Following President Biden’s announcement calling on Congress to put $400 billion toward expanding access to quality, affordable home- or community-based care for aging relatives and people with disabilities, the House Democratic Caucus Task Force on Aging & Families (TFAF) leadership released the following statement:

“Quality, affordable health care should be accessible to every single American whether they’re able to travel to receive treatment or require care in their own homes,” said the House Democratic Caucus Task Force on Aging and Families. “There is a crisis in caregiving that has plagued seniors, families and health care workers alike for too long, since before the COVID-19 pandemic began. Too many families and caregivers – predominantly women – feel unseen as they struggle to provide for the health, safety and dignity of their loved ones. Today’s announcement is an acknowledgment that House Democrats and the Biden-Harris administration see you and that help is on the way.

“This investment of $400 billion into the care economy will make home care more affordable, accessible and dignified. It is particularly crucial for workers and families that President Biden has a plan to ensure that home health care providers have a pathway to good-paying jobs with union protections, as we know that when we support our caregivers and provide them with a better quality of life, the quality of care rises as well.

“This investment represents the beginning, not the end, of our collaboration with the Biden administration to support the workforce that empowers older Americans and people with disabilities to live in their own homes and communities.”

President Biden’s American Jobs Plan for improving the caregiving industry includes:

• $400 billion for expanding access to home and community-based services (HCBS).
• Extending the longstanding Money Follows the Person program that supports innovations in the delivery of long-term care.
• Supporting well-paying caregiving jobs that include benefits and the ability to collectively bargain.
• Building state infrastructure to improve the quality of services and to support workers.

Vice Chair Debbie Dingell (D-MI), Co-Chair Conor Lamb (D-PA) and Vice Chair Ayanna Pressley (D-MA) led a letter with 108 of their colleagues to President Joe Biden and Vice President Kamala Harris reiterating the importance of including home- and community-based services (HCBS) in the Build Back Better infrastructure package. A copy of the letter can be found here. The Task Force on Aging and Families has advocated for the importance of HCBS for families throughout the pandemic, including in its April 2020 principles for protecting the health and dignity of older Americans amid COVID-19.

A caregiver, sometimes referred to as a caretaker, refers to anyone who provides care for another person. Millions of people living in the United States take care of a friend or family member with Alzheimer’s disease or a related dementia. Sometimes caregivers live with the person or nearby, other times they live far away. For many families, caring for a person with dementia isn’t just one person’s job, but the role of many people who share tasks and responsibilities. No matter what kind of caregiver you are, taking care of another person can be overwhelming at times. These tips and suggestions may help with everyday care and tasks.

Early on in Alzheimer’s and related dementias, people experience changes in thinking, remembering, and reasoning in a way that affects daily life and activities. Eventually, people with these diseases will need more help with simple, everyday tasks. This may include bathing, grooming, and dressing. It may be upsetting to the person to need help with such personal activities. Here are a few tips to consider early on and as the disease progresses:

• Try to keep a routine, such as bathing, dressing, and eating at the same time each day.
• Help the person write down to-do lists, appointments, and events in a notebook or calendar.
• Plan activities that the person enjoys and try to do them at the same time each day.
• Consider a system or reminders for helping those who must take medications regularly.
• When dressing or bathing, allow the person to do as much as possible.
• Buy loose-fitting, comfortable, easy-to-use clothing, such as clothes with elastic waistbands, fabric fasteners, or large zipper pulls instead of shoelaces, buttons, or buckles.
• Use a sturdy shower chair to support a person who is unsteady and to prevent falls. You can buy shower chairs at drug stores and medical supply stores.
• Be gentle and respectful. Tell the person what you are going to do, step by step while you help them bathe or get dressed.
• Serve meals in a consistent, familiar place and give the person enough time to eat.

Communication can be hard for people with Alzheimer’s and related dementias because they have trouble remembering things. They also can become agitated and anxious, even angry. In some forms of dementia, language abilities are affected such that people have trouble finding the right words or have difficulty speaking. You may feel frustrated or impatient, but it is important to understand that the disease is causing the change in communication skills. To help make communication easier, you can:

• Reassure the person. Speak calmly. Listen to his or her concerns and frustrations. Try to show that you understand if the person is angry or fearful.
• Allow the person to keep as much control in his or her life as possible.
• Respect the person’s personal space.
• Build quiet times into the day, along with activities.
• Keep well-loved objects and photographs around the house to help the person feel more secure.
• Remind the person who you are if he or she doesn’t remember, but try not to say, “Don’t you remember?”
• Encourage a two-way conversation for as long as possible.
• Try distracting the person with an activity, such as a familiar book or photo album, if you are having trouble communicating with words.

