13:30 - 14:00 and my mom were the primary caregivers for their spouses and the toll -- the physical toll on their health ultimately made it very difficult to separate the sufferer from the person who was caring for the sufferer. We feel like Alzheimer's took all four of them. So, those definitions become very fluid and I think my hope is that this amazing panel that we have here today -- their different perspectives -- will help
• 14:00 - 14:30 shake up our calcified definitions and remind us that to age is to live and to care is to be human. So, let me introduce this wonderful panel starting at the far end. Secretary Robert McDonald. Robert is the Secretary of the U.S. Department of Veteran's Affairs a position he has held since July of 2014. He previously served as Chairman/President and CEO
• 14:30 - 15:00 of Proctor & Gamble. Next, is Ai-Jen Poo who is the Director of the National Domestic Worker's Alliance and co-Director of the Caring Across Generations campaign. She's been organizing immigrant women workers since '96 and in response to the growing call for caregivers in the home she helped launch Caring Across Generations to address two of the major social issues of our time widespread unemployment and the need for care of the nation's expanding aging population and in 2015 she published a book "The Age of Dignity."
• 15:00 - 15:30 Next, is Frank Fernandez who serves as Vice President of Government Programs and President and Chief Executive Officer of BluePlus for Blue Cross and Blue Shield of Minnesota where his role focuses on Blue Cross' Medicare, Medicaid, and the federal employee programs and he was elected President and CEO of BluePlus in 2010. Harry Leider is a general internist with over 20 years' experience as a physician executive in a
• 15:30 - 16:00 variety of health care organizations and he currently is the chief medical officer and group vice president of Walgreens and in this role is responsible for ensuring enterprise-wide health and wellness, service offerings, and outcomes that provide customer value and improve patient lives. And finally, sitting right next to me is Britnee Fergins. Britnee is a 30-year-old chemist; works full time at a chemical plant. She received her bachelor's degree in chemistry at Grambling State University. She is also a single mother of a two year old and the
• 16:00 - 16:30 primary caregiver for her 90-year-old day Percy Frasier -- a veteran with Alzheimer's and dementia and she lives in Shreveport, Louisiana. So please, help me welcome our distinguished panel. (applause) So, let me start -- I have some questions here -- let me start with Secretary McDonald. I served on a panel a few weeks ago where it was a very moving interview with a woman whose husband was a
• 16:30 - 17:00 veteran and she spoke a lot about the services that the Veterans administration provide and I just wonder if you could tell us about how the VA Caregiver Supports Program fits in with all the work going on at the Veterans Administration to support veterans. Robert McDonald: Thank you, David. And thank you for moderating this important panel. If you think about the veterans -- the Department of Veteran's Affairs -- we're the largest integrated health networks in the country and as a result we
• 17:00 - 17:30 tend to be the canary in the coalmine for medical issues for the United States and aging is no different. If you think back to the crisis that occurred for the VA in 2014 most Americans would think that that was because we'd been fighting a war in Afghanistan and Iraq for over 14 years. The reality is that aging of the veteran population was one of the primary if not the primary reasons for that
• 17:30 - 18:00 crisis. The year I graduated from West Point in 1975 we had about two million veterans that were over the age of 65. In 2017 we're going to have 10 million veterans over the age of 65. A quintupling of the number of veterans over the age of 65 means that our number of disability claims has gone up by 50 percent in a very short period of time and it also means the number of items per claim -- on other words, the number of chronic illnesses occurring -- has
• 18:00 - 18:30 more than doubled. So this has put tremendous stress on our system and a system in which we have to build capacity. Obviously as veterans age the need for caregivers dramatically increases so what are we doing for caregivers? Well, first we're providing support and education. We have things like webinars, workshops, face to face training, telephone training.
• 18:30 - 19:00 Since being a caregiver can lead to isolating we also have peer support programs, which are very important to linking caregivers and also identifying best practices. Secondly, we've opened a national caregiver's support line. It's a phone line in 2011. The number in case any of you would ever need it is 1-855-260-3274, 1-855-260-3274. There's licensed social workers there that will
• 19:00 - 19:30 answer the phone and provide counseling and information for caregivers. To date we've had over 190,000 calls and we've provided 33,000 referrals. Third, we have a program -- there's an acronym for it -- many things in the VA and the government have acronyms. It's called REACH.
