Guest blogger Priscilla (Pris) Rogers, Ph.D. is the Program Manager for VisionAware and co-author of Aging and Vision Loss: A Handbook for Families. Her other works include Self-Advocacy Skills Training for Older Individuals Who Are Visually Impaired and Solutions for Success: A Training Manual for Working with Older People Who Are Visually Impaired. She has an M.A. degree in gerontology and a Ph.D. in special education with an emphasis in vision and aging.
In A Summary of the White House Conference on Aging Issues and Initiatives: Part One, Pris described the major issues and initiatives addressed during the 2015 White House Conference on Aging (WHCOA). This week, she summarizes the conference initiatives related to aging and vision loss addressed by the American Foundation for the Blind’s Letter to the President.
Background and Overview
The White House Conference on Aging (WHCOA) took place on July 13, 2015. It was an historic occasion that occurs once a decade. This year’s conference was the first to take place on a national stage with the opportunity for people across the nation – and even the world – to listen in and participate through social media, including a Twitter feed @WHAging that enabled virtual attendees to ask questions and make comments.
The American Foundation for the Blind’s (AFB) Letter to the President articulated major WHCOA issues related to aging and vision loss. AFB and the 70+ agencies that signed on to the letter emphasized the need for a systemic approach to ensure that older Americans who are blind or visually impaired are able to (a) receive the training in independent living they need to carry out everyday tasks, (b) obtain critical technologies to enhance their health, independence and safety, and (c) access appropriate support services, such as transportation.
Editor’s note: The initiatives detailed in this post come from Fact Sheet: White House Conference on Aging. These initiatives are related to the themes of the conference and to additional older adult-related concerns. We have included specific AFB responses and remarks to tie the WHCOA initiatives to issues of concern to AFB.
Initiative: Aging in Place
Older Americans prefer to stay in their homes and communities as they age. As the older population grows, housing that meets their needs is increasingly important.
- To address these needs, the U.S. Department of Housing and Urban Development released Aging in Place: Facilitating Choice and Independence, a guide to help older homeowners, families, and caregivers make changes to their homes so that older adults can remain safe and independent.
Advocates should check this guide for relevance to older people with visual impairment. For example, the guide should include (a) a checklist and information about preventing falls, (b) using environmental cues such as color, contrast, and texture, and (c) providing good lighting and controlling glare.
- Home Depot also released Simplifying Your Home for the Future, a tip sheet and “how to” video highlighting simple home modification steps to help individuals age in place.
Again, advocates should check this guide for relevance to older people with visual impairment. For example, VisionAware offers videos about home modification and vision loss and suggestions for enhancing visual contrast.
- Washington State University will test new models of using technology to keep older adults safe and healthy as they live independently in their own homes, including a partnership with the Good Samaritan Society to equip 1,500 homes across the country with wireless sensors to help clinicians monitor those older adult residents who voluntarily chose to participate for health concerns.
Initiatives: Long Term Care, Healthy Aging, and Elder Justice
- A proposed rule by the Centers for Medicare and Medicaid Services (CMS) to update, for the first time in nearly 25 years, the quality and safety requirements for more than 15,000 nursing homes and skilled nursing facilities to improve quality of life, enhance person-centered care and services for residents in nursing homes, improve resident safety, and bring these regulatory requirements into closer alignment with current professional standards
- A new proposed rule from the U.S. Department of Agriculture to increase accessibility to critical nutrition for housebound, older Americans and people with disabilities by enabling Supplemental Nutrition Assistance Program (SNAP) benefits to be used for services that purchase and deliver food to these households
- A final Victims of Crime Act (VOCA) victim assistance rule from the U.S. Department of Justice (DOJ) to be released by the end of the year.
- U.S. Department of Housing and Urban Development (HUD) guidance confirming that its Equal Access rule applies to all HUD-assisted and HUD-insured multifamily housing, including Section 202 Supportive Housing for the Elderly.
- The SCAN Foundation is investing $2 million in assisting community-based aging networks in developing the skills and capacity necessary to build collaborative partnerships with the health care sector.
Initiative: Helping Older Americans Stay Healthy
- To reduce the occurrence of falls among older Americans, Kaiser Permanente will implement the Centers for Disease Control and Prevention’s (CDC) evidence-based falls prevention tool, known as STEADI (Stopping Elderly Accidents, Deaths & Injuries) across all of its regions. The CDC is also launching a free on-line course, based on the STEADI program, which will offer continuing education credits to physicians, nurses, and other health professionals on making fall prevention a routine part of clinical care.