Eating healthy and staying active is good for everyone and is especially important for people with Alzheimer’s and related dementias. As the disease progresses, finding ways for the person to eat healthy foods and stay active may be increasingly challenging. Here are some tips that may help:

by Jannette Jauregui

The term “food insecure” is not a familiar part of our culture’s vocabulary, but it is a regular part of the conversation at the Ventura County Area Agency on Aging (VCAAA).

The team of dietitians that are part of the VCAAA’s Senior Nutrition Program focused their time on developing class curriculum, recipes, and other resources for healthy eating on a budget long before the COVID-19 crisis began – all while recognizing that the populations served often face food insecurity, meaning they have limited or no access to regular meals, much less healthy meals.

With a special focus on the nutritional needs of older adults in particular, the team is dedicated to identifying gaps in daily intake and addressing those needs with resources made available through the various elements of the Senior Nutrition Program. Prior to COVID-19, home delivered meals were offered to older adults who are unable to leave their home, while congregate meal services were offered through 11 community meal sites throughout Ventura County with no cost requirement other than a suggested donation of $3 per meal. But the COVID-19 crisis exacerbated the gaps in services and resources for many communities throughout the country, with few populations hit harder than older adults.

The VCAAA immediately identified the fact that stay-at-home orders and restaurant closures meant the people who depended on VCAAA’s home delivered and congregate meal services, and even those who had never been part of the program, were going to need access to food more than ever before. As a result, the VCAAA expanded its existing pantry to include a much larger COVID-19 Food Pantry that brought two or more weeks-worth of food safely to the homes of some of Ventura County’s most vulnerable residents. Partnerships with dozens of locally owned restaurants and World Central Kitchen have offered daily deliveries of high-quality restaurant meals. In total, the VCAAA has served nearly 3.6 million meals since March 2020.

While the demand for food and meal resources increased, so did the need for the educational components of the Senior Nutrition Program. In response, the VCAAA transitioned the once in-person education-based nutrition classes and individualized counseling to the virtual platform via Zoom and telephone. Aimed at arming older adults with the information and resources needed to eat healthy on a budget, classes and individualized nutrition counseling focus on all topics of concern, including high blood pressure, increased cholesterol, diabetes, heart disease, and more. Recipes developed and shared by VCAAA dietitians are created with a fixed budget in mind, and are affordable to people of all income levels.

Classes currently offered each month include EatFresh.org and Eat Smart, Live Strong. There is also a “bonus” class offered monthly that focuses on a unique topic. For April, that class will focus on “How to Build a Healthy Plate.”

All classes and nutritional counseling are open to people 60 and older and are offered at no cost to participants. To learn more about current class offerings, visit www.vcaaa.org. For more information, or to register for a class, call (805) 477-7300 or e-mail [email protected].

People with dementia have a higher risk of getting COVID-19, are more likely to require hospitalization, and are more likely to have severe or fatal cases of this disease compared with people without dementia. This risk is even higher in Black patients with dementia, according to a new study funded in part by NIA and published in Alzheimer’s & Dementia.

A person’s age and preexisting health conditions such as asthma, diabetes, heart disease, and obesity are significant risk factors for serious illness from COVID-19. Interestingly, these factors are also linked to dementia. However, scientists and doctors have little information about how COVID-19 affects people who have dementia. The new study, led by researchers at Case Western Reserve University, used information from the electronic health records of about 61.9 million U.S. adults from all 50 states to explore the link between dementia and COVID-19. The data was collected as part of the IBM Watson Health Explorys database. In this dataset, more than 1 million patients had dementia, 15,770 had COVID-19, and 810 had both.

The study found that people with dementia were twice as likely to get COVID-19 compared with people without dementia, even after adjusting for age, sex, living in a nursing home, and having similar preexisting conditions. The researchers suggest that the memory problems associated with dementia might make it difficult for patients to stick to safety measures such as wearing masks, washing hands frequently, and social distancing.