• 19:30 - 20:00 It stands for Resources for All Caregivers Health. It's an evidence-based clinical evaluation program used to teach caregivers of veteran's with dementia problems, how to solve problems and how to get things done. As part of a National Alzheimer's Project act VA works with the Indian Health Services as well to assess whether REACH interventions are effective and can also meet the needs of those in tribal communities.
• 20:00 - 20:30 There was a fourth program, it's called My VA communities and this is a very recent one. We're just establishing My VA Communities around the country. This is an opportunity to bring together local veterans, veteran support groups, service providers, caregivers, and advocates through community driven networks that we've established and these are chaired by local leaders, not by VA employees to bring people together, to talk about common issues, and make sure we're applying the right resources to get these
• 20:30 - 21:00 issues resolved. We've launched the first of these this month and we hope to have 50 of them by the end of the summer and over 100 by the end of the year. I can think of no more important group that we can care for in the VA than the caregivers. No more generous group, no more kind group, and we're working hard to do that and to share our knowledge with
• 21:00 - 21:30 others. Thank you, David. (applause) David Pierce: Thank you. That's fantastic and it's true. The reach of that work goes far beyond veterans. We're all taking advantage of what you're learning and exporting it to the wilder community so that. Okay. Britnee. So, as we said, you're the mother of a small child and you're taking care of someone with dementia.
• 21:30 - 22:00 What is your -- that's definitely of the sandwich generation by the way -- caught in the middle. And I'm just wondering what it was like with the diagnosis and process of dealing with your dad was like and what your daily life is like. Britnee Fergins: My daily -- did it come on? Oh, okay. Sorry. My daily life is very difficult balancing a 12-hour work shift, also a very, very, very energetic
• 22:00 - 22:30 two year old. And my dad, who can be stubborn at times because he is so used to being independent it's very difficult. There are medical appointments, there are prescriptions, general things like grocery shopping, even going to the bank. It has been very difficult for me but he is my father
• 22:30 - 23:00 and he's been a great father so I do it. (applause) David Pierce: Are you pretty much on your own handling this? Britnee Fergins: Pretty much. My mom helps when she can but she's also suffering from arthritis so she helps when she can but it's pretty much me. David Pierce: And how old's your mom? Britnee Fergins: My mom is 62.
• 23:00 - 23:30 You're going to get me killed. David Pierce: No, no one will know. No one will know. And so, first of all how is she holding up under this? Because I know for a spouse it can be very traumatic. How is she holding up under her husband's illness? Britnee Fergins: She's doing pretty well. I help him and her so it's really difficult but we get through it. She's doing pretty good, pretty good. David Pierce: And finally I'd just ask, here you are.
• 23:30 - 24:00 Thank you. It's amazing you're here. How did you -- who's taking care of the fort? You know, how did you manage this? Britnee Fergins: My mom has my son now. My mom and my brother is helping as well and I was conveniently off work for the next couple of days to that was easy. David Pierce: Great, well, we're lucky to have you. Britnee Fergins: Thank you. David Pierce: Thanks. (applause)
• 24:00 - 24:30 David Pierce: So question for Frank Fernandez. Frank, Minnesota is amazing. It's real a role model in terms of what it's been doing. It's on the forefront of care and taking care of people especially I'm thinking of with Alzheimer's and dementia. And you've made great strides and Minnesota has with dementia friendly community's initiative. I'm just wondering how the program works, whether it's a program that would work elsewhere and would be exported? And also, because it's such a diverse community that you
• 24:30 - 25:00 have in Minnesota whether that enters into how these communities are formed and what part of the process that is. Frank Fernandez: Yeah, absolutely, thank you for the question. As David said, at the heart of what's going on in Minnesota are the dementia friendly communities and these communities are critical in terms of supporting people living with dementia and their caregivers. They ensure that those experiencing dementia can continue to live in the community but not just live but to thrive and to continue to be part of the
• 25:00 - 25:30 community and do that things that Britnee was talking about in terms of being about to continue to go to the grocery store or go to the bank. In Minnesota, the act on Alzheimer's collaborative has developed tools and resources and a community engagement process that includes technical support that is fostering 34 dementia friendly communities in every region of the state. Those communities are rural, urban, suburban, as well as
• 25:30 - 26:00 communities of interest that are more highly impacted by the disease such as the African American community and the Latino communities. The dementia friendly community is informed, safe, and respectful of individuals with dementia and their families and the caregivers. It provides options and fosters a higher quality of life. The resources that have been developed provide a process tool and national, international dementia
• 26:00 - 26:30 friendly practices that help communities convene stakeholders from all sectors of a community such as law enforcement, government, businesses, legal, and financial service providers, government and healthcare and faith communities. And these very different segments then work together to develop dementia friendly practices. And in fact, David to your point, the exciting part about being here today is that it's a great pleasure
• 26:30 - 27:00 to share with you that there's a huge desire to replicate and accelerate this work across the country and so it's my great pleasure again, to announce the launch of a national effort called Dementia Friendly America. And the initiative is a collaboration of nearly 50 organizations with the shared goal of supporting dementia friendly communities across the United States and we're going to pilot 15 dementia
