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Remembering the Older Americans Act During Older Americans Month

May is Older Americans Month

During the year this month of commemoration was instituted, there were approximately 17 million Americans who were 65 years of age or older. Of these, about one third was living in poverty. At the time, only a small amount of programs were meeting seniors’ needs. A meeting was organized in April 1963, between President John F. Kennedy and the National Council of Senior Citizens.

As a consequence of the meeting, May was designated as the Senior Citizens Month, which later became known as Older Americans Month. 

Every President since then has celebrated the contributions of older Americans to our country, and rightfully so. Every senior should be recognized for the contributions and sacrifices they have made— and continue to make— to support families, communities and our society. Starting within the household, seniors play a vital role to the well-being of their relatives and loved ones. Numerous older adults are caregivers to the children within their family, and even friends or neighbors. Others provide financial and emotional support to their grown up kids.

At the community level, older adults represent a high percentage of volunteers. 

It may seem the contrary, but the reality is that more seniors are seeking volunteer opportunities, both domestically and abroad. Frequently, they give their time to local religious and social service organizations, such as Maria in Miami. After years of helping family members navigate U.S. systems and seeing how vulnerable they were to fraud, abuse, and scams, she decided to become a volunteer. She received training from NHCOA on Medicare fraud prevention through our National Hispanic SMP

Despite their selflessness, older adults— especially Latino seniors— are falling into poverty as they age.

Currently, the poverty rate of Latino seniors is twice that of the total population of adults 65 years and older. Hispanic older adults are also more reliant on Social Security as their sole source of income. According to the U.S. Census Bureau, 21 percent of older adults who receive income from Social Security will only have their Social Security benefits to depend on for income. Among Hispanic seniors— who are estimated to represent 20% of the older adults by 2050— this percentage increases to almost 90%.

In addition to financial problems, a majority of Hispanic older adults suffer disproportionately from health problems. 

Hispanics are 66% more likely than non-Latino Whites to suffer from diabetes. According to Center for Disease Control report on AIDS, Hispanics were twice more likely to be diagnosed with HIV than non-Latino Whites. In 2013, data showed the U.S Hispanic population continues to face numerous health disparities and difficulty accessing healthcare. For example, Latino seniors were much more likely to lack health insurance than non-Hispanics. Moreover, diverse older adults typically bear more out-of-pocket costs for health care, which amount to more than one-third of their income for those at the lowest income levels.

The Older Americans Act— the most important piece of legislations for America’s seniors— can address these issues, but lacks the reauthorization to better serve the population it was created to help.

Given the growth and diversification of the U.S. aging population, the Older Americans Act needs to be reauthorized to reflect our current reality, as well as meet the needs of our most vulnerable seniors across the country. This law supports a variety of home and community-based services, including in-home care, transportation, legal services, elder abuse prevention, and caregiving support. The law helps older Americans remain as independent as possible, for as long possible, as well as help avoid hospitalizations and nursing home care, which translates into savings at the local and federal level.

Throughout the month, we will be sharing more information about the Older Americans Act, why we should all care about it, and what we can do to ensure it is reauthorized.

NHCOA Celebrates Older Americans Month

This year’s theme, “Get into the Act”, focuses on community engagement to enhance the well-being of seniors 

Washington, DC— Dr. Yanira Cruz, President and CEO of the National Hispanic Council on Aging (NHCOA)— the leading organization working to improve the lives of Hispanic older adults, their families, and caregivers— made the following comments regarding Older Americans Month. Celebrated each year during the month of May, Older Americans Month was created to recognize seniors for their valuable contributions to our society. This year’s theme, “Get Into the Act”—in honor of the 50th anniversary of the Older Americans Act— focuses on how older adults are taking charge of their health, getting engaged in their communities, and making a positive impact in the lives of others.

