Giggles and the patter of little feet echo through the halls of Providence Mount St. Vincent in Seattle—not exactly the sounds you’d expect to hear in a living-care community for older adults. Then again, “the Mount,” as it’s known, isn’t your typical nursing home.Five days a week, residents and staff share the 300,000 square-foot facility with up to 125 children, ages zero to five. These children and their teachers make up the Mount’s Intergenerational Learning Center (ILC), a licensed nonprofit child-care center and preschool established on the Mount’s premises in 1991.The program was designed to counterbalance the loneliness and boredom that so often characterize life in a nursing facility. These challenges can be particularly evident in homes like the Mount, where the average age is 92 and residents are largely fragile, non-ambulatory, and in need of significant assistance. “We wanted a living, vibrant community; to make sure that this was a place where people came to live, not die,” says Charlene Boyd, an administrator at the center. Bringing children in was a natural solution.Numerous studies have linked social interaction with decreased loneliness, delayed mental decline, lower blood pressure, and reduced risk of disease and death in elders. Socializing across generations has also been shown to increase the amount of smiling and conversation among older adults, according to one Japanese studyfrom 2013.While it’s unclear what kind of impact such social interaction has on children, research suggests it may come with a variety of benefits for them as well. For example, kids who have early contact with older people are less likely to view them as incompetent—and simply exposing children to positive depictions of elders makes them less likely to exhibit ageism. These intergenerational interactions also enhance children’s social and personal development. And, as many of the parents whose children attend the ILC will attest, the kids are prone to feel more comfortable around those with disabilities and impairments of all kinds than their peers who lack such experiences.Integrating preschools and nursing homes isn’t an established trend, and there appears to be no real tally of how many are in existence. But judging by the viral nature of videos and articles depicting these programs on social media, it’s a movement many are eager to embrace. In 1976, a Japanese man named Shimada Masaharu combined the nursery school and home for the aged in Tokyo’s Edogawa municipality under one roof. By 1998, Kotoen was one of 16 such joint facilities, according to the Tokyo Ministry for Health, Labour, and Welfare. The idea trickled over to North America around the same time, and today there are intergenerational centers for elders and young children across Japan, Canada, and the United States.Humans are, and have always been, an intergenerational species. Still, to keep up with the demands of the culture and society of today, the responsibilities of child and elder care have, out of necessity, been outsourced to professionals. “We live in a culture, time, and place where creative people have to use creative means to accomplish something that was always the most ordinary, customary thing in the human experience: older people and younger people sharing their lives,” says Bill Thomas, a doctor and international authority on geriatric medicine and eldercare.
At the Mount, there are plenty of opportunities for intergenerational engagement between residents and the children. Six times a week, teachers take their groups to the residential floors to visit the elders for anywhere from 20 minutes for the infants to 60 minutes for the older children. Residents are welcome to observe in the classrooms, and structured activities for the children and residents to participate in together are scheduled daily. Because they share the same building, there are opportunities for spontaneous engagement, too—when inclement weather strikes, and the children must make do with the halls, lobby, and vacant rooms as their playground, for example. Or when an area musician comes around to play tunes for the children to sing and dance to along with the elders.
Of the families that send their children to the Mount, roughly 10 percent are employees and a large majority are from the West Seattle area. Thanks to support from the Mount and its parent organization, Providence Health & Services, the center is able to offer tuition assistance and a 20 percent discount to staff members. Parents are interested in the program largely due to its reputation. The teachers, who are required to have at least 15 college-credit hours in early childhood education and complete an annual senior-care training, are cited as the biggest draw.“A huge foundational piece of what we do here is teach the children how to solve their own problems,” says Marie Hoover, the director of the Intergenerational Learning Center. “We spend a lot of time with phrases like ‘I see you both want the same ball. What are your ideas for how to solve this?’ Then we work with the kids until they either come up with their own ideas or the teacher gives them some suggestions for working it out. We get a lot of positive feedback about that.” It isn’t until parents tour the facility that they take notice of the intergenerational component, according to Hoover, which only serves to get them more excited about the program. Last I checked, there were more than 400 families on the ILC’s waitlist.Meanwhile, for the residents, the intergenerational engagement is a jolt back to the world of the living. In fact, it was this dynamic that caught the attention of the Seattle-based filmmaker Evan Briggs in early 2012. “For a long time I had been wanting to make a film that explored the issue of aging in America,” she says. “When I found out about this retirement home with a preschool inside of it, I felt that was a really beautiful and poignant way to frame some of the issues and themes I wanted to address.” Present Perfect, the resulting documentary due out in 2017, explores what happens when human connection across generations is encouraged and facilitated.In a clip from Briggs’s documentary, a resident in a wheelchair with drooping jowls and stooped shoulders leans in close to a small boy to ask his name. “Max,” the boy replies. “Oh, Mack,” the gentleman says, leaning back in his chair. With admirable patience, particularly for one so small, the child states his name repeatedly, with increasing volume and ever more precise articulation, as the resident continues to get it wrong.