• 27:00 - 27:30 friendly communities across the country in 2016 with the hope of ultimately supporting any willing community across the country. At this point in time there are six communities ranging from rural and metro communities and including cities, counties, and even an entire state. So the communities that are leading this effort right now are Denver, Colorado; Knoxville, Tennessee; Tempe,
• 27:30 - 28:00 Arizona; Santa Clara County California, Prince George's county Maryland, and the entire state of West Virginia. And so we're so proud to share this information with you today. We're really excited and we want all of you who are working to make an impact on this disease join us and be part of the effort. Now I did want to add a little bit about what you were talking about David, in terms of, about communities
• 28:00 - 28:30 who unfortunately suffer disproportionately from the disease. We've been working really hard in Minnesota to ensure that we're paying attention to those cultural differences whether they're linguistic or other issues that create barriers to seeking care and so forth. We've had a health equity subcommittee in place and we're been working on, you know, some of the basic things -- translating information. But other ways in which we can make sure that the communities who are traditionally underserved
• 28:30 - 29:00 have access to the tools and supports that are necessary in order to be successful in caregiving. Thank you. (applause) David Pierce: It's fantastic and it all boils down in a weird way to one word, which is awareness. When these communities are made aware, when law enforcement is made aware, when they're made aware of what the issues are, what the possibilities are and then as the whole country is made aware of what we can do
• 29:00 - 29:30 and that it's possible both between what you guys at the VA are doing and in Minnesota, that's extraordinary and that's what all of this is part of as well, is raising awareness. Going back to this whole issue of categories and names we tend to think of caregivers as being, well, they're either family members or they're paid professionals and is that right? To make that distinction or do you see people in both roles or do you see that there's a combination of
• 29:30 - 30:00 those roles that can be had? What is your sort of vision for; as your book calls it, "Aging with Dignity" and how does that include caregivers? Ai-Jen Poo: Well, I actually think David, that the former First Lady Rosalyn Carter said it best when she said there are only four kinds of people who are caregivers or will be caregivers and people who need care or will need care. And many of us experience those identities in overlapping ways and even within caregivers there are
• 30:00 - 30:30 many family caregivers who become professional caregivers and most professional caregivers also have families who they're caring for and that's just the truth of it, that we are a caregiving nation. We are a nation of caregivers and even as we speak there are 50 million of us who are either caring as family caregivers or as professional caregivers for
• 30:30 - 31:00 our growing aging population and for people with disabilities and those numbers are going to double by the year 2050. And so the challenge and also the opportunity ahead for us is really to put into place the systems to really support and value of caregivers both our family caregivers and our professional caregivers and to say a word about the professional caregiving workforce -- this is a workforce whose job it is to
• 31:00 - 31:30 support the dignity of the people we love every day and they do it with incredible skill, incredible patience, hard work, and the average annual median income for a home care worker in this country is $13,000 per year. This is to care for the most precious people in our lives who have cared for us and so when we look at the future of caregiving and the opportunity in my head to
• 31:30 - 32:00 put into place a whole new system to support our families and to support living well across generations it has to revalue care and particularly support good quality caregiving jobs so that we can have a sustainable, strong, vibrant, diverse, and dynamic caregiving workforce for the 21st century to support, to be a part of
• 32:00 - 32:30 that care force for the future that we're going to need in this country to live well. (applause) David Pierce: It's so true. I keep hoping that capitalism will catch up with, you know, the need because these people we've all had the experience when you find someone who is so dedicated and will work for so little. You know, the people who last as these paraprofessional caregivers are people with the biggest hearts and the strongest backs and --
• 32:30 - 33:00 Ai-Jen Po: Attract the best caregivers to this field that's so important. David Pierce: Exactly. That's so true. All right. Harry, Walgreens is everywhere. It has thousands of stores with a presence in every community just about in every state. So, how does such a big and powerful organization play a role in supporting not just older American's health but
• 33:00 - 33:30 also the health of caregivers? Harry Leider: Well, David, thank you for the opportunity and I want to thank the White House too for the opportunity to participate. Before I answer your question caregiving has certainly touched my family this year as I've watched my wife struggle to support two elderly parents with dementia. So it's really an honor to be part of the dialog today so thank you. I think the way that we support caregivers and in particular seniors is based on three factors that
• 33:30 - 34:00 provide us a unique opportunity. The first is really around convenience. As you mentioned we're everywhere. We have over 8300 Walgreens stores across the country and there's some really interesting statistics about convenience. About 67 percent of Americans live within three miles of a Walgreens so when you're a caregiver, Britnee, like you when you need a prescription filled or you need something for, you know, you parent, you're within three miles away usually.