As noted previously, fall prevention is a major issue for older adults with vision loss and VisionAware provides many solutions and suggestions for prevention.
- By the end of 2015, Epic Systems Corporation, the electronic health record (EHR) technology provider, will make available to its EHR clients a clinical decision support tool for falls assessment based on CDC’s guidelines, to make it easier for health care providers to screen for falls, intervene to reduce risk, and provide follow-up care.
- The U.S. Department of Health and Human Services (HHS) Health Resources and Services Administration announced $35 million in awards to health professions training programs to expand geriatrics education to prepare the health care workforce to respond to the needs associated with advancing age.
One respondent to AFB’s National Conversation on aging and vision loss said this: “Long term services or support are difficult to maintain if available at all. Most services are short term, addressing immediate needs. Facilities, for the most part, do not employ persons with the knowledge base to truly assist the vision impaired individual. Most do not know where services are available – if at all. In rural Arizona this is compounded by lack of services and distance to, or to receive, services. Most rely heavily on family or friends, if available, for long term support. The ‘golden years’ aren’t very golden for many living with vision loss.”
- The Centers for Medicare and Medicaid Services (CMS) is working with AARP, the American Medical Association, the American Association of Family Physicians, and many other organizations to disseminate information to patients and members on Medicare’s preventive benefits. Efforts to increase use of recommended preventive services will include, for example, co-branding CMS publications on preventive services and distributing a user-friendly checklist to help Medicare beneficiaries understand and use their Medicare preventive benefits.
The Medicare preventive services include a “simple vision test” (undefined) and “glaucoma” tests. These services should be expanded to cover a dilated eye exam at least annually. Further, doctors are not required to refer patients diagnosed with severe vision loss for services to help them cope with vision problems. Patients are normally unaware that such services exist. AFB has developed a simple, free, IOS app to help with this referral process.
- A Centers for Medicare and Medicaid Services (CMS) and Social Security Administration (SSA) effort to improve Medicare enrollment educational materials has resulted in updated Web-based information and frequently asked questions, as well as a redesigned Social Security Statement containing more prominent Medicare enrollment information for individuals over age 60.
- The National Prevention Council will release a Healthy Aging Action Plan during Spring 2016 to advance its National Prevention Strategy and will identify Federal action steps to promote prevention and well-being among older Americans.
- The John A. Hartford Foundation plans to invest $3 million to support the delivery of evidence-based services and programs by Area Agencies on Aging, which provide community-based support to older Americans and their caregivers. It has allocated $2 million to help the HHS Geriatrics Workforce Enhancement Program meet its goals of improving health outcomes for older adults.
- The Stanford Center on Longevity will develop a State of Longevity Index to be released in early 2016 that will measure how well the United States is doing to improve the prospects for long-term well-being in financial security, physical health, social connectedness, educational attainment, and age-friendly communities.
Initiative: Keeping Older Americans Moving
- The Surgeon General has joined with the YMCA in issuing a challenge to the 850 YMCA associations across the country: Hosting intergenerational physical activity events during the first week of August to promote opportunities for young and older Americans to be active together.
- The National Institutes of Health is partnering with a diverse group of public and private partners to promote healthy aging through its Go4Life exercise and physical activity campaign for older adults. Go4Life Month is September 2015.
VisionAware has partnered with Go4Life to develop Exercise for People with Low Vision.
- The U.S. Department of Transportation will launch the National Aging and Disability Transportation Center in Fall 2015. This $2.5 million investment will provide technical assistance to improve the availability and accessibility of transportation options that serve the needs of people with disabilities, seniors and caregivers.
- Uber is announcing pilot programs in Florida, Texas, Ohio, Arizona, and California that will partner with senior community centers and other advocates to provide free technology tutorials and free or discounted rides to older Americans to increase access to transportation options and support mobility and independence.
- Airbnb has conducted research to support and understand the experience of older Americans in their travels and in their use of technology and is partnering with communities to enhance accessibility and the user experience for older populations.
Transportation always has and continues to be a major deterrent to independence to people with visual impairment. This concern surfaced repeatedly during AFB’s National Conversation on aging and vision loss: “Public transportation is critical for all persons with vision loss to maintain their independence. Unfortunately however, public transportation is often limited or not available at all. This results in older individuals who are blind or experiencing vision loss being dependent on friends and relatives for transportation, or being housebound.”
For More Information
Information on the WHCOA initiatives has been excerpted from Fact Sheet: The White House Conference on Aging.