“During the month of May we celebrate our country’s most valuable treasure: older Americans. While the challenges seniors faced five decades ago aren’t exactly the same as those older Americans currently confront, we must remain vigilant to ensure we are doing everything in our reach to ensure they can live their golden years with dignity, economic security, and in the best health possible.

“In particular, NHCOA centers its public policy and program efforts around what we consider four key indicators of well-being: health, economic security, housing, and leadership empowerment and development. We believe each area is equally important for all older Americans, especially Hispanic older adults. Latino seniors, like other diverse seniors, have a lot to celebrate despite the difficulties and challenges, including a history of low wages, language barriers, and access to healthcare. While, these barriers create significant roadblocks to healthy aging, opportunities like Older Americans Month help draw awareness to the issues most impacting seniors.

“This year, Older Americans Month’s theme is ‘Get Into the Act’, and we join the Administration for Community Living in raising awareness on the importance of community engagement as a tool that enhances the well-being of all seniors. Together, we can empower older Americans across the country to take charge of their health and become more engaged in our communities and organizations.”

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Mature women and sexual health

Sexual health for women can touch on a range of various, but significant issues such as cervical or breast cancer to simply enjoying a healthy sex life. This encourages the idea that regardless of sexual orientation, age, or culture, all women should be able to access knowledge on how to keep their bodies healthy and functioning. The significance lies in manifesting the freedom of women being able to understand their bodies so they can decide how (or how not to) express their sexuality. Along with that, sexual health for women also includes being content with themselves in order to identify the healthy and unhealthy relationships they can develop throughout their lives.

A gynecologist is a doctor that specializes in women’s reproductive health, while an obstetrician cares for a woman during her pregnancy and immediately following childbirth. An ob-gyn is equipped with knowledge to care for either situation; meaning they can address women’s health issues ranging from use of birth control, menopause, pelvic or urinary tract problems. The quality of a woman’s relationship with her ob-gyn is extremely important because it relies on communication of sensitive health issues in order for the physician to be able to appropriately advise the patient on matters of sexual health.

Studies from the University of North Carolina at Chapel Hill’s department of Family Medicine determined the prevalence and type of sexual concerns among women seeking routine gynecological care. From the 964 responses of the 1480 surveys they sent out, results showed that 98.8% of women reported one or more sexual concerns. The most frequently reported were lack of interest at 87.2%, body image concerns at 68.5%, unmet sexual needs at 67.2%, and needing information about sexual issues at 63.4%. These are all concerns that effect women in every age category and signal the importance of sexual health within health care.

The above figures from the study also indicate concerns many older women develop during or well past their menopause stage. In order to properly address these women as well, many factors have to carefully be considered such as cultural settings where sexual expression in old age is frowned upon. Their sexuality as well, should not be left at the door when deciding how health services can assist these older women. This entails better training and understanding of the sexual needs within older age, along with more willingness to open a dialogue with these older patients who refrain from introducing the subject.

In their Sexual Health across the Lifecycle: A Practical Guide for Clinicians, Margaret Nusbaum and Jo Ann Rosenfeld mention the added benefit of clinicians learning more about their own background and growing more comfortable with the topic of sexuality to the sexual health promotions within their clinical practices. They also describe the importance of clinicians being aware of the times when they are most vulnerable and at risk for crossing or losing sight of professional boundaries. More research and guidance on how to manage delicate or complex issues surrounding older adults still needs to be developed in order to make it a regular discussion amongst this population. This can go a long way in constructing the comfortable setting these older adults need to appropriately release their inhibitions.

Sexual Health: Let’s Talk About It!

Sexuality is an integral part of life, especially for older adults. With a country that boasts a melting pot of cultures and ethnicities, the expansion and normalization of sexual health within the context of aging is very vital. The World Health Organization defined sexual health as “the integration of the somatic, emotional, intellectual and social aspects of sexual beings in ways that are positively enriching and that enhance personality, communication and love.”