• 34:00 - 34:30 But it's not just the physical convenience of being on these best corners of America. It's the hours. Many of our pharmacies are open 24 hours. If you've got a young child we've got drive through pharmacies. We have over 400 retail clinics where nurse practitioners can write prescriptions or treat illnesses so that idea of convenience after hours and on weekends really is an advantage when perhaps the primary care giver is like -- provider like the primary care doctor is not available.
• 34:30 - 35:00 The second thing is we can provide some really important services for caregivers and seniors. Things like medication management. The average senior today is on four, five, or six medications and keeping them straight so you can stay healthy is really important. And these drugs can have interactions. They could be lifesaving, but they could have interactions which it more likely to fall or to be confused and our pharmacist really helps support the caregivers, the patients, and the doctors sort that out.
• 35:00 - 35:30 And then there are other support services that we provide that are critical like immunizations, which are so important to saving lives in seniors like influenza, pneumonia, and what's very, very painful is zoster, that many of you know is shingles. And finally of course, the clinic services. And then the third factor really is frequency. I'm a primary care doctor by background and when I was
• 35:30 - 36:00 treating seniors I would feel fortunate if I got to see them 2 or 3 times a year and just as a statistic you might find interesting, the average diabetic or their caregiver comes to our pharmacy 20 times a year to pick up prescriptions or supplies. So the opportunity for our pharmacist and our staff to be supportive of the doctors and the patients and the caregivers is really unique. So there are three factors, convenience in the community and then the services that really are important and that frequency of connection being on the front line really provides us with a great place to try and make
• 36:00 - 36:30 a difference. David Pierce: That's fantastic. It really is stepping up to the plate and seeing the need and filling it. We have some questions that were tweeted to us. Because it's 2015. (laughter) Robert McDonald: Well, one of the things, we mentioned Alzheimer's on the panel here and I think one of the
• 36:30 - 37:00 things that's exciting is the research that we in the VA do. We in the VA I think are necessary for the medical care of veterans but also necessary for American Medicine. We have a project, which the President has very much supported and touted, called the million vet project
• 37:00 - 37:30 where we have the blood samples of a million veterans who have volunteered. We're not yet at a million but we're working our way there. We're doing the genome mapping on all of those veterans and at the same time for most of them we have 4--50 years of medical records because they spent their careers in the military. So we have, you know everything that happened in their lives. And that genome mapping those medical records are going to be available for research to be done so that we can do research and discover precision medicine.
• 37:30 - 38:00 You know how do we -- how to we understand using the genome what medicine to prescribe, how to care for people in order to do a better job of identifying the potential for Alzheimer's before it occurs. I think this is incredibly exciting and I think it's a very important part of research that we're doing which makes me very optimistic for the future of
• 38:00 - 38:30 getting ahead of some of these diseases before they begin. David Pierce: And with that particular gene pool maybe you can discover the gene for bravery. Now we have from Janice Kirsch and Cheryl Sumakendri on Facebook and Tammy Wiggins on Twitter, they asked questions about the support we can provide. Okay, yeah. I think this is a good question for you. They're asking about the support we can provide
• 38:30 - 39:00 family caregivers. What is the thing or things that you think -- you most wish -- you had? Britnee Fergins: I most wish I had convenience. I wish I had the programs that they have -- all the great programs that I hear them talking about I call them. There are numerous 800 numbers and I'll call and either no one answers the phone or they won't return a
• 39:00 - 39:30 phone call or if they do answer there's another 800 number because I've called the wrong department. So that has been a big difficultly of mine to get the resources and the benefits that he needs. So I would like to have it more convenient for me basically. David Pierce: Yeah, or to have the system work. Britnee Fergins: Right.