Results showed that 73% of Black patients with dementia and 54% of White patients with dementia were hospitalized within 6 months of their COVID-19 diagnosis, compared with 25% of patients without dementia. Only 20% of Black patients with dementia but not COVID-19 and 12% of White patients with dementia but not COVID-19 were hospitalized within the same time frame. Patients of either race with dementia were almost four times more likely to die from COVID-19 than patients without dementia. The researchers also found that vascular dementia, which is caused by damage to the vessels that supply blood to the brain, led to the highest risk of COVID-19, suggesting that damaged blood vessels might make it easier for disease-causing bacteria and viruses to get from a person’s blood into the brain.

Although their findings need to be replicated using other databases and registries, the researchers note that the study lays the foundation for future research into the interactions between COVID-19 and brain diseases, including whether COVID-19’s effects on the brain increase the risk of or worsen dementia. The study demonstrates the need for innovative and effective measures to protect older adults with dementia from COVID-19 as part of controlling the pandemic and highlights the pressing need to address health disparities.

This research was supported in part by NIA grants AG057557 and AG062272.

A third round of stimulus payments are on their way. But has your second one shown up yet? Next question: Did you file last year’s 2019 taxes on paper instead of e-filing? If so, that might well be the reason you don’t have your money yet.

The IRS got behind on processing the paper tax forms we sent a year ago. If all had gone well, those who were eligible should have received a $600 stimulus check (the second one) by Jan. 29, 2021.

The IRS has a specific page for you to check the status of your stimulus payment, but it’s only good for the third stimulus check. All information for your first and second stimulus money has been removed from their website.

Start with www.irs.gov/coronavirus/get-my-payment and scroll to Get My Payment. Click on it and fill out the information. You’ll go to a page that tells you the status of the payment you’re to receive now, the third payment. If it says that payment information is Not Available, it means you’re not going to receive a payment the easy way (and might be why your second payment is still missing). On the Get My Payment page, click on Frequently Asked Questions to see what applies to you.

Even if you don’t normally file, you’ll need to file for 2020 (preferably e-file) if you want that stimulus money quickly. Look for Line 30 on the Form 1040 or 1040-SR. It’s called the Recovery Rebate Credit. If you received Notice 1444 or 1444B in the mail from the IRS, it will tell you what figures to use.

If you’re confused about COVID vaccine and when our lives are going to change for the better, you’re not alone. We’re considered to be fully vaccinated once two weeks have passed after the second dose of Pfizer or Moderna vaccines, or two weeks after the one-dose Johnson & Johnson.

What’s new is this, per the Centers for Disease Control and Prevention: If fully vaccinated, you can be indoors with other fully vaccinated people without wearing a mask. You can meet indoors with unvaccinated people in one household unless one of those people has a health risk. If you’ve been around someone who has COVID, you don’t have to stay away from people or get tested unless you have symptoms … or live in a group setting. In that case, stay away from others for 14 days and get tested, even if you don’t have symptoms.

It gets worse. According to the CDC, as fabulous as this new vaccine is, even if fully vaccinated, we still need to wear masks in public. We still need to social distance. We still need to avoid medium and large crowds. We still need to stay out of poorly ventilated spaces. We should delay travel.

So what’s the holdup? Why are we still under restrictions after getting the vaccine? The best I can figure out is that the answer lies with the COVID variants, the different versions created as the virus mutates.

(c) 2021 King Features Synd., Inc.

Vascular dementia is caused by conditions such as stroke that disrupt blood flow to the brain and lead to problems with memory, thinking, and behavior. Vascular dementia is the second most common dementia diagnosis, after Alzheimer’s disease, and can occur alone or alongside another form of dementia.

Vascular dementia is caused by conditions that damage blood vessels in the brain and interrupt the flow of blood and oxygen to the brain. In the research community, these conditions are known as vascular contributions to cognitive impairment and dementia (VCID). The brains of people with vascular dementia often show evidence of prior strokes, thickening blood vessel walls, and thinning white matter — the brain’s connecting “wires” that relay messages between regions.

Not everyone who has had a stroke will develop vascular dementia. A person’s risk for dementia after stroke depends on the size and number of strokes and the brain regions affected. Vascular dementia can also result from other conditions that impede blood flow and delivery of oxygen to the brain, such as narrowing of the arteries.

High blood pressure, problems with the heartbeat’s rhythm, diabetes, and high cholesterol can increase a person’s risk of vascular dementia. By controlling or managing risk factors, you may lower your chance of developing cognitive impairment and dementia.

Symptoms of vascular dementia can appear suddenly and may progress slowly over time. Symptoms often look similar to those of Alzheimer’s disease, but memory loss is more prominent in Alzheimer’s, whereas problems with organization, attention, and problem-solving may be more obvious in vascular dementia.

People with vascular dementia may experience:

• Difficulty performing tasks that used to be easy, such as paying bills
• Trouble following instructions or learning new information and routines
• Forgetting current or past events
• Misplacing items
• Getting lost on familiar routes
• Problems with language, such as finding the right word or using the wrong word
• Changes in sleep patterns
• Difficulty reading and writing
• Loss of interest in things or people
• Changes in personality, behavior, and mood, such as depression, agitation, and anger
• Hallucinations or delusions (believing something is real that is not)
• Poor judgment and loss of ability to perceive danger
• Symptoms may depend on the size, location, and number of damaged areas of the brain.

To diagnose vascular dementia, a doctor may ask about problems with daily activities, conduct memory or thinking tests, and speak with someone who knows the person well to see if symptoms of dementia are present. Medical history, lifestyle, and brain imaging tests are often used to help determine whether vascular dementia is the cause of symptoms.

No treatments are available to reverse brain damage that has been caused by a stroke. Treatment for vascular dementia focuses on preventing future strokes. Medications to prevent strokes, such as blood thinners, may help decrease the risk of further damage to the brain. Medications that help treat the symptoms of Alzheimer’s disease might benefit people with early vascular dementia. A doctor may also recommend treating risk factors, such as high blood pressure or high cholesterol, through medications and lifestyle changes.

A healthy lifestyle is important to help reduce risk factors of vascular dementia. This includes eating well, limiting alcohol, not smoking, exercising, and managing stress.

If you are concerned about vascular dementia symptoms, talk with your doctor. If you or someone you know has recently been diagnosed, explore the resources on this website and linked below to find out more about the disease, care, support, and research.

Endurance activities, often referred to as aerobic, increase your breathing and heart rates. These activities help keep you healthy, improve your fitness, and help you perform the tasks you need to do every day. Endurance exercises improve the health of your heart, lungs, and circulatory system. They also can delay or prevent many diseases that are common in older adults such as diabetes, colon and breast cancers, heart disease, and others. Physical activities that build endurance include:

• Brisk walking or jogging
• Yard work (mowing, raking)
• Dancing
• Swimming
• Biking
• Climbing stairs or hills
• Playing tennis or basketball

Increase your endurance or “staying power” to help keep up with your grandchildren during a trip to the park, dance to your favorite songs at a family wedding, and rake the yard and bag up leaves. Build up to at least 150 minutes of activity a week that makes you breathe hard. Try to be active throughout your day to reach this goal and avoid sitting for long periods of time.

Do a little light activity, such as easy walking, before and after your endurance activities to warm up and cool down.

Listen to your body: endurance activities should not cause dizziness, chest pain or pressure, or a feeling like heartburn.

Be sure to drink liquids when doing any activity that makes you sweat. If your doctor has told you to limit your fluids, be sure to check before increasing the amount of fluid you drink while exercising.

If you are going to be exercising outdoors, be aware of your surroundings.

Dress in layers so you can add or remove clothes as needed for hot and cold weather.

To prevent injuries, use safety equipment, such as a helmet when bicycling.

Your muscular strength can make a big difference. Strong muscles help you stay independent and make everyday activities feel easier, like getting up from a chair, climbing stairs, and carrying groceries. Keeping your muscles strong can help with your balance and prevent falls and fall-related injuries. You are less likely to fall when your leg and hip muscles are strong. Some people call using weight to improve your muscle strength “strength training” or “resistance training.”

Some people choose to use weights to help improve their strength. If you do, start by using light weights at first, then gradually add more. Other people use resistance bands, stretchy elastic bands that come in varying strengths. If you are a beginner, try exercising without the band or use a light band until you are comfortable. Add a band or move on to a stronger band (or more weight) when you can do two sets of 10 to 15 repetitions easily. Try to do strength exercises for all of your major muscle groups at least 2 days per week, but don’t exercise the same muscle group on any 2 days in a row.

Always remember to breathe normally while holding a stretch.

Talk with your doctor if you are unsure about a particular exercise.

For More Information About Exercise and Physical Activity

American Council on Exercise
888-825-3636 (toll-free)
[email protected]
www.acefitness.org

American Physical Therapy Association
800-999-2782 (toll-free)