Their definition embraces the healthy liberation of sexual behavior and the prevention of interferences with sexual functions. In Margaret Nusbaum and Jo Ann Rosenfeld’s Sexual Health across the Lifecycle: A Practical Guide for Clinicians, the Cambridge University Press listed the benefits of a healthy sense of sexuality among older adults as: “(1) a link with the future through procreation; (2) a means of pleasure and physical release; (3) a sense of connection with others; (4) a form of gentle, subtle, or intense communication; (5) enhanced feelings of self-worth; and (6) a contribution to self-identity.” Every older adult should have the opportunity to experience these benefits, armed with the confident attitude needed.

This applies especially to older adults who may not feel comfortable enough to communicate or explore their lack of desire, diminished, or absent capacity for sexual fulfillment due to physiological, mental, or cultural barriers. Although they are well past their reproductive years, older adults often still have the desire and the capacity to lead full sexual lives as well as grasping the conduct within sexual actions. A 2008 NIH study on sexuality and health among older adults in the United Sates indicated that despite the high prevalence of bothersome sexual problems, the frequency of sexual activity did not actually decrease substantially with increasing age.

Data from the study also approximated that one quarter of sexually active older adults with a sexual dysfunction reported avoiding sex as a consequence. They as well, deserve the opportunity to achieve that even through addressing the implications for mental health and the health of relationships. In order to produce awareness on the matter, communication and dialogue throughout the older adult community is imperative.

In working to encourage the communication of sexual health, it is important to consider the traditional communities where there is an encumbrance in openly expressing themselves. For example, NHCOA’s extensive work with Hispanic older adults across the nation in the area of health-related topics reveals that Hispanic older adults are hesitant to talk about socially sensitive subjects even with healthcare providers. Along with that, there is a stigma constantly attached to older age and sexual activity that does not encourage a healthy discussion on the topic. The prior NIH study also concluded that reasons for the poor communication on the topic include the unwillingness of patients and physicians to initiate such discussions, along with gender, age, and cultural differences between patients and their physicians. Negative societal attitudes about women’s sexuality along with their age also inhibits such discussions.

Data from NHCOA’s HIV education and awareness program has illustrated the rise of the percentage of sexually transmitted infections among seniors over fifty years old. Now more than ever, it is important that we encourage physicians as well to advance their knowledge on sexuality at older ages in order to improve their skills in boarding the topic on patient sex education and counseling. This also means incorporating a more open understanding from physicians on cultural consciousness as a means to encourage a diligent and gentle approach in initiating the patient’s comfortable communication. This would assist in bridging the disconnect that is present due to cultural norms that are applicable with respect to some older ethnic adults.

If older adults do not confront the plethora of concerns, lack of information, and myths regarding sexuality, it can cause undue denial of what is a normal and important aspect of the quality of life and fulfillment as an older adult. The Institute of Medicine report No Time to Lose elaborates on the potential negative effects; they range from impeding the development and implementation of effective sexual health and educational programs, to impacting the level of counseling training given to health care providers to assess sexual histories as well as comfort levels of providers conducting risk-behavior discussions with clients.

In the former Surgeon General Dr. Satcher’s call for action, he challenged the country in: gaining an understanding on the importance of sexual health in everyday lives, being aware of sexual health care needs for patients, training professionals to manage these needs and, generally promoting an open and honest national dialogue about sexuality and sexual health.

Hispanic Community Health Study Data Book: A Report to the Communities

Working Together to Improve the Health of all Hispanics

Multi Generation Hispanic Family Standing In ParkSOL LOGO

The Hispanic Community Health Study/Study of Latinos HCHS/SOL, funded by the National Institutes of Health (NIH), is the largest and most comprehensive study of Hispanics living in four communities in the U.S.A. The Hispanic Community Health Study Data Book: A Report to the Communities contains a summary of findings from examinations of 16, 415 Hispanic adults conducted from 2008 to 2011. The study funding has been renewed until 2019.