• 39:30 - 40:00 David Pierce: You know? I think that's such an incredible point because there's so many well-intentioned organizations and as you say phone numbers and everything else but it's bad enough if you are trying to get your car fixed and you can't get though. Imagine dealing with caring for multiple people and you don't have time to make the call in the first place and then to have that kind of run around, that's a very interesting problem for everyone to think about how to make that system work and work better. Ai-Jen, do you have anything to add to that? Ai-Jen Poo: Well, I think what it points out is just
• 40:00 - 40:30 the need -- the way that we have to kind of shift our culture and the way that we think about our systems to see caregivers as a huge part of the solution for the future, as a huge part of the equation for quality of life and for how we improve not only health outcomes but our relationships, our quality of life, how our systems work. Caregivers who are responsible for the
• 40:30 - 41:00 wellbeing and quality of life of so many are just an incredible leverage point for the society that we all want to live in. David Pierce: Frank? Frank Hernandez: Yeah, I just wanted to add that I think that at the end of the day when you think about a dementia friendly community it's about supporting the caregiver and easing the burden that we all know the caregiver's have I terms of doing the daily thing that we all take for granted at times. And so, it's really about integrating the system.
• 41:00 - 41:30 Getting away from the silos so that the end of the day, the caregivers and the folks who are experiencing dementia themselves can live full and rich lives. And so if you have the disparate parts of the system working together understanding, having the awareness and then the tools that are necessary to better support the individuals and the caregivers then we're getting somewhere and that's why we believe strongly that these dementia friendly communities are one of the ways in which we're going to do a much better job
• 41:30 - 42:00 supporting the Britnee's out there and the other caregivers. David Pierce: That's great. And I have a question from Katie Barnett with the Elder Care Workforce Alliance. She emailed a question, "What can be done to increase and better support?" The caregiving workforce which I think is what she's referring to paid and paraprofessional workers. So, and you mentioned actually paying them is a good idea. Ai-Jen Poo: Yes, actually paying them is a great idea. Paying a living wage where you can actually take pride
• 42:00 - 42:30 in your work, support your family, care for you own loved ones, right? As a first step. But there's also training and other kinds of supports. I mean one of the things about caregiving is that it can be incredibly isolating both for family caregivers and for professional caregivers so creating community, connection, support, and letting every caregiver know that they are valued and that they are a critical part of our economy and our society and our
• 42:30 - 43:00 families. (applause) David Pierce: I sat in on training/support groups that the Alzheimer's association has. I was in the New York City Office and just like any family member, what they are going through, these incredibly dedicated people and the opportunity to just vent and learn from each other -- plus it's a very
• 43:00 - 43:30 specific -- especially when we're dealing with issues of dementia how you respond to this ever shifting disease. It really takes training and expertise and that's vital. This I'm going to toss out to anyone on the panel. The National Association of Area Agencies on Aging annual convention in Philadelphia is live streaming our conference today and --
• 43:30 - 44:00 (applause) And they asked via Twitter what the single most important need caregivers have? And what can the area agencies on aging do to support them? So, what do you think? Anyone? Frank Fernandez: Well I have the privilege of joining them in Philadelphia tomorrow and they've played an important role in what's going on in Minnesota in terms of supporting the efforts and being the ones
• 44:00 - 44:30 that are in the community who understand what the supports are and ensuring that those are available to the communities that are learning and building education and awareness and trying to understand what those supports are so that everyone who needs them can take advantage of them. So they're been very critical in terms of their participation in the dementia friendly community efforts. And also, going forward at the national level will be
• 44:30 - 45:00 very involved in what's happening across the country. And so we're very happy as a collaborative that they'll be part of that and we look forward to evolving these communities across the country with the help from the N4A. David Hyde Pierce: I was just going to say I think -- if I were to say the most important thing that they could do for caregivers is to find them; that I continue to be amazed. I've been working as a spokesperson for the
• 45:00 - 45:30 Alzheimer's Association now for about 20 years, and I'm still amazed at how many places people just don't know. There's still the stigma about dementia and that disease and some of it is because of culturally different communities and their different ways of looking at dementia. But it's just -- it continues -- and also just the isolation of being a caregiver and your time is taken up taking care. So unless we find ways to reach into people's homes
