American Society on Aging 575 Market Street, Suite 2100 San Francisco, CA 94105-2869


MOWA’s mighty volunteers p. 9 | Delivering meals to isolated elders proves to be its own reward.

The intersection of violence and isolation p. 12 | A Q&A with Elizabeth Tung


Covering advances in research, practice and policy nationwide

JANUARY–FEBRUARYR 2020 volume xli number 1

the bimonthly newspaper of the American Society on Aging t i t l f t i i t i

What happens when a nursing home closes its doors? Transfer trauma and stress

In this issue

FORUM How to solve a silent crisis? Reach out to neighbors, community page 3 AGINGWITH OPTIONS A roadmap to a longer— and healthier—life page 5 IN FOCUS Community—it’s all about human connection pages 7–11 Trust for America’s Health bridges public health and aging services page 14 Good reads: a unique view of direct care; on physician burnout; and tips on assisted living page 16

son, the potential for trauma to residents remains the same. Implementing better policies and practices, however, can mini- mize negative impacts.

By Cynthia Rudder and Lori Smetanka W hen a nursing home closes and a resident has to move, her health can deteriorate. Change is difficult for vulnerable nursing home residents, many of whomhave some form of dementia and most of whom have already reluctantly left their homes to move into a long-term-care facility. The response to stress caused by a relocation— often called “transfer trauma”—may in- clude depression, distress, agitation, withdrawn behavior, self-care deficits, falls and weight loss. Many nursing homes are closing across the country, and there seems to be an epidemic of closures in rural counties ( ). These closures are primarily due to bankruptcy or other financial issues; forced closure due to poor care or safety concerns; or a change in business model. Regardless of the rea-

Study Offers Strategies to Protect Residents

“best state practices,” highlighting effec- tive approaches being used to oversee clo- sures and minimize their negative effects on residents. One of the study’s clear messages is that state and federal oversight and en- forcement must be stronger to improve care before a facility is forced to close, and to hold providers accountable for follow- ing the rules when a facility does close. Several important findings, noted be- low, highlighted strategies for managing the closure process in a way that engages and protects residents. A coordinated team , made up of state agencies with roles in providing residents

The study by the National Consumer Voice for Quality Long Term Care, “Nursing Home Closures Toolkit for Ombudsmen Relocation can cause depression, distress, agitation, self-care deficits, falls and weight loss. and Advocates” ( ), funded by The Retirement Foundation, sought to identify obstacles to a success- ful transition for residents, as well as pol- icies, procedures and actions to overcome these obstacles. Also the study identified

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Even in independent living, community is all-important

By Verna M. Cavey H aving now lived in retirement communities for a decade, I val- ue this opportunity to write from the perspective of a resident (of inde- pendent living), and respectfully offer a few thoughts. I worked for many years in education, but it took retirement for me to reach the peak of satisfaction in work and in all oth- er compartments of my life—social, spiri- tual, emotional and intellectual. That’s saying a lot. At 72, the critical piece for my friends and myself is community, and the essence of community is human connection. Every- thing else is secondary. Yes, in retirement communities such asmine, budgets need to be followed and excellent programs may be run, but , if the people who live and work in these communities feel ignored or neglect- ed, there is a systemic failure. The workers in our retirement com- munity dwell in private areas beyond resi-

The AiA19 Panel of Pundits, from left: Bob Blancato, Allyson Schwartz, Yanira Cruz, Rich Browdie, John Zogby, Paula Basta.

dents’ view. Residents do as well, in their own hidden worlds. Amid the space of our larger retire- ment community, we residents have our mini-communities, sharing a glass of wine and friendship behind our apart- ment doors. We also have the outside sup- port of family and friends. And staff who are so caring become close to us. All of these people nurture us, emotionally and physically. But there are challenges in communi- ties such as ours: I watch residents in in- dependent living units try to hide their increasing losses of memory and other functions. Many people residing here

At AiA2020, policy takes center stage T he 2020 presidential election is top of the news most days, and though candidates are scrutinized ad infinitum, especially via pointed com- ments about their age, it is rare to see me- dia attention focused more generally on the topic of older adults. The 2020 elec- tions are critically important for elder policy and advocacy, and ASA’s 2020

Aging in America Conference (AiA) offers a concentrated track in these areas. Conference attendees can get the polit- ical lay of the land on Tuesday’s General Session, “Panel of Pundits 2020: The Decision Year.” Presenters first will fo- cus on such issues as Medicare, Social Se- curity, the Older Americans Act and elder justice. Then the focus will shift to the up- coming presidential and congressional elections andwhat election outcomes may mean for older adults in America. The “National Forum on Older Adults and Access to Justice,” on

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