It is important that the Hispanic community is aware of the HCHS/SOL study outcomes, they show challenges and opportunities to work together to improve the health of Hispanics. Feel free to share them with your friends and colleagues.

For English: http://catalog.nhlbi.nih.gov/pubstatic//13-7951/13-7951.pdf

For Spanish: http://catalog.nhlbi.nih.gov/pubstatic//13-7951/13-7951Spanish.pdf

Visit the HCHS/SOL study website: https://www2.cscc.unc.edu/hchs/

NHAAAD 2014: Shifting Attention and Focus to HIV/AIDS and Aging

Aging is a part of life; HIV doesn’t have to be.

This is the theme for the 7th annual National HIV/AIDS and Aging Awareness Day (NHAAAD), which is observed yearly on September 18.

This awareness day was created to address two distinct truths:

  1. Many older Americans are not getting tested for HIV. Myths, stigma, and lack of targeted education make this population, especially diverse older adults, less aware of how to protect themselves from the virus. This is concerning because the Centers for Disease Control and Prevention (CDC) estimates that by next year, 50% of the people living with HIV in the United States will be 50 years or older.
  2. Medical breakthroughs have improved HIV treatment, allowing people living with HIV/AIDS who stick to regular and continuous care lead longer and healthier lives. While this is a positive outcome, we face a shortage of services and support mechanisms for older Americans living with HIV/AIDS. In addition, there isn’t enough research or data about the impact of HIV/AIDS on the normal aging process.

“If we look at the data, the numbers are very clear. There is a clear need to shift attention and focus to older Americans, who face many of the same HIV risk factors that younger age groups do, yet are more likely to receive a late diagnosis,” said Dr. Yanira Cruz, NHCOA President and CEO.

“This is particularly true among diverse seniors, who face many health disparities compared with their White non-Hispanic peers. That is why NHCOA became a proud partner of the CDC’s Act Against AIDS Leadership Initiative to help reduce the rates of HIV in hard-to-reach and diverse communities. While NHCOA serves and represents the needs and interests of Hispanic older adults, we know they don’t live in a vacuum.”

“Through our work with AAALI we leverage the strong connections, leadership, and influence Latino seniors have within their families, communities, and places of worship and leisure by offering culturally and linguistically appropriate outreach and education focused on intergenerational storytelling and dialogue to break the silence and eliminate the stigma.”

What you can do on National HIV/AIDS and Aging Awareness Day

  • Get the Facts. Start a conversation at home, or with a loved one, on HIV/AIDS. You can get more information here.
  • Get Tested. If you are sexually active, ask your healthcare provider for an HIV test during annual check ups. [Under the ACA, most new health insurance plans must cover certain recommended preventive services, including HIV testing. Free HIV screening is also included in Medicare Part B.]
  • Advocate. Read the Diverse Elders Coalition’s Eight Policy Recommendations for Improving the Health and Wellness of Older Adults with HIV.
  • Join the Conversation. Follow us on Facebook and Twitter with the hashtags #AIDSandAging and #NHAAAD to be part of the ongoing conversation. Here are some sample messages and memes to get you started.
  • Go Viral. Share this blog post and NHCOA videos like the one below with your contacts and raise awareness about HIV/AIDS and aging.

 

The ABCs of Hepatitis

Today is Hepatitis Testing Day in the United States, a valuable opportunity to talk about a disease that misunderstood and highly undiagnosed. Essentially, hepatitis is the inflammation of the liver, usually due to a viral infection. There are different types of hepatitis, which are caused by a different virus and spread in different way. The most common types of this disease are Hepatitis AHepatitis B, and Hepatitis C. While Hepatitis A does not cause a long-term infection, both Hepatitis B and C can develop into chronic, life-long infections and result in serious health problems.

According to the CDC, Hepatitis B is 50 to 100 times more infectious than HIV.