• 45:30 - 46:00 and say, "Hey, guess what? There's a resource. There're people you can talk to. There are places you can go. There are people who will answer the phone." That, for me, would be the most important thing. Yes, Robert. Robert McDonald: David, I would also say, from my brief experience in government the second time, that collaboration is incredibly important. There are only certain programs you can have on a national level, on a state level, on a local level, and getting collaboration between all of them so that
• 46:00 - 46:30 you have that scale and the importance of that scale in the program, setting up the program, the resources: demographics are destiny. So we know the people who are going to be aging in the future because they're alive today. But at the same time then you've got to have a human being on that phone line that Britnee calls so that you get this personalized service and an automated answer isn't the right answer. So how do you get that collaboration that permeates the entire system; everybody working together synergistically so that you get the scale but, at the
• 46:30 - 47:00 same time, you get the customized, individual service at the local level? Male Speaker: Let me just toss that back. We've got so many people that come from the business community and what you just described sounds to me like how a business would want to be run and, therefore, we sort of know how to make that happen. So what do we do to create that kind of collaboration nationwide? Harry Lieder: I'll just make a comment. I think some of the barriers to that happening
• 47:00 - 47:30 (inaudible) . David Hyde Pierce: Try again. Harry Lieder: Testing, no? There we go. Okay, so some of the barriers I think to that happening that I think have been alluded to really are economic where the funding doesn't exist always to enable that collaboration. So, for example, there's a lot more that we could do to leverage our 8,300 stores with our pharmacists because they are open late and on weekends but we don't always
• 47:30 - 48:00 have the mechanisms to compensate them for the work that they do. There're many other caregivers that are in the same -- providers that are in the same boat. So I think we have to find ways to create business models to really compensate folks that are in the community, that can provide the care, and we were chatting a little bit about that before the panel and that's a work in progress. But it would make a huge difference so some of it's economic.
• 48:00 - 48:30 David Hyde Pierce: I see. Ai-jen. Ai-jen Poo: I just wanted to add that I think there needs to be a lot of attention on how our aging population is also very diverse. I mean, we have LGBT elders. We have immigrant elders, elders of color, and lots of different needs, and not just in terms of health and different illnesses and conditions that people are living with, but also traditions and cultures and quality of life is so deeply tied to so many of those
• 48:30 - 49:00 realities. And so, to the extent that the offices, the area agencies on aging can really be oriented toward how is the reality of who's aging and what their caregiving needs are changing in the full diversity of who we are, as a country. I think that that is a really key priority. David Hyde Pierce: Yeah. (applause) Frank Fernandez: So in Minnesota Blue Cross and Blue Shield of Minnesota has essentially been living out
• 49:00 - 49:30 its mission of making a healthy difference in people's lives through this work, and so we've been focused on creating an atmosphere on the job of being supported. So we've had brown bag lunches where we provide education and create awareness for our employees. We've provided training for our customer service representatives so that they can detect issues and then do a better job of helping those individuals navigate what is a very complex system, and then going to the point about how do we better support those
• 49:30 - 50:00 cultural communities? One of the unique ways in which one of the community partners has been raising education and awareness is through having written a play called "El Orden del da Sorden", roughly translating to "Order Out Of Disorder," and the play is based on the real, live experiences of three families. And so that's one way in which we've been able to sort of break through some of those barriers with this work and help people have a better understanding and
• 50:00 - 50:30 awareness of the impact on a family and, more importantly, that there are people out there who care and can support you and provide the resources for, not only the individuals experiencing the dementias, but the caregivers. And in -- yeah -- (applause) David Hyde Pierce: How great that theater could play a role like that and I think that's very exciting. I'm not sure what our time is but does anyone have any questions that they want to toss up to us while we're
• 50:30 - 51:00 here? We've got quite a group here. Yeah, Female Speaker 1: (inaudible) folks to help take care of their loved ones and new members of their families from twinkle to wrinkle? (applause) David Hyde Pierce: Sorry -- Female Speaker. From twinkle to wrinkle. David Hyde Pierce: Oh, okay. So do you -- it was considering paid family leave for people who need to take care (laughs) , as I said, from twinkle to wrinkle, which is an expression I've never heard before. Britnee, that would be probably okay for you,