Another resident with advanced Alzheimer’s whose speech was incomprehensible garble was able to speak in complete, fluid, and appropriate sentences the moment she was wheeled into the baby room. “You could immediately see that she had accessed some part of her brain that had raised several kids,” Hoover says.
During interviews with staff members at the Mount, I asked how the children at the ILC tend to deal with the death of a resident. I was told that the children might notice a resident was missing and ask a few questions but typically demonstrate little significant emotional attachment.For Thomas, the geriatrician, this raises questions about whether truly meaningful relationships are being developed through the ILC. “Say the kids are coming in to see the elders,” he posits. “If one of the kids calls out the name of an elder and runs toward that elder with their arms outstretched, that’s the next step.” While Thomas applauds the efforts of the Mount and other institutions experimenting with these types of programs, he says more opportunities for meaningful engagement and reciprocity are needed to reach that next level.The institutionalization and bureaucracy of care homes tend to limit their ability to create such opportunities, according to Matt Kaplan, a professor of intergenerational programs and aging at Pennsylvania State University. “In nursing homes, policies tend to be rigid,” he explains. “How you spend your time, where you spend it—it’s all being regulated.” In other words, rather than forming organically, any relationships that develop do so within the framework set by the professionals.And ultimately, just like Cinderella’s enchanted transformation, the magic may only last for a fixed amount of time. “As beautiful as [a program like this is], they march those kids right out of there at [6 o’clock], and five minutes later, that elder who had just been brought to life is sitting slumped over in a chair by a nurse’s station,” Thomas says. “And that’s the sad part of the story.”
At events like these, we often automatically recall our stereotypes as we gaze over the people. The older folks are stuck in their ways. The younger people are too engrossed in technology to carry on a real conversation. So we flock to the people we know best, who are most like us, because we live in a society of STPs, or “same ten people.” That’s according to Donita Whitney-Bammerlin, faculty member in Kansas State University’s College of Business Administration.
Whitney-Bammerlin said she believes generations of people need to better understand one another to maximize on the uniqueness that all people have to offer to a family, workplace or community.
“As humans we tend to get tunnel vision,” she said. “I think it’s important for people to realize certain strengths and weaknesses of people who are different than them.”
We see a greater disparity among generations today than ever before, Whitney-Bammerlin said, because we as a society have gotten away from two things: sitting down over a family meal and talking with one another, and progressing away from intergenerational living in the United States.
“I don’t think communities maximize the innovativeness and energy that may be with a young generation, or on the other side, sometimes we don’t maximize on the wisdom and experiences of senior generations,” she said.
I would like to encourage you to take a moment to reflect and connect with any older person who has made a difference in your life and acknowledge the contribution they have made to others.
Older Americans should be honored. What better time than during May, Older Americans Month.
When I was a middle schooler, maybe younger, my friends and I considered someone in their late 20’s to 30 year of age as being old. If we look back in history, the average life expectancy during the 1800’s was mid-thirties. Women died in childbirth and plagues could wipe out a town. During that time period, if you were in your twenties, you definitely bordered on old age.
Why have an Older Americans Month
According to the Administration for Community Living, “When Older Americans Month was established in 1963, only 17 million living Americans had reached their 65th birthday. About a third of older Americans lived in poverty and there were few programs to meet their needs. Interest in older Americans and their concerns was growing. A meeting in April 1963 between President John F. Kennedy and members of the National Council of Senior Citizens led to designating May as “Senior Citizens Month,” the prelude to “Older Americans Month.”
Some of you reading this may remember Erma Bombeck who said, “If life is a bowl of cherries, then what am I doing in the pits?” There are those of us who can relate to that.
During my journey in life, I have tried to find or create ways to live a positive experience when dealing with “the pits” in life. I call these experiences “Purposeful Projects.”
