Volume 33 Number 2 Spring 2018

Case Study Addressing the Spiritual so is providing spiritual care. Yet worship; that is, scratching the sur- often this component of holistic face. Needs of People Aging care is neglected. with Dementia and/or According to the 2014 Pew Lifelong Disabilities “Indeed, in today’s care system, the Research Center Religious Land- physical needs of patients are obvi- scape Study, about 72 % of people by Kathy Fogg Berry, MRE, MS, ously recognized; that after all is over 75 consider their faith to be why they are in the system. If the very important to them. The Certificate in Aging Studies right personnel are available, and if Alzheimer’s Association’s 2017 time permits, a patient’s psychoso- Alzheimer’s Disease Facts and Fig- Educational Objectives cial needs can also be addressed. ures Report states that one-third of But all too often their spiritual people over 85 have Alzheimer’s 1. Present the need for spiritual care needs are not recognized or consid- disease, and nearly one half have as part of holistic care for people ered legitimate targets for interven- some form of dementia. So, at a living with dementia and/or lifelong tion; certainly these needs are not time when they may need their faith disabilities. frequently acknowledged, recog- to help them cope with dementia 2. Distinguish the difference nized and dealt with by medical and other major life transitions, between spirituality and religion. professionals” (Sapp, 1999). elders are often unable to initiate 3. Discuss how to assess the spiritu- and sustain faith practices and spiri- al needs of people living with A visit to a new doctor’s office usu- tual disciplines that bring them dementia and/or lifelong disabili- ally begins with questions about peace, comfort, a feeling of close- ties. medical status, past and present. ness to God. This is also true for 4. Show through case study exam- Similarly, a visit to a new psychia- people aging with lifelong disabili- ples specific ways to address the trist or social worker begins with ties, who may not have the physi- spiritual needs of people living with questions about mental and social cal, cognitive, or communication dementia and/or lifelong disabili- health and history. Spiritual health abilities to initiate, ask for or sus- ties. and well-being are rarely, if ever, tain faith practices essential to their assessed. Such an assessment can well-being. Family and profession- Introduction provide valuable insight into a per- al caregivers often do not assess son’s total health or disease. Yet, spiritual needs or assist with vital Just as caring for the physical and rarely is more spiritual/religious religious and spiritual practices emotional needs of people aging information gleaned by those caring which could enhance quality of life with dementia and lifelong disabili- for elders than someone’s faith for those they’re caring for. ties is essential for their well-being, affiliation and perhaps place of

Inside This Issue:

VCoA Editorial, 6 Ruth Anne Young Award, 11 Museum Dementia Events, 15 DARS Editorial, 7 Age Wave Student Scholars, 11 VCU Road Scholar, 16 Alzheimer’s Training, 9 Legislative Breakfast Recap, 12 VCoA Brand Refresh, 17 ARDRAF Final Reports, 10 is Everywhere, 14 Calendar of Events, 18 The Federal Government mandates conduct (Post and Whitehouse, join in with organized activities or that skilled nursing facilities must 1999). Fischer, in her book Winter rituals, and they will probably fol- promote each resident’s quality of Grace (1998), says that spirituality low the teachings or philosophies life (42 CFR §483.15). Yet, spiri- doesn’t mean just one compartment either of a living spiritual leader or tual/religious care in long term, of life, but the deepest dimension of of an important religious figure assisted living, and nursing care all of life; spiritual life is not a stat- such as Jesus, Moses or Buddha. facilities is often relegated to volun- ic state but movement, growth, and Religion is, therefore, often based teers who provide generic worship process. on the past, while spirituality tends services, religious music programs, to be more about individual devel- or friendly visits. While these pro- Comparing spirituality to religion opment in the present.” grams might be quite valuable, they on its website, www.reComparison. do not address the unique spiritual com says: “Spirituality is about Sam Harris, neuroscientist, philoso- needs of everyone and cannot meet finding one's own path, which may pher, best-selling author, and self- the challenging needs of residents require the assistance of religious proclaimed atheist, claims, “Spiritu- for day-to-day spiritual support practices or spiritual leaders, but ality must be distinguished from through life’s transitions. which can also be achieved alone religion because people of every or through unconventional means. faith, and of none, have had the If 72% of elders over 75 consider Spirituality is more about an inner same sorts of spiritual experiences” their religious faith to be important, quest than an outward perfor- (2005). then facilities are not doing enough mance, so it can be harder to recog- to maintain or enhance elders’ qual- nize and it can also be much more Everyone is a spiritual being, but ity of life. This is especially true in individual than religion. People not everyone adheres to a particular regard to residents who, due to may achieve spirituality in their religious belief or becomes part of a dementia or lifelong disabilities, own unique way. Some people have religious organization. Whether cannot practice their religion and found a spiritual connection persons living with dementia and/or nurture their spirit without assis- through prayer or meditation, while a lifelong disability live at home tance. Administrators, doctors, others were struck by spirituality with caregivers or in a facility, find- nurses, social workers, recreational while walking, surfing, gardening ing ways to help them explore and therapists and all staff, not just or even working. Typically, spiritu- nurture spirituality is essential to chaplains, should seek to under- ality involves feeling a connection providing quality care, as is stand and address the spirituality of to a higher power or to a larger enabling them to practice their residents. Most facilