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“Building a direct care workforce for an aging population”

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By: Cathy Rowe
June 6, 2022

This article was originally published on njbiz.com and is posted here with permission.

At New Jersey Advocates for Aging Well, we are always looking at the numbers. So, consider these statistics. The population age 65+ was the fastest growing group in New Jersey between 2010 and 2020, increasing 26.8%, according to usafacts.org/data. This number means the 65+ population increased from 13.5% in 2010 to 17% in 2020. And the trend is expected to continue. The U.S. Census Bureau projects that by 2030, those aged 60 and older will make up 24.5% of our state’s population.

This trend in aging is a good thing. It represents not only baby boomers reaching retirement age, but also increased longevity. Not only are more people “older” but they are also living longer than ever before. The hope is that these seniors will lead vibrant and interesting lives for many years. However, an estimated 70% will need some type of support as they age. And so, our aging population will increase demand on our care infrastructure.

That is why NJAAW has partnered with PHI, a national organization focused on the direct care workforce, to bring the Essential Jobs, Essential Care initiative to New Jersey, and to build on recent progress in the state to support the direct care workforce. This workforce – which includes certified home health aides, certified nursing assistants, and direct support professionals – provides essential care to thousands of residents in their homes, community settings and in-patient facilities. As the COVID-19 pandemic has made clear, direct care workers provide critical support to older adults and people with disabilities across the state. With our aging population, we know the need will increase just as the workforce is shrinking.

Inadequate compensation, limited training and advancement opportunities, and other challenges are pushing direct care workers away from this sector. With recent increases in minimum wage and demand for workers in other sectors, people can choose to work in easier settings for the same or more pay DCWs need to pay for classes, training and to receive certification from one of several state offices before they can earn their first paycheck in patient care. In addition, nearly 40% of New Jersey’s direct care workers live in or near poverty, and 41% access some form of public assistance. This results in workers paid through Medicaid being eligible to receive Medicaid – an unsustainable situation.

Caring for seniors
The U.S. Census Bureau projects that by 2030, those aged 60 and older will make up 24.5% of our state’s population.

The U.S. Census Bureau projects that by 2030, those aged 60 and older will make up 24.5% of our state’s population.

It is becoming more and more difficult for providers to meet current and growing demand. So, we are committed to building a strategic road map for recruiting, training and retaining direct care workers that will benefit all New Jersians, both now and in the future.

Currently, there are just over 101,000 direct care workers in New Jersey. PHI estimates that long-term care employers here will need to fill nearly 179,000 job openings in direct care by 2030, which includes new jobs to meet growing demand and jobs that must be filled when existing workers transfer to other occupations or exit the labor force. Our seniors are relying on this workforce to support them; we must do more to ensure it is there for them.

There has been some great progress in recognizing the need for and the needs of direct care workers recently. The Long-Term Care Ombudsman’s Office secured higher pay for nursing home workers under COVID. The New Jersey Health Care Quality Institute produced a comprehensive report on the need for an across-the-board strategy to expand and prepare the health care workforce in the state. The Coalition for a DSP Living Wage made great strides in helping workers serving people with disabilities. Programs including NJ Pathways and Schools that Can are opening training and establishing career pathways to bring more people into this important field.

In addition, the state has committed funds to this effort – Gov. Phil Murphy earmarked $240 million last July to wage increases for a range of direct care workers; early this year, he signed into law a bill that dedicates $1 million to creating pipeline and career advancement opportunities for direct support professionals. These are great starts. What we need now is to work together to build a strategy that will see us through the current worker shortage, find commonalities, and create advocacy road maps with concrete and achievable policy goals and activities that will work for the long term.

Over the next 18 months, we will continue bringing together representatives from a wide range of providers and services in N.J. for a common goal – to increase and improve the direct care workforce. As we learned in the first convening of the PHI Coalition on May 23 and 24, DCWs have unique skills and character traits. This is a hard job, both physically and emotionally. Older adults deserve a workforce that is qualified to care, and also bring patience, compassion and dedication to their patients.

I invite stakeholders to join us in this effort. We are striving for a strategy that benefits all sectors of health care services. With a well-trained and fairly compensated workforce, all health care and service providers can benefit – whether inpatient facilities or home-based services.

At NJAAW, we advocate for what it takes to age well, encourage people to think ahead about where and how they want to age, and what they need to do to prepare. But no matter how strategic we are, we will never know what support we need until we need it. As they say, “the best laid plans of mice and men…” So, we must plan for a future where a significant portion of our population will need supportive services to age in the great state of New Jersey. This future needs a strong workforce.

Cathy Rowe is executive director of New Jersey Advocates for Aging Well. The Essential Jobs, Essential Care NJ initiative is supported by The Henry and Marilyn Taub Foundation.

Home is where the heart is

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by NJAAW Executive Director Cathy Rowe, DrPH

I recently had a discussion with one of my oldest and best friends. Both of her parents, who no longer drive, are facing physical challenges as they age in their bi-level home in the suburbs.

My friend and her siblings help with doctors’ appointments, meals and whatever else possible, while working, raising their kids and doing the things we all need to do.

When I suggested that my friend look into getting help, she immediately replied, “I am not sending my parents to a nursing home!”

This was the inspiration for NJAAW’s Housing Series webinars in February.

I will leave my friend’s name out, just in case she is reading this blog, but I think her reaction is one that many people have because they are not aware of the range of housing options for older adults.

There isn’t one large leap from living independently in one’s home to needing assisted living — there are numerous steps and choices.

There isn’t one large leap from living independently in one’s home to needing assisted living – there are numerous steps and choices.

Housing needs are not clear-cut nor consistent. There are a continuum of needs, finances, preferences and opportunities.

Housing is likely the biggest investment most of us will ever make — our home becomes a place we can call our sanctuary, and build memories. As such, the “where” and “how” we live are among the most important decisions we make. And these decisions cannot — or should not — be made suddenly or in a moment of crisis.

According to statistics, more than 23% of NJ’s total population is over 60 — and by the year 2030, all Baby Boomers will be of retirement age. Additionally, studies show that the majority of adults 50+ wish to remain in their homes and/or communities as long as possible, with a sense of independence and connection.

We need to spend time educating ourselves about available options, planning in advance for adapting our current home, exploring our next home and preparing for change.

We need to spend time educating ourselves about available options, planning in advance for adapting our current home, exploring our next home and preparing for change.

For all of these reasons, we are hosting the NJAAW Housing Series, bringing together experts in the realm of NJ housing to explore options at each stage and need, to help you make informed decisions for yourself or for the older adults in your life.

The series takes place online on consecutive Wednesdays in February at 4 p.m.

Speakers will explain strategies to help you stay in your homes with modifications and built design. They will also discuss options for getting help in the home, downsizing and when assisted and supportive living becomes necessary.

You’ll find more information at njaaw.org/events. Please register once for Zoom links to all four sessions Those who register will also have on-demand access to session recordings.

Special thanks to our sponsors for letting us provide this series at no cost to NJ residents: Raise the Roof Sponsors Parker Health Group, Inc. and Horizon Blue Cross and Blue Shield of NJ, Build the Walls Sponsors AARP NJ and New Jersey Relay & CapTel and Lay the Foundation Sponsor Springpoint.

I hope you can join us!

I’m proud of you, New Jersey!

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As we wind up 2021, I just want to take a moment to say I’m proud of you, New Jersey! Now, with all the jokes made about the great Garden State, you might not be used to the compliment, but here is why I am proud of our older residents, in particular.

New Jersey was hit hard early in the pandemic and suffered tremendous loss of life.

When we started 2021, we were on the edge of our seats waiting for the COVID vaccine and a return to normalcy. It was a frantic rollout but once the supply caught up with demand, the older residents in New Jersey led the way in getting vaccinated.

December 15 is the anniversary of the first COVID-19 vaccinations being administered in the state of New Jersey. According to multiple reports, Garden State residents age 65 and over are among the highest vaccinated group in the country. New Jersey is leading the nation in fighting COVID.

According to multiple reports, Garden State residents age 65 and over are among the highest vaccinated group in the country. New Jersey is leading the nation in fighting COVID.

Now, I am not talking about politics or the misinformation that is affecting personal decisions on getting vaccinated. I am talking about the facts: Our fellow New Jerseyans over the age of 65 remember growing up in a time before vaccines. They can remember when polio, measles and other contagious diseases would shut down schools and swimming pools, and put communities on edge. They had lived through this before.

We hear the term “unprecedented” used in discussions about COVID, the vaccines and mandates. Yes – this is unprecedented; the last time we saw a health crisis of this magnitude, a true pandemic, was over 100 years ago.

Living through the flu epidemic of 1918

There are a handful of people who lived through the influenza epidemic of 1918, which spread worldwide before we had airplanes, cars and the social interactions we were so accustomed to until COVID arrived.  Many of the medical advances we take for granted were not developed – vaccines were in their infancy and penicillin was still 10 years away.

One of my favorite books is Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It, written by Gina Kolata and published in 1999. I was deep in my graduate work in public health then and found the book to be a real thriller. (I still do, but realize not everyone shares my interest in contagious things.)

No corner of the globe was left unaffected and the similarities of the 1918 pandemic and COVID-19 are surprising, considering the century of medical progress that has passed in between.

A few years ago, I made a documentary with SOMA (South Orange Maplewood) Two Towns for All Ages, in which we asked older residents about their memories of growing up before vaccines. Stories included children being sent away to family members in the countryside for the summer, to avoid polio. One woman recalled a relative who returned home from World War II a hero, only to succumb to polio a few weeks thereafter. Another witnessed diseases first-hand as a young nurse. Their honest recollections come to my mind every time I hear updates on vaccination rates.

We have come a long way and I am truly proud that people who can remember the time without vaccines took the lead in getting them to not only protect themselves but also others.

Vaccination rates for people 65+: nationwide vs. NJ

As of this writing, the national vaccination rate among adults age 65+ is 90+% ; in NJ it is over 98% with some communities reporting all residents over age 65 are vaccinated. 

In addition, vaccination rates for BIPOC (Black, Indigenous and People of Color) NJ residents are above the national average, elevating protection in communities that have been hit hardest by this virus. (Source: NJ Department of Health, USAfacts.org and CDC.gov)  

So, well done NJ! Once again, our older neighbors have proven that they are leaders and have so much to teach the rest of us.

I thank all of the people who drew on their life experiences and memories in making their health care decision to get the COVD vaccine. May we all look to your example.

To see the SOMA Two Towns for All Ages documentary “A Time Before Vaccines,” click here. This oral history shares the personal memories of SOMA residents growing up in a time before vaccines, and how now preventable diseases like polio, diphtheria and measles affected their lives.

COVID-19 and Senior Volunteering: To Serve or Not to Serve?

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Guest blog by Lauren Lamin, Program Coordinator, New Jersey’s Foster Grandparent Program

The onset of the pandemic hit NJ’s Foster Grandparent Program hard. The novel coronavirus was particularly concerning to our program because according to public health officials, two of the most vulnerable groups at risk were seniors aged 65 and older and school-age children. Unfortunately, those also happen to be the core segments of our program’s demographics…

New Jersey’s Foster Grandparent Program (NJ/FGP), part of AmeriCorps Seniors, provides low-income senior residents, ages 55 and up, with the opportunity to work one-on-one as mentors and role models to children with special or exceptional needs.

Volunteers, who must be retired and/or receiving Social Security, do this work in classrooms or institutionalized settings throughout the state. Income eligibility (200% under the federal poverty line), criminal history and background checks are required for volunteers to serve, and they receive a tax-free stipend of $3 an hour. Travel reimbursement, free breakfast and lunch provisions, supplemental accident and liability insurance and an annual award-recognition event are some of the program benefits.

Foster Grandparents support schools and community needs related to children where traditional services are not available, such as encouraging socialization, modeling appropriate behaviors and skills, assisting in the development of motor and learning skills, tutoring, listening, talking, singing, walking and reading.

THE PANDEMIC

In March, the new reality of pandemic-related lockdowns, social distancing and limits on travel and gatherings were put in place as safety measures by Gov. Murphy’s executive orders. Such measures kept our Foster Grandparent volunteers at home and off duty.

Major fears for our volunteers escalated because many were afraid or not able to leave their homes, even to shop for food. And a few of our volunteers suffer from food insecurities and isolation.

HELP AND KEEPING CONNECTED

My colleagues and I made weekly phone checks to our volunteers, home visits to drop off food to those in need and ran errands as a courtesy to those who expressed a need. We also completed monthly conference calls to keep all of our volunteers connected to the program and each other.

Fortunately, the national office of AmeriCorps Seniors has made it possible to continue monthly stipends during this period by providing a COVID-19 allowance until December 31, 2020. Many of our volunteers have come to rely on these stipends.

BACK TO SERVICE

Now that some of the Governor’s executive orders, COVID curfews and closure restrictions are lifting, and some schools have re-opened, we are working to transition our volunteers back into service. A number of our volunteers remain concerned about the potential risks that COVID-19 may have on their health, and we’re concerned for them as well. Nonetheless, the majority cannot wait to go back to their sites. They love and miss working with the children.

Our pathway back to service includes practicing social distancing, using required personal protective equipment (PPE) and taking on new permissible service roles.

DIGITAL DIVIDE

COVID-19 thrusted our senior volunteers into the virtual world. Many of our older adults were not very “tech-savvy” and nervous about all things web-related. Right away, we saw first-hand how Foster Grandparents were deeply affected by the digital divide. Our volunteers not only lacked the knowledge of how to use technology, but they also lacked the equipment and access to the internet.

As a team, we developed a few solutions to address this issue, starting with training. We now have a mandatory “Computing 101” course that includes setting up WiFi, how to log in and how to use Zoom. We have also teamed up with CyberSeniors, a national organization whose mission is to bridge the digital divide, and Rutgers Extension to provide online training content and services.

Besides virtual engagement with the students during the coronavirus, our volunteers have been packing and delivering lunches to students in local NJ communities and serving as School Greeters to walk students to their classrooms, because parents are no longer allowed in school buildings. Those volunteers who are more tech-savvy are helping as in-person guides and assistants to students learning virtually at home or in the classroom.

GREAT GRANNIES!

Foster Grandparents join the program to give back to communities and offer their time, wisdom and unique skills. We are so pleased that NJ FGP volunteers are able to continue to serve children and their families throughout this pandemic.

It is quite rewarding to see our volunteers in their “second act” of life learning new skills and becoming essential resources. “Volunteers add positivity, care, and warmth that the children in our center need to thrive,” Program Director Pat Staltari says. “The volunteers give that extra love and attention that many of our students are not receiving at home. We love our grannies!”

When you volunteer, you’re not just helping others — you’re also helping yourself. Volunteering leads to new discoveries and new friends. Additionally, in a two-year AmeriCorps Seniors study completed in 2018, 85% of participants said that volunteering helped stabilize or improve their health. Plus, 88% of the volunteers said that they felt less isolated and now have a new purpose in life. Other research shows that volunteering helps you live longer and promotes a positive outlook on life. Join us!

For more information on NJ’s Foster Grandparent Program, and to meet guest blogger Lauren Lamin and Grandma LuLu, one of her volunteers, watch Aging Insights, Episode 110 on NJFA’s YouTube channel.

Lauren Lamin (left) is a Program Coordinator with the New Jersey Foster Grandparent Program (NJ/FGP), an AmeriCorps Seniors program. NJ/FGP is sponsored by NJ Department of State, Governor’s Office of Volunteerism (GOV). Donna Teel is NJ/FGP Director and Rowena Madden is Executive Director GOV. For more information, visit https://nationalservice.gov/programs/senior-corps, follow @VolunteerNJ on Facebook, and email Lauren at lauren.lamin@sos.nj.gov.

Elder Index at Work: Defending Property Tax-Relief Programs for Older Homeowners in New Jersey

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This blog post was written by Steven Syre of the Gerontology Institute at University of Massachusetts Boston, and is reprinted with their permission. 

multigeneration portraitThis article is one in a series of stories about how people across the country are using the Elder Index to understand the true cost of living for older adults and its economic implications. If you know someone who would like to receive information about these stories, send us a note at gerontologyinstitute@umb.edu.

Late this spring, New Jersey Gov. Phil Murphy faced a big problem that was all too familiar to other governors across America. The staggering economic impact of the COVID-19 pandemic had created a state budget crisis, with unemployment soaring and new annual revenue projections falling billions of dollars short.

Murphy approached the problem by moving back the start of New Jersey’s next fiscal year from July to October and passing a three-month stop-gap budget to tide the state over. Included in the short-term budget: Cuts to two important property tax-relief programs that help older adults in New Jersey afford to remain in their homes.

This was no small detail. New Jersey homeowners pay the nation’s highest property tax rates, about twice the U.S. average. Nearly 580,000 homeowners benefitted from one of the  programs under the axe and 158,000 others took advantage of the other. Both programs primarily benefitted older homeowners and the combined impact of the cuts was expected to exceed $480 million.

Melissa Chalker, executive director of the New Jersey Foundation for Aging, understood all that. Along with AARP New Jersey and other advocates, Chalker immediately launched a campaign to convince the governor and state legislators to restore the critical programs. One of her key tools in advocacy calls and letters: The Elder Index.

“All of these communications would reference the Elder Index,” said Chalker. “It not only allowed us to tell policymakers that 54 percent of older adults in New Jersey have difficulty making ends meet, but a recent related report showed how effective one property tax-relief program in particular was in reducing the economic security gap facing older adults in the state.”

Melissa Chalker

Melissa Chalker

The index, developed and managed at the University of Massachusetts Boston, is a free online tool that provides realistic and detailed cost of living data for older adults living in every U.S. county. Combined with state-level income data, the index can also determine the percentage of older adults who have insufficient income to meet the cost of living in their states. UMass Boston’s Gerontology Institute published a report on state-by-state elder economic security last November.

The New Jersey Foundation for Aging and the Gerontology Institute have been working together for years to provide state and local leaders with clear data about the economic circumstances of their older citizens. The foundation helped promote legislation enacted in 2015 that requires an elder economic security report based on Elder Index data be maintained by state government as a public resource.

A companion report, prepared with Rutgers University and a consultant, analyzes racial and ethnic details in the data, as well other factors including the effectiveness of individual state programs in reducing elder economic insecurity.

“We want to constantly use the Elder Index to remind policymakers and people in state government that there is a need here with older adults,” said Chalker. “Whether it’s the SNAP nutrition program, housing or prescription drug prices, we’ve been able to send letters and testify at the statehouse on those issues stating the Elder Index data.

“We’ve also used it to arm our partners, whether they are funders, county office on aging staff or senior center staff to help them meet the needs of older adults in their communities,” she said.

But the foundation had always understood that housing expenses played an outsized role in New Jersey’s elder economic security problem. The online index can help anyone get sense of those dimensions in just a couple of clicks.

Here’s how: Enter New Jersey and national average queries for older couples in good health who own their own home without a mortgage. You’ll find total monthly expenses more than 20 percent higher in New Jersey, compared with the national average. Housing costs, almost double the national average in New Jersey, account for nearly all of the overall difference.

New Jersey Gov. Phil Murphy

New Jersey Gov. Phil Murphy signs the state’s budget.

Data like that explain why Chalker and other advocates knew how important it was to save New Jersey’s property tax-relief programs. After a burst of calls, letters and op-ed columns, their efforts paid off last month. Murphy signed a new $32.7 billion budget for the remainder of the fiscal year, preserving both property tax relief programs for the future.

“I think the Elder Index was crucial in terms of the effort,” said Chalker. “You can anecdotally say how hard it is for seniors and tell some very compelling stories. But you’ve got to have metrics if you are making the case to policymakers and the elder economic insecurity reports provided what we needed.”

About the Gerontology Institute
The Gerontology Institute conducts research and policy analysis in the field of aging, and offers lifelong learning and pension protection services to older adults. The institute’s priorities include income security, long-term service and supports, healthy aging, age-friendly communities and social and demographic research on aging.

World Elder Abuse Awareness Day 2020

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NATIONAL CENTER ON ELDER ABUSE

Red Flags of Abuse

Our communities are like structures that support people’s safety and wellbeing. One of the most important ways we can all contribute to this ongoing construction project is by looking out for warning signs of maltreatment. Does someone you know display any of these signs of abuse? If so, TAKE ACTION IMMEDIATELY. Everyone, at every age, deserves justice. Report suspected abuse as soon as possible.

Emotional & Behavioral Signs

  • Unusual changes in behavior or sleep
  • Fear or anxiety
  • Isolated or not responsive
  • Depression

Physical Signs

  • Broken bones, bruises, and welts
  • Cuts, sores or burns
  • Untreated bedsores
  • Torn, stained or bloody underclothing
  • Unexplained sexually transmitted diseases
  • Dirtiness, poor nutrition or dehydration
  • Poor living conditions
  • Lack of medical aids (glasses, walker, teeth, hearing aid, medications)

Financial Signs

  • Unusual changes in a bank account or money management
  • Unusual or sudden changes in a will or other financial documents
  • Fraudulent signatures on financial documents
  • Unpaid bills

WHAT IS ELDER ABUSE?

Elder abuse is the mistreatment or harming of an older person. It can include physical, emotional, or sexual abuse, along with neglect and financial exploitation. Many social factors—for example, a lack of support services and community resources—can make conditions ripe for elder abuse. Ageism (biases against or stereotypes about older people that keep them from being fully a part of their community) also play a role in enabling elder abuse. By changing these contributing factors, we can prevent elder abuse and make sure everyone has the opportunity to thrive as we age.

HOW CAN WE PREVENT AND ADDRESS ELDER ABUSE?

We can lessen the risk of elder abuse by putting supports and foundations in place that make abuse difficult. If we think of society as a building that supports our wellbeing, then it makes sense to design the sturdiest building we can—one with the beams and load-bearing walls necessary to keep everyone safe and healthy as we age. For example, constructing community supports and human services for caregivers and older adults can alleviate risk factors tied to elder abuse. Increased funding can support efforts to train practitioners in aging-related care. Identifying ways to empower older adults will reduce the harmful effects of ageism. And leveraging expert knowledge can provide the tools needed to identify, address, and ultimately prevent abuse.

HOW CAN WE REPORT SUSPECTED ABUSE?

(This section has been edited to include links specific to NJ.)

No matter how old we are, justice requires that we be treated as full members of our communities. If we notice some of these signs of abuse, it is our duty to report it to the proper authorities. Programs such as Adult Protective Services (APS), the Long-Term Care Ombudsmen and Disability Rights New Jersey are here to help.  If you or someone you know is in a life-threatening situation or immediate danger, call 911 or the local police or sheriff. The National Center on Elder Abuse (NCEA) directed by the U.S. Administration on Aging, helps communities, agencies and organizations ensure that older people and adults with disabilities can live with dignity, and without abuse, neglect, and exploitation. We are based out of Keck School of Medicine of USC. NCEA is the place to turn for education, research, and promising practices in preventing abuse.

Visit us online for more resources! ncea.acl.gov

This material was completed for the National Center on Elder Abuse situated at Keck School of Medicine at the University of Southern California and is supported in part by a grant (No. 90ABRC000101-02) from the Administration for Community Living, U.S. Department of Health and Human Services (DHHS). Grantees carrying out projects under government sponsorship are encouraged to express freely their findings and conclusions. Therefore, points of view or opinions do not necessarily represent official ACL or DHHS policy. LAST DOCUMENT REVISION: DECEMBER 2018

Grandparents Stepping Up to Assist Grandchildren with Virtual Education

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Dr. Charisse Smith

As a young child growing up in New Jersey, I recall spending countless summers in the sandy woods of Wall Township with my maternal grandmother, Carolyn Holland.

On her screened-in porch, we spent hours playing such card games as Pitty Pat, War and Casino. This card shark, with less than an eighth-grade education, showed me no mercy, winning game after game! Through these card games, she fortuitously taught me how to quickly identify numbered groups (subitizing*) and strategy (critical thinking).

My paternal grandfather, Robert E. West of Neptune, instructed me in the art of applying the correct tip for great service at the local Perkins Pancake House. Maternal aunt Doris Sergeant of Asbury Park cultivated my love of reading and storytelling through her reading aloud. Her fluctuating animated voice magically fit each and every character of the stories she read.

As I reminisce about these special moments as a wide-eyed, inquisitive youngster, I now appreciate them as authentic learning experiences. I truly cannot recall specific reading or math lessons or feeling that these moments were “school,” but as an educator, I recognize that the benefits of simple card games and stories read to me set me on the path toward academic success.

Although I assist teachers in applying curriculum and best-teaching practices to classrooms, the simple games, conversations and nightly read-alouds with Carolyn, Robert and Doris were invaluable.

COVID-19 and virtual teaching/learning

According to the New Jersey Department of Education, there are approximately 2,734,950 students in New Jersey’s public and charter schools who are now participating in some form of virtual or remote learning due to the COVID-19 crisis. Many New Jersey schools pivoted from photocopied worksheets and packets to working exclusively online with students in virtual classrooms.

In a matter of a few weeks, New Jersey school districts found themselves quickly gathering their troops of learning experts, teachers and educational technology departments to provide quality learning opportunities for all of their students. Families also found themselves banding together to navigate through digital learning platforms like Zoom, Google Classroom, Google Meets, Microsoft Teams, Class Dojo, Canvas and Blackboard.

Older Americans are teaching/learning, too

Older Americans also fearlessly accepted the call to join the ranks of the virtual homeschooling faculty. Because many parents continue to work as essential workers, older adult family members have been designated as the at-home schoolteacher. These older family members are ensuring that children are logging on, participating and completing school assignments.

One example is a 68-year-old grandmother in Mercer County’s Hamilton Township, Mrs. Jones. She joined the ranks of homeschoolers this March. Mrs. Jones is not only caring for her ill husband, but by working in online learning platforms to assist her kindergarten-aged grandson, has expanded her technological skill set.

Through perseverance and a little bit of coaching, Mrs. Jones is now more comfortable helping her grandson with the daily requirements of cyber-learning such as logging on to online class meetings; monitoring reading, writing, and math assignments in Google Classroom; accessing books online; following up with emails, and communicating with teachers via the Class Dojo app.

Familiarizing oneself with multiple learning platforms can be overwhelming even for the most tech-savvy person. But older Americans, like Mrs. Jones, are courageously balancing the duties of being a caregiver for an ailing spouse, running a household and homeschooling an active kindergartener.

I admire Mrs. Jones for her tenacity and grit during this challenging time. She admits that working with technology is frustrating, and she felt like giving up, but I encouraged her to take care of herself and to do her best. Her best is amazing!

Other ways older adults can share knowledge/expertise

I encourage all older adults who are caring for and/or homeschooling young family members to share their knowledge and expertise by:

  • Having conversations
  • Counting and grouping the number of tiles on the floor
  • Finding a pattern in the carpet
    • *I mentioned subitizing before. Subitizing is a hot topic in math education circles. It means “instantly seeing how many.” Math educators have discovered that the ability to see numbers in patterns is the foundation of strong number sense. Visit https://mylearningspringboard.com/subitizing/
  • Following a recipe using measuring spoons and cups
  • Writing a song together and recording Tik-Tok videos of you singing
  • Coloring in coloring books
  • Listening to books on tape or online together
    • This website features videos of actors reading children’s books, alongside creatively produced illustrations. Activity guides are available for each book. https://www.storylineonline.net/
  • Teaching them how to play a card game

Other resources to use

Older adults have much to give and young people, much to receive! I would dare to guess that there are many Mrs. Joneses here in New Jersey. Are you one? You deserve our gratitude, respect and support.

As a New Jersey educator, I would like to thank all of the caring and brave older Americans in our state who are committed to sharing their knowledge, wisdom, love and expertise to help our students continue to grow and learn!

Dr. Smith is the featured guest on Episode 106 of Aging Insights, with host Melissa Chalker — watch “Learning Together” now!

Dr. Charisse Smith of Trenton earned a Ph.D. in Education with a specialization in Professional Studies. She serves on the boards of New Jersey Foundation for Aging and Notre Dame High School, is an Instructional Coach with the Hamilton Township Public Schools, President of ETE-Excellence Through Education of Hamilton Township and is the owner of Sankofa Educational Consulting, LLC.  Dr. Smith proudly notes that she has been married for 23 years and has two beautiful children!

 

The COVID-19 Crisis at NJ’s Long-Term Care Facilities

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We’d like to thank guest blogger and NJFA friend Laurie Facciarossa Brewer, NJ’s Long-Term Care Ombudsman, for her blog post.

By Laurie Facciarossa Brewer, NJ’s Long-Term Care Ombudsman

The COVID-19 crisis in long-term care facilities is an unprecedented national tragedy. Around the country, tens of thousands of vulnerable residents of nursing homes and assisted living facilities have died.

In fact, as of today in New Jersey, more than 5,400 long-term care residents have lost their lives due to the pandemic. To better put this into perspective, these deaths are more than half of New Jersey’s total cases.

Not only are the numbers themselves horrifying, but the inability of family and friends to physically be there with their loved ones in their final moments-as facilities were locked down to attempt to prevent more infection-makes it all the more painful and traumatic.

I mourn and hold dear the loss of each of these residents and wish peace and healing for their loved ones. And I am deeply concerned about the health and welfare of the long-term care residents who remain, and about the staff who care for them.

As an independent state agency that advocates for long-term care residents by investigating allegations of abuse and mistreatment, the New Jersey Office of the Long-Term Care (NJ LTCO) Ombudsman has been in the forefront in attempting to help residents and families deal with any issues or problems they may be having during this health emergency.

The investigation process

Usually, when we receive a complaint or concern, we make an unannounced visit to the resident in question and obtain consent to do an investigation.

Unfortunately, those visits stopped on March 13 when the federal and state government decided to severely restrict any visits to long-term care facilities, including by state regulators, families and representatives of the Ombudsman program.

The sudden inability to go into the facilities to witness what was happening there–to see firsthand the staffing levels and the physical conditions­­–and to have to rely on phone calls, FaceTime and other technologies to gain insight into what was truly happening, was very jarring and required some out-of-the-box thinking.

Fortunately, the NJ LTCO has highly seasoned and experienced investigators who have deep contacts in, and experience with, long-term care facilities in New Jersey.

In addition, the NJ LTCO has more than 200 highly trained volunteer ombudsmen assigned to an equal number of nursing homes. Under normal circumstances, these volunteers would be in their assigned nursing home every week, speaking with residents and handling their concerns.

So, even though we are not visiting LTC facilities, the NJ LTCO is well-positioned to reach deep into a facility and identify the right person who can solve problems for residents and their families.

Our volunteers continue to keep in contact with residents in nursing homes and have distributed letters reminding residents that the NJ LTCO is still here to assist them with any problems they may be having.

The dramatic increase in calls and cases

Our investigators have never been busier.

During March and April, calls to the NJ LTCO intake line increased by 40 percent, as did the number of cases opened for investigation.

The types of complaints that we have been receiving reflect the deepening crisis in long-term care. Here are some examples:

  • A woman called to tell us that her 56-year-old sister was on a ventilator, fighting for her life after being diagnosed with COVID-19. The long-term care facility in which her sister lived, she alleged, had refused to send her sister to the hospital.
  • A 71-year-old, bed-bound resident called the NJ LTCO to complain that she was not receiving her medication and that she hadn’t been changed–and was sitting in her own urine for more than 24 hours.
  • A nurse called to tell us that she was the only one who showed up to care for more than 60 residents during an evening shift in a nursing home.
  • A man called to see if we could find his mother, who was COVID-19-positive, had a fever and had been hurriedly moved out of her nursing into another one–with no advance notice to the family. He didn’t know if his mother was dead or alive.
  • A family member called to report that he was informed that his father had a fever, that COVID-19 was suspected and that he was fine. He was called 90 minutes later and told that his father had died.
  • Multiple staff members called the NJ LTCO intake line to report that they were not given proper personal protection equipment (PPE) in order to care for residents safely.
  • Dozens of family members called us to state that their loved ones died of COVID-19, alone and without family by their side. Most of these callers alleged care neglect due to poor staffing.

As this crisis unfolds into late spring and early summer, it appears that there is more PPE and more testing available. These are the two things that are absolutely critical to stemming the tide of this horrific virus and getting to a place where our office, state regulators, and families and friends can once again visit long-term care residents.

Stepping up outreach

In the meantime, here at the NJ LTCO, we continue to adapt to this new reality. While we look forward to the day when we can go back into long-term care facilities, we are stepping up our outreach to residents via newsletters, direct phone calls and utilization of tablets and smart phones.

In mid-May, we began to distribute a resident-focused monthly newsletter to residents of long-term care facilities. In the inaugural edition, we remind residents that they have rights and that they can always call us for assistance. In addition, we remind them that most of them will get a $1,200 stimulus payment as a result of the COVID-19-related CARES Act and that this money is theirs-and no one can take it from them.

Conditions at long-term care facilities; hope for the ensuing months

I wish I could say that the tragedy of COVID-19 in our long-term care facilities was totally unforeseeable, but that would not be the whole truth. While the scope and speed at which the COVID-19 tragedy unfolded were certainly new, the conditions in many of our long-term care facilities were ripe to fuel this type of situation.

In the ensuing months, it is my hope that we will see the effects of this terrible virus wane in long-term care facilities. In its wake, I am sure that there will be a clear-eyed assessment of how we, as a society, could have done more to protect vulnerable elderly and disabled people living in residential settings. We have learned much about this virus and the terrible toll it can take in long-term care facilities. My expectation is that we all will apply the lessons we have learned so that we are better prepared for any future outbreaks.

The thousands of souls we have lost and the thousands of vulnerable elderly and disabled people currently living in long-term care facilities deserve at least that much.

For more information on the LTCO, visit nj.gov/ooie/. The LTCO can be reached by calling 1-877-582-6995 or by email at ombudsman@ltco.nj.gov.

Any opinions expressed within guest blogs are those of the author and are not necessarily held by NJ Foundation for Aging.

Caregiving by the Numbers

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See resources at the end of this blog, including information for caregiving during COVID-19. 

A Caregiving Report by AARP’s Susan Reinhard and Lynn Friss Feinberg revealed that in 2017, about 41 million family caregivers in the U.S. provided an estimated 34 billion hours of care to an adult with limitations in daily activities. Support included basic functional activities (such as help with eating and bathing), household chores (such as meal preparation and help with shopping), and medical/nursing tasks, to help individuals remain in their homes and communities for as long as possible.

The estimated economic value of their unpaid contributions was approximately $470 billion. By comparison, all out-of-pocket spending on U.S. health care in 2017 was only $366 billion.

Here in the Garden State, nearly 2 million New Jersey residents — this writer included — provide varying degrees of unreimbursed care to family members or friends who are elderly or disabled and limited in their daily activities. Another AARP report noted that the services caregivers provided in the state had an annual value of more than $13 billion.

The prospect that someone will be a caregiver, or potentially need a caregiver, by 2030 is great because the nation’s population is changing and will mark a significant demographic turning point by then, according to the U.S. Census Bureau’s 2017 National Population Projections.

The year 2030 is when all baby boomers will be older than age 65 — meaning that one in every five U.S. residents in 2030 will be of “retirement age.”

In a press release revised in Oct. 2019, Jonathan Vespa, a demographer with the U.S. Census Bureau, said, “The aging of baby boomers means that within just a couple decades, older people are projected to outnumber children for the first time in U.S. history. By 2034, there will be 77.0 million people 65 years and older compared to 76.5 million under the age of 18.”

When it comes to being a caregiver, there appears to be few age boundaries. Of these nearly 41 million family caregivers nationwide, the majority are in their 40s and 50s, AARP reports, but about 1 in 4 is part of the millennial generation.

Conversely, a recent story in the Daily Record of Morris County spotlighted the 100th birthday of Carmela “Millie” Scarnato. A newly minted centenarian, Scarnato is still a caregiver for her son with special needs, who is 57.

COSTS AND CHALLENGES

The work of a caregiver, AARP notes, can often morph into a part-time job or more, and cost caregivers more than $600,000 in lost wages and missed Social Security benefits over a lifetime.

One of the greatest challenges of family caregivers though is training, noted Forbes Senior Contributor Howard Gleckman in his article titled “Compassion isn’t enough for family caregivers. They need training too.” Gleckman contends that family caregivers often provide aid with lots of love and compassion, but zero skills.

“That lack of training makes their lives more difficult and makes it more likely that those they are caring for will fall, get infections, or suffer from dehydration or malnutrition,” Gleckman says in the article. “And as family members increasingly are expected to provide nurse-like wound care or complex medication management, their need for training is even greater.”

Gleckman cites a study published in JAMA Internal Medicine indicating that 93 percent of family members caring for an older adult said they had never been taught how to do this difficult work.

WHAT’S HAPPENING IN TRENTON

In 2018, a bill was signed into law creating the New Jersey Caregiver Task Force to evaluate caregiver support services in the State and provide “recommendations for the improvement and expansion of such services ensuring that New Jersey is doing all it can to support caregivers who provide invaluable services to loved ones and friends.”

The NJ Caregiver Task Force consists of representatives from the public and private sectors.

“Studies show that the emotional and physical health of caregivers often suffers as a result of the stress and physical demands they encounter, particularly when it comes to caring for people with dementia or Alzheimer’s,” said Assemblywoman Vainieri Huttle, a co-sponsor of the bill, in a press release. “This task force will take an honest look at how we can better address these needs.”

The Task Force will:

  • Identify and survey caregivers in the state, in order to develop an aggregate summary of caregiver characteristics, including age, geographic location, the amount of time spent in caregiving activities and acting in the caregiver role.
  • Solicit testimony from caregivers on the nature and type of tasks they perform; the feasibility of task delegation; the availability and sufficiency of caregiver training programs, financial support services.
  • Submit a report to the Governor and the Legislature detailing its findings and providing recommendations for legislation, or for regulatory or programmatic changes.

“Caregivers devote their lives to their loved ones, often missing work and missing out on wages, and this is going to become more of a concern in the coming years with an aging population,” noted Task Force member and Commissioner, New Jersey Department of Human Services, Carole Johnson.

HELPFUL INFORMATION

If you’re a caregiver, or will soon become one, consider the following:

  1. Hire an elder-care attorney to draw up financial and medical power of attorney documents, plus determine if a loved one is eligible for other services. Watch episode 86 of NJFA’s “Aging Insights” TV program, “The Three Most Important Documents,” at https://youtu.be/axmetvdDQQ8
  2. Learn about expanded paid time off for caregivers. Watch “Take the Time You Need,” episode 95 of NJFA’s “Aging Insights,” at https://youtu.be/gJrnqz_Mehc
  3. View “Giving and Getting Support, episode 99 of “Aging Insights,” which is devoted to caregiving, at https://youtu.be/9T5ObyIkdRQ
  4. Visit NJ’s county-by-county Aging & Disability Resource Connection/Area Agency on Aging (ADRC/AAA) for resources  https://www.state.nj.us/humanservices/doas/home/saaaa.html
  5. Caring for a veteran? Check out resources available through Veterans Affairs at https://www.nj.gov/military/veterans/benefits-resources/
  6. Become familiar with the CARE (Caregiver Advise Record Enable) Act, which was enacted to help the growing number of family caregivers know what to do/how to do it after a parent or older loved one’s hospitalization. [Download a wallet card at https://www.aarp.org/caregiving/local/info-2017/care-act-aarp-wallet-card.html]
  7. Social workers and nurses at hospitals and medical practices who are treating your loved one can suggest appropriate local services.
  8. Visit the AARP’s caregiving resource area https://www.aarp.org/caregiving/
  9. Visit the Family Caregiver Alliance for NJ https://www.caregiver.org/state-list-views?field_state_tid=89
  10. Read more about caregiver burnout and ideas to help combat it https://www.aginginplace.org/caregiver-burnout/

Here are resources specific to caregiving and the coronavirus:

https://www.johnahartford.org/dissemination-center/view/coronavirus-disease-covid-19-resources-for-older-adults-family-caregivers-and-health-care-providers

https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-caregiving-for-the-elderly

https://www.ncoa.org/covid-19/covid-19-resources-for-older-adults/

REFERENCES

Links to references are in the blog copy.

by Sue Burghard Brooks, Communications Manager for the New Jersey Foundation for Aging. A published author, Sue is also a caregiver for her Dad, who is a nonagenarian veteran and a Mason.

 

 

Testimony given by NJFA Executive Director Melissa Chalker to the inaugural meeting of the Assembly Senior Services Committee, 1/27/2020

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The New Jersey Foundation for Aging’s Executive Director, Melissa Chalker, was invited to testify at the inaugural meeting of the Assembly Senior Services Committee on January 27, 2020. The committee includes Chair Valerie Vainieri Huttle, Vice-Chair Shanique Speight and members BettyLou DeCroce, DiAnne C. Gove, Angela V. McKnight and P. Christopher Tully. This was Melissa’s testimony. To read more about the meeting, see the NJ Spotlight coverage here.

“Good afternoon, Assemblywoman Vainieri Huttle and members of the Assembly Senior Services Committee. Thank you for this opportunity to speak with you today. I am Melissa Chalker and I’m the Executive Director of the nonprofit New Jersey Foundation for Aging (NJFA).

NJFA was founded in 1998 by four County Office on Aging Directors. They wanted to create a statewide organization that would address public policy issues related to the changing and diverse needs of our growing aging population. Since then, we have worked with a wide variety of partner organizations, as well as state government officials, to enable older adults to live with independence and dignity in their communities.

Today, I would like to tell you about NJFA’s advocacy priorities and present some current data related to older adults.

FINANCIAL INSECURITIES

NJFA developed the state’s first Elder Index Report — a cost-of-living table — in 2009. In 2015, the NJ State Legislature passed a bill that mandated the use and updating of the report by the Dept. of Human Services — specifically the Div. of Aging Services, which I am sure my friends from the Division can tell you more about.

From the first report in 2009, through the national database update that was unveiled last week, this Elder Index data allows us to look at the cost of living for seniors in NJ, determine how many fall below the Elder Index Benchmark ($29,616 a year for a single elder renter) and focus on how they can be supported by public benefits and other programs to fill the gap.

Because of the Elder Index research, we know that 8% of New Jersey’s older adults live at or below the federal poverty level. Those seniors are among our most vulnerable — both financially and medically.

Additionally, Social Security is the only source of income for 30% of older adults in New Jersey. The average annual Social Security benefit for a retired elder in NJ is $18,065. We know that number is even lower for women, plus there are many other seniors who receive far less than the average benefit. We have received calls and letters from older adults seeking help, stating that they are trying to get by on their monthly Social Security benefit of $700. After paying their rent and health care premiums, they are often left with $100 or less for groceries, co-pays and other expenses.

In addition to those seniors living below the federal poverty level, there are older adults who may be above that benchmark, but still struggling to meet all their basic needs. In fact, the most recent NJ Elder Economic Security Index indicates that more than half (54%) of New Jersey’s seniors do not have the annual income needed to provide for their basic needs. This is what is referred to as New Jersey’s statewide Elder Economic Insecurity Rate (EEIR). These are the older adults that we refer to as being “in the gap.” That gap is having income too high to qualify for government programs, but too low to adequately cover basic expenses.

The Elder Index statistics influence much of NJFA’s advocacy work, including, but not limited to, affordable and accessible homes, nutrition and food security, and access to quality healthcare. However, this data should serve as a reminder that the state must also consider older adults when discussing tax relief programs — including property taxes — and review the structure of retirement income taxes, compared to that of neighboring states.

HOUSING INSECURITIES

Ensuring that New Jersey’s aging population has safe and affordable housing is also imperative. Two years ago, we convened a stakeholder group, which developed a policy recommendation report. I have provided a copy for each of you to review [see the report here].

In the 10 recommendations listed, you will see that we are suggesting increases in vouchers and units for older adults within existing housing programs. We also identified ways to streamline the process and implement incentives to provide more housing to older adults that is safe, affordable and accessible.

When we consider the housing needs of seniors, we must consider every senior — there is no one-size-fits-all for older adults. When implementing policies and programs, we need to recognize seniors with chronic health conditions and those who are facing economic insecurity.

Additionally, there are middle-income seniors who struggle to find appropriate, accessible places to live in their communities of choice, and worry about being able to afford all their retirement expenses — including the potential need for long-term care services, which can add up to $50,000 a year to their costs depending on the level of care. Along with our partners, we’re engaged in discourse about age-friendly communities, particularly how social and wellness services can better be incorporated.

FOOD INSECURITIES

Much like anyone in any age category, the nutritional needs of seniors are a priority. Protecting the SNAP [Supplemental Nutrition Assistance Program] program from Federal cuts would ensure that those who rely on the program will still be able to access healthy foods. What we have learned from partners doing outreach with seniors is that often an older adult on SNAP is better able to follow a doctor’s dietary guidelines because of this benefit.

One area of need, though, is finding and educating seniors who do not know about the SNAP program, or those who fear the stigma of public benefits and the stories about the difficulty in applying for the program. My friends at the Division of Aging Services can confirm that there has been under enrollment of seniors in SNAP for quite some time.

An improvement to SNAP program would be a Standardized Medical Deduction for seniors applying for SNAP, which would make it easier for seniors to take advantage of the medical deduction provision. Having one max deduction amount that all seniors could utilize would make it easier for them to apply for, and receive, SNAP.

FAMILY CAREGIVERS

The issues and struggles surrounding informal, unpaid family caregivers have been well documented. Family members provide most of the care for older adults and individuals with disabilities here in NJ. Our healthcare system will need to respond to the continued growth of the 65+ demographic over the next decade. Relying on family caregivers to fulfill all facets of care is unrealistic; but we know that it will become a necessity for many. Therefore, we need to not only look at policy changes to the healthcare system, but also the support of caregivers.

There is an urgent need to bring greater public awareness to this issue and to advocate for caregivers. Expanding access to home-based, long-term care services for NJ’s older adults would provide some relief in that area. The state has done a great job increasing the number of people who receive home- and community-based services through the state’s MLTSS [Managed Long Term Services and Supports] program.

Therefore, NJFA continues to participate in dialogue around the need for a policy or program to address those who fall in the gap between eligibility for Medicaid and the ability to pay privately for care.

In conclusion, there is no single answer to “how do we better serve older adults in NJ,” because there isn’t just one issue. Across our nation (and even the world), longevity is increasing, which is good news. However, that means that society’s ageist views, which place barriers on the road to aging well, need to be dismantled now. Investing dollars into housing, nutrition and healthcare services (including those that benefit caregivers) will ensure that everyone in NJ has the opportunity to live a long and healthy life.

Thank you for your time.”