Millions of Americans — including older adults — have chronic viral hepatitis and don’t even know it because the infection can be dormant for years, even decades. For example, baby boomers (those born between 1945 and 1965) are disproportionately affected by chronic hepatitis C and many don’t know how or when they got infected.

Chronic hepatitis is a leading cause of liver cancer.

That is why it is important for hepatitis testing to be part of a person’s routine screenings, especially among those at a higher risk for hepatitis, including people living with HIV. It is the only to know if you are infected. [Take CDC’s Hepatitis Risk Assessment to see if you should be tested for viral hepatitis.] Check out the CDC sponsored Hepatitis Testing page to get a free or low cost test for hepatitis.

Take action!

Share this post and this infographic with your loved ones and protect yourself from hepatitis.

ABCs of Hepatitis-2-01

The Importance of Clinical Trials in Vaccine Development

A Conversation with a Vaccine Clinical Trial Participant

Augusto Paredes, BSN, RN Vaccine Trial Participant
Augusto Paredes, BSN, RN Vaccine Trial Participant

Almost since the discovery of HIV, the virus that causes AIDS, scientists have been hard at work trying to find a vaccine to prevent HIV infection. After all, vaccines have proven to be a vital part of public health by preventing infectious diseases from smallpox to influenza and have saved hundreds of millions of lives since the 18th century (History of Vaccines, 2014). As we commemorate HIV Vaccine Awareness Day, the conversation must include thanking the more than 30,000 HIV vaccine trial participants worldwide (HIV Vaccine Trials Network, 2013). If researchers are to develop a globally effective HIV vaccine one day, their efforts will have to include a diverse group of study volunteers, advocates, and community advisors. NHCOA recently had the opportunity to sit down with Augusto Paredes, BSN, RN about his experiences as a vaccine trial participant.

Augusto is the Nurse Manager at the Georgetown Hospital Division of Infectious Diseases and Travel Medicine in Washington, DC and has worked in HIV prevention and education in the Latino community for years. He attributes his experiences in community outreach and advocacy to his motivation to participate in clinical trials at the National Institutes of Health in Bethesda, MD.

 

What made you decide to participate in a clinical trial?

I was mostly driven by my involvement in the HIV field. I’ve always wanted to do more for the medical field in general and participating in research seemed like a good way to do it. I was originally recruited by Marco Zurita [colleague and long-time community liaison for National Institute of Allergy and Infectious Disease (NIAID) through the PACT Program] for an HIV study looking at different tissues of HIV negative people to see why anal sex was riskier than oral sex [in terms of possible HIV infection]. The funds that [Marco] had allowed him to provide me transportation – he made things pretty easy, he took care of me as a volunteer. He made sure I was being taken care of everywhere from phlebotomy to getting me to the Clinical Center at NIH. All I had to do was call him and he made things happen. I ended up not participating in that study, but they kept my information and when a vaccine study came up, they contacted me and I went in to find out more.

 

What was process like for you becoming a research participant?

The first visit for the screening you meet with the nurse and they explain to you the risks, the benefits, they’re pretty thorough, spending 15-20 minutes explaining the study to you. I did some blood work, got instructions about what procedures would be done including EKG and HIV test. When I got a call back [about the HIV study], at first I thought it was a positive HIV result, but thankfully it was just an abnormal EKG. They asked if I wanted to have my blood used for a different study and I said yes, so they ended up paying me for that – compensation they call it over there [at NIH]. At the time I was going to college and I kind of needed the money (laugh). With the vaccine study, it was pretty much the same thing – I met with the nurse, they told me all about the study, and we did some blood work to see if I was eligible to participate. That one I did end up enrolling in and participating all the way through.

Recently, I got a letter about the article that they published with the data. I was very excited to see that update; I was contributing a little to medical research. Without medical research, we wouldn’t have cures for cancers or HIV medications or all these great things that are keeping people alive. Vaccines themselves are such a great tool for disease prevention and being part of such an important thing was just great; it felt good.

“Vaccines themselves are such a great tool for disease prevention and being part of such an important thing was just great; it felt good.”

 

What did your friends and family think of you participating in a clinical trial?

They were kind of afraid, especially when they heard I was going to be receiving an actual vaccine. They were like, “Why are you doing that??” I was fine; I never had any doubts like I wasn’t concerned about getting a disease from it. I never really thought too much about it, like I wasn’t thinking, ‘Oh my God, they’re putting an experimental product in my body.” The vaccine [in the study] had already been through many trials. The safety had already been proven; they were just [adjusting the dosage]. I knew that the vaccine had already been studied and it was safe to be injected into humans, so it was fine. I felt good about it.

 

What would you say to anyone concerned about a loved one participating in a clinical trial?

Honestly, I would tell them to take it easy. When people hear the term ‘research’ and they know you’re getting some kind of medication or [researchers] are injecting something into your body, they’ll ask, “Why are you doing that?!” and my response is, “Why are you asking questions without getting educated on the subject?” If someone is asking valid questions, I’ll absolutely answer them but if someone just [has a gut reaction of] “Don’t do this!” I’ll ask them how they can be against something they have so little information about.

I dismissed a lot of people’s concerns, but with my mother, she was more worried and I was more patient with her. She worried about her son getting an experimental product. I explained the whole study to her, what it was about, and reinforced to her over and over again that I wasn’t going to get sick. She trusts me and knows I wouldn’t get myself into something that would potentially hurt me.

 

What advice would you give someone considering volunteering for a research study but might be concerned about what family might say?

Well, first, definitely do it [participate]. I think education is the best tool anything really, not just this but anything. Know what kind of research you’re going into because there are lots of different kinds of trials and there are some studies where you’re getting medications that could potentially hurt you. For example, I have a patient [at Georgetown Hospital] that has been battling cancer for many years and he’s getting some experimental drugs because they’ve tried everything else and nothing is working. We don’t know whether he’s going to be okay or not. Usually healthy volunteer studies are not going to hurt [participants]. A lot of people are skeptical of the government and they don’t trust research institutions and things like that. I do and I think we need to put a little bit more trust in our medical professionals. I feel like in the Latino community especially there’s a lot of skepticism with the medical field in general and we just need to put a little bit more trust. I feel like that comes with education, and not just going online and googling everything but having discussions with not only physicians but also, especially in immigrant families in the United States, it also means having younger generations talk to older adults about what they’ve learned.

 

The views and opinions expressed on this blog post are soley those of the person interviewed. These views and opinions do not necessarily represent those of the National Hispanic Council on Aging, its staff, and/or any/all contributors to this site.

NHCOA Celebrates Mothers on National Women’s Health Week

Washington, DC- Dr. Yanira Cruz, President and CEO of the National Hispanic Council on Aging (NHCOA)– the leading national organization working to improve the lives of Hispanic older adults, their families, and caregivers– made the following statement in commemoration of National Women’s Week, celebrated May 11-17, 2014:

“Mothers are the backbone of Latino families and as such NHCOA happily joins in the celebration of National Women’s Health Week to commemorate the important contributions of the women in our lives.

With implementation of the Affordable Care Act (ACA), millions more women now have access to preventive health services such as vaccinations, mammograms, Pap smears, and lower cost birth control. By creating a health environment that encourages healthier lifestyles, the ACA has primed families everywhere to take greater control of their health, particularly given that mothers tend to serve as the health decision-makers for their families.

Now that millions more have access to preventive health services, however, it is imperative that we as health professionals do our part to bridge the knowledge gap between diverse communities and the U.S. health system with which they may not be familiar. In addition to knowing how to use their new health insurance, mothers must be able to prevent and identify health care fraud and what their rights are as a patient. By working together to increase access to and appropriate use of health services, we can create healthier mothers and families for generations to come.”

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