• 51:00 - 51:30 wouldn't it? Britnee Fergins: Yes, it would be. Right now he needs surgery but I can't take off work to be with him so paid leave would be wonderful. (applause) David Hyde Pierce: Yeah, at the back. Male Speaker 3: This is directed to the gentleman from Walgreens (inaudible) elder abuse and you have a wonderful opportunity in Walgreens stores to identify (inaudible) because elders will always come for their prescriptions and be able to be -- they won't be hidden away. So perhaps an opportunity to bring awareness through your
• 51:30 - 52:00 extraordinary chain of stores. Harry Lieder: Yeah, and let me just -- (applause) David Hyde Pierce: Let me just repeat that for the people at home; make sure that it was -- the issue of elder abuse, which is such a plague in this country and that, because many of these people will be coming into Walgreens, that's actually a great resource to be observant and maybe noticed when this is happening. Harry Lieder: Yeah, I think it's a very important
• 52:00 - 52:30 comment. Again, I commented on that frequency of interactions where you'll have a senior or their caregivers come in 20 or more times a year. It's a great opportunity where our pharmacists develop these relationships and can often pick up subtle things that are really amiss. So I really appreciate the comment and the insight. I think it's on target. David Hyde Pierce: Yes. Sandy Wash: Hi, I'm Sandy wash. I'm about to be 82. I'm from New York City and I'm a Jewish, lesbian
• 52:30 - 53:00 feminist and my big fear is not being able to do what it is I have to do and, therefore, to need caregiving and to go into a system known to be discriminatory, homophobic, and so I'm concerned that, after all the years of being an activist, I'm going to have to go back in the closet, both if I need home giving -- caregiving at home, and if I have to go into an institution. So I'm concerned that the government write into whatever is going on in the Older Americans Act -- there
• 53:00 - 53:30 should be training. First of all the non-discriminatory laws and then that there should be training from the administrative level down to the caregiving level because things start at the top. I don't want to go into an institution. Most of all, I don't want to ever have to go back into the closet again. Thank you. (applause) David Hyde Pierce: Thanks, that's -- I just have to say that's such an incredible point because when we talk about diverse communities, there are all kinds, as
• 53:30 - 54:00 Aijen had said, of diverse communities and the fact that you live in New York City and have that fear is very sobering, right, you know. Yeah. Female Speaker 1: Yes, I have two questions in one. One is for the Veterans Affairs. You mentioned about the program that they had for training social workers, caregivers. I know that they have social workers in there in their training programs but when there is a veteran that
• 54:00 - 54:30 needs long-term care, then who pays the bill? Where does the Veterans Administration fit in on that, because the families can't afford to pay a caregiver. Then what happens to that veteran? And number two question is -- and that's for all of you -- do you support and believe that home care workers really are worth the $15 an hour -- minimum wage?
• 54:30 - 55:00 (applause) I mean, they're underpaid and they're fighting to get recognition to hold onto their dignity and to take care of their own families. So where do you stand on that? That could come from anyone up there. Robert McDonald: The answer to your question is it depends upon the status of the veteran. The application of benefits for veterans is somewhat complex because of the number of laws that have been passed over the years.
• 55:00 - 55:30 I think the best way to get an answer to a specific question would be to call our caregiver line and I'll repeat that number again: 855-260-3274 because we'll need to drill down on the specific status of each veteran, to be able to answer the question. Ai-jen Poo: And just on the question of 15, of course,
• 55:30 - 56:00 the work of caregiving and home care workers deserves at least 15 an hour, if not more. (applause) At least, and that's just the first step in what it will take to secure a really strong home care and caregiving workforce to support to the 90 percent of us who would prefer to age in place, at home, in our communities, connected to our families, living life on
• 56:00 - 56:30 our own terms. And I just want to shout out Mrs. Sun, who is my grandmother's caregiver. She takes care of my grandmother and supports her to live independently, takes her to church so she can be in the church senior choir and sing twice a week, so she can play mah-jongg with her friends. And you do not want to take her on in mah-jongg, by the way (laughs) and all of that is made possible by the work of Mrs. Sun so I just wanted to recognize her here today.
• 56:30 - 57:00 David Hyde Pierce: I think that is a great note on which to wrap up, talking about a great caregiver. I want to thank the panel. I want to thank all of you, and I just want to take this second to thank the President and the Congress, miraculously, all moving together to pass the National Alzheimer's Project Act. We talk a lot about the division in this government. There was unity there and we all benefit from that and I'm grateful to be able to thank them and thank all of you. Have a wonderful rest of the conference.
• 57:00 - 57:30 (applause)