In the 1960’s, concerns for the care of the elderly heightened. Programming and resources were limited.
As a young mother in the 1970’s, I began teaching a craft class for homemakers and older citizens at Highland Community Ministries (HCM) while my daughter attended Mother’s Day Out.
I volunteered at the newly formed HCM Adult Day Center in the late 1970’s by providing a Creative Expression program which consisted of writing, arts and crafts.
Older Americans work and volunteer in communities across the US. By paying tribute to men and women who raised, inspired, guided and protected us, we are honoring their involvement and impact on our lives.
By volunteering with or for older Americans, you can strengthen intergeneration connections while giving back to the community.
“Americans who volunteer are also likely to be healthier. There are abundant opportunities to get healthy by volunteering on public land.”” ~~ National Get Outdoors Day
You may want to get outdoors and volunteer, Day of Hope needs your help on June 11 for Get Outdoors Day.
“Volunteers are the only human beings on the face of the earth who reflect this nation’s compassion, unselfish caring, patience, and just plain loving one another.” ~Erma Bombeck Volunteers of all ages are SPECIAL…THANK YOU
Why a series of essays on the future of aging? Because the issues could not be more important, and attention is needed now. The global demographic shift, a product of increasing longevity and lower birthrates across much of the world, will, like climate change, affect humanity forever.
At the Center for the Future of Aging, we’re proud to be associated with a group of extraordinary advisers — thought leaders — who are working in their own domains and in their own ways toward a stronger society and a better future for people of all ages. Their essays identify challenges and opportunities that must be urgently considered. Will the future of aging realize the breathtaking possibilities stemming from longer life, or heighten the risks and costs of an aging population?
In the United States, about 10,000 people turn 65 each day, and one in five Americans will be 65 or older by 2030. Globally, the number of people age 60 and over is projected to leap from about 900 million in 2015 to 2 billion by 2050, according to the World Health Organization. Between 2000 and 2050, the 80-and-older cohort will almost quadruple, and those 65 and over will outnumber children under the age of 14. It should be noted that many experts see these demographic predictions as too modest. In the wake of the decoding of the human genome, even longer lives and larger aging populations may be just ahead.
We envision a future that advances public health, creates age-friendly homes and communities, enables lifelong learning, work and entrepreneurship, and promotes purposeful engagement and volunteerism.
More Change to Come
Increasing longevity has contributed to unprecedented global economic growth and wonderful opportunities for personal fulfillment. This gift of more years, due to advances in science, sanitation and safety, may be the most momentous accomplishment in human history. But, as remarkable as this progress has been, there is more change to come.
The demographic aging shift will have massive impacts on government budgets, living standards, individual health and well-being and economic and social stability. While longer lives mean exciting possibilities for individuals, families and societies, increasing longevity will also bring great challenges — from financial insecurity and disease to intensifying strains on social and financial safety nets and health care systems.
The issues are big, and the stakes are clear. But there’s reason for optimism.
The Reasons for Optimism
Today’s older adults are generally healthier and more vibrant than those of generations past. They are changing retirement norms as they seek to learn, work and contribute. They are driving growth and opportunity in entrepreneurial ventures and bolstering economic vitality as creators and consumers. In workplaces and classrooms, their guidance and beneficial support enhance performance and intergenerational collaboration. In encore careers, volunteering and civic and social settings, their balance and problem-solving abilities contribute to society’s well-being.
They are the beneficiaries of continuing advances in health and technology that will change the aging experience.
In times of economic stress and seemingly intractable social challenges, there is a need for fresh ideas and collaborative solutions. Older adults may provide just that. This largely untapped resource has much to offer — not just wisdom, but the practical experience and skills that can enrich families as well as work, educational and social settings.
Realizing the Potential of the Aging Population
But to realize the potential and value of the aging population, we must shift course and shape a future that’s different from yesterday’s model. We envision a future that advances public health, creates age-friendly homes and communities, enables and encourages lifelong learning, work, and entrepreneurship, and promotes purposeful engagement and volunteerism.
It’s a future that speeds the development of empowering technologies, social networks and accessible transit systems, and builds a vibrant longevity economy to increase access and opportunity for the current generation of older adults as well as generations to come.
It’s a future that enables and empowers a population seeking fulfillment, ready and willing to engage so long as engagement is possible. It’s a future that elevates beneficial purpose as a new life course model, harnessing the talent of a vast cohort — and calling on them to remain actively and valuably involved by contributing to the lives of younger people as educators, mentors and coaches.
Beginning a Different Conversation
We must combat ageism, magnify opportunity, celebrate contribution and enhance dignity. We must change hearts, minds and attitudes about the possibilities of healthy, productive and purposeful aging. We must begin a different conversation about getting old.
We are at an inflection point, at the intersection of a fundamental demographic change and a search for a new model. If we join together and do what’s needed, we’ll enrich aging lives, strengthen families, businesses and communities and ensure a better future, not just for older adults, but for people of all ages in every corner of society.
We hope you enjoy these essays by our “Future of Aging” authors. We believe their ideas will expand perspectives and encourage involvement. Let us know your reactions, and, please, join the conversation.
Two-thirds of all the people who have ever lived past the age of 65 in the entire history of the world are alive today. For a more local reference, when our Constitution was crafted, the average life expectancy in the U.S. was barely 36 years and the median age was a mere 16. During the time of our founding fathers, there was no anticipation of an “age wave.” In this regard, we are living in truly unchartered territory and longevity is humanity’s new frontier. As the baby boomers turn 70 at the rate of 10,000 a day, America is becoming a “gerontocracy.” Already, 42% of the entire federal budget is spent on Medicare and Social Security. In the 2012 election, older adults out-powered all other age groups with 72% of men and women 65+ voting, while only 45% of those 18-29 did.
This demographic transformation will create new lifestyle, social contribution, and marketplace opportunities as well as potentially devastating medical, fiscal, and intergenerational crises. Are we prepared? NO. Are Trump, Clinton and Sanders addressing this “age wave” and offering innovative solutions? NO. Has the political media of all persuasions been covering this issue and all its facets in proportion to its social, political and economic importance? NO. I have watched every minute of every debate and I am outraged that these core issues have not been meaningfully covered.
Based on 40 years of research, dialogue, analysis, and activism on aging, I have come to believe that there are five essential transpartisan issues that must be addressed if our newfound longevity is to be a triumph rather than a tragedy.
Age Wave Issue # 1: What is the New Age of “Old?”
Our economy is hinged to 19th century notions of longevity and old age. When Otto Von Bismarck picked 65 to be the marker of old age in the 1880s, in preparation for Germany’s first pension plan, the average life expectancy in his country was only 45. Similarly, when Social Security began, the average American could expect to live only 62 years, and there were 42 workers paying for each “aged” recipient (“Social Security” is only the nickname for OASDI – Old AgeSurvivor and Disability Insurance). Today life expectancy is approaching 79 (and steadily rising) and due to decades of declining fertility, there are fewer than three workers to pay for each recipient. But, is 65 – or even 67 – the right marker of old age? This is not a Democrat or Republican issue that only impacts “seniors.” As longevity rises, continuing to use an obsolete marker of old age could have a particularly brutal impact on the millennial generation.
Questions for Trump, Clinton and Sanders:
In repeated recent surveys, when asked when old age begins today, people say somewhere between 75 and 80. At what age do you think that people become “old” today?
Do you think of yourself as “old” or as a “senior?” Why do you think this is the right age for you to be running for president?
If there were breakthroughs that would further elevate life expectancy, would you consider “indexing” entitlements to rising longevity?
Would you support funding the retraining of older workers for new careers? Would you incentivize employers who hired older workers?
Age Wave Issue #2: The Diseases of Aging Could Be the Financial and Emotional Sinkhole of the 21st Century.
Until recently, most people died swiftly and relatively young of infectious diseases, accidents, or in childbirth. As a result of modern medical advances and public health infrastructure, we’ve managed to prolong the lifespan, but we have done far too little to extend the healthspan—as pandemics of heart disease, cancer, stroke, Alzheimer’s and diabetes are running rampant. In addition to being quite costly, our healthcare system is incompetent at preventing and treating the complex and intertwined conditions of later life. For example, Alzheimer’s (and related dementias) now afflicts one in two people over 85, and it has become the nation’s scariest disease. Unless there is a breakthrough, its sufferers are anticipated to grow from 5+ million today to 15+ million as the boomers age, with its cumulative costs soaring to $20 trillion by 2050. But our scientific priorities are outrageously out of synch: for every dollar currently spent on Alzheimer’s care, less than half a cent is being spent on innovative scientific research. Our doctors are also not aging-ready. We have more than 50,000 pediatricians, but fewer than 5,000 geriatricians. Only eight of the country’s 145 academic medical centers have full geriatrics departments, and 97% of U.S. medical students don’t take a single course in geriatrics.
Questions for Trump, Clinton and Sanders:
Are you willing to make beating Alzheimer’s before it beats us your “moonshot” and commit whatever resources are necessary to make it happen?
Would you make it mandatory for medical and nursing schools to teach core geriatric skills to all students?
Considering 34 million people are providing care to an elder loved one, what changes would you make to the tax code and work leave policies to help them out?
Where do you stand on active euthanasia, passive euthanasia, and assisted suicide?
Age Wave Issue # 3: Averting a New Era of Mass Elder Poverty
During the 1930s, one third of America’s elders were impoverished. Since then, thanks to Social Security, Medicare, pensions and a widespread savings mentality among those who grew up in the shadow of the depression, the elder poverty rate has plummeted. However, the future is precarious. Today, according to the Government Accounting Office, 52% of all households near retirement (headed by someone age 55+) have NO retirement savings and about 51% of our population have no pensions beyond Social Security. We could be heading to an era in which tens of millions of impoverished aging boomers will place crushing burdens on the U.S. economy and on the generations forced to support them. On top of this, to avert future generations of poor older adults, we are not fostering financial literacy or responsibility among the young (many of whom might live exceptionally long lives). For example, thirty-seven states require providing sex education to high school students by law, while only 17 states require financial education.
Questions for Trump, Clinton and Sanders:
How would you avert mass poverty among the aging boomer generation (half of whom are already retired and for whom it may be too late to catch up)?
Would you consider increasing personal savings rates through mandated, tax-advantaged savings programs such as in the UK and Australia?
Considering the substantial “asset inequality” among older adults, would you affluence test entitlements to give more to those in need and less to those who are not?
Describe Social Security as you think it should be for the millennial generation.
Age Wave Issue # 4: Ending Ageism
In Colonial times, elders were respected and honored for their wisdom and perspective. In addition, because the primary American industry was farming, it was grandpa and grandma who usually owned the property and decided who did what and who inherited what. During the industrial era, all of that turned upside down. Now, in our youth-focused society, many people of all ages are “gerontophobic”—uncomfortable both with older adults and their own aging process. And many institutions are both youth-centric and ageist — from education, to technology, to employment hiring practices to housing. For example, our homes and public buildings were not built for aging bodies: less than 2% of our housing stock is built to be safe and accessible for elders (and one third of the elderly fall each year). Similarly, the routes of public transportation were created with young workers, not retirees, in mind. And what of popular media – our most potent export – where advertisers still “profile” their audiences by age and will pay TV networks far more for a 30 year old viewer than one who is 60. If that profiling was race vs. age motivated, it would not be tolerated.
Questions for Trump, Clinton and Sanders:
Do you believe that ageism exists in America? What would you do as president to wipe it out?
Do you think our society discriminates more against aging women than men: against non-white vs. white older adults?
How should our communities become more “aging friendly?” Since millions of older adults struggle with mobility and transportation (and corresponding social isolation), what would you do to remedy that?
For you personally, has aging been an ascent or a descent? What do you think the “upside” of aging is?
Issue # 5: The New Purpose of Maturity
As it turns out, today’s retirees feel that they are in the best time in their lives to give back. And they do: contributing both more dollars and volunteer time than any other age group – doing everything from teaching schoolchildren to read, to helping their peers recover from loss to building homes for Habitat. Going forward, medical science can—and will—increasingly prolong life. Yet political, religious, and community leaders have yet to create a compelling vision for the purpose of those additional years. For example, our 68 million retirees currently spend an average of 49 hours (2,940 minutes) a week watching television. Ultimately, the problem may not be our growing legions of older adults, it may be our absence of imagination, creativity and leadership regarding what to do with all of this maturity, longevity and encore talent. The unprecedented historical challenge/opportunity of the age wave is how we can unleash our greatest growing natural resources that are hiding in plain sight: experience, skills and wisdom.
Questions for Trump, Clinton and Sanders:
Do we ask too little of our elders?
What is your biggest idea for what America’s 68 million retirees could be doing to contribute to our society?
If we could trade two hours per week of retirees’ television viewing time for two hours per week of volunteer time, what would you do with those 200+ billion additional public service hours over the next 25 years?
Because of your age, do you think of yourself as a role model for purposeful aging?
An “age wave” is coming that could either make or break America. Are we prepared? No. Just as society’s institutions were grossly unprepared for the baby boom, we have done far too little to prepare for the coming “age wave.” Do we as a nation have the guts and wisdom to ask – and answer — these questions? I believe we do. Time and time again Americans have proved that we are a creative, industrious nation with tremendous capacity for improvement and transformation. The next eight years will be the turning point. I surely hope that our next president is prepared to address these critical issues and boldly make the course-corrections necessary to usher in a healthy and purposeful future of aging.
Editor’s note: This commentary is by Beth Stern, who is executive director of Central Vermont Council on Aging and president of the Vermont Association of Area Agencies on Aging.
President Obama signed the reauthorization of the Older Americans Act on April 19 — five years after the previous reauthorization expired in 2011. Those of us who are elders, or who work with elders, or who will someday be older should celebrate this long overdue action.
The Older Americans Act “affirms our nation’s commitment to the health and well-being of older adults.” The funding from the Older Americans Act makes up about half of the budgets of Vermont’s area agencies on aging, and supports core services which preserve the right of all older adults to live independently and with dignity, to participate in community, to volunteer, and to make their own decisions about their lives. This includes nutrition services, options counseling, transportation and other supportive services either contracted or done directly by agency staff.
The new act contains some important new provisions including encouraging the use of local foods in senior meals, encouraging intergenerational senior centers, promoting evidence based wellness programs, and increased technical assistance for transportation. Additionally the act will provide tools to assist elders and their families choose home based services, training on elder abuse prevention, support of better oral health, guidance on serving Holocaust survivors and much more.
However, signing the act is not enough. It would seem that something as bi-partisan as an act authorizing services to older Americans, one that took five years to authorize, must be pretty special. One would hope that the new Older Americans Act might actually mean that elder services, which have been underfunded for decades, would actually get the funding and attention they need and deserve.
It’s no secret that Vermont is an aging state. Each day, 23 Vermonters turn 65 and many will live well into their 80s and 90s.
Reality is unfortunately not the same as hope. The act contains modest increases of about 7 percent over the next three years, until 2019 when it will need to be reauthorized again. However, funding recommendations are just that – recommendations to the appropriators. Those who make the actual decisions on funding can take them or leave them. Elder services and programs could get the recommended increase, flat funding, or a decrease. It all depends on the will of our Congress, and we know how functional Congress is these days.
Older Americans Act funding is not in danger of being zeroed out, so those out there who rely on home delivered meals, caregiver support, options counseling or other services through your area agency on aging or our contractors should not panic. However, due to sequestration and other cuts, Older Americans Act funding levels are stuck at 2004 levels. While the state and federal government profess to be aware of the demographics facing us, funding levels remain woefully inadequate to account for inflation and the rising numbers of seniors. Without additional funding, some agencies serving elders will likely need to institute waiting lists or reduce services over the next few years.
It’s no secret that Vermont is an aging state. Each day, 23 Vermonters turn 65 and many will live well into their 80s and 90s. State Medicaid funding for Vermont’s hospitals and nursing facilities has risen steadily over the years – 32 percent for nursing homes over the last 10 years – while too many community providers struggle with deficits, stagnant wages, talent flight and downsizing. Vermont legislators just took an important first step to increase Medicaid rates by 2 percent to home and community-based services (including AAAs). While we are very grateful for the growing recognition among lawmakers that services from community providers like the AAAs, home health agencies and mental health providers are absolutely essential, we must continue to push for adequate funding into the future. Most community providers lack operating reserves, and far too many measure their “cash on hand” at just a few days. If we are to honor the desire of 95 percent of Vermonters to “age in place” — and the state’s avowed health reform priority to keep people at home — we cannot starve the providers who make this possible.
Those of us who work within this field were thrilled when the Older Americans Act passed and we thank our congressional delegation for their important part in moving this bill forward. However, our work is not done. May is Older Americans month. It’s a great time to demand increased, fair and adequate funding from the state and from the Older Americans Act — to support those very services which are supposed to help elders live at home, stay healthy, be involved in community and stay out of expensive nursing homes and emergency rooms. It’s not enough for the president to sign an “act” and feel good. We have to demand that it mean something more than the piece of paper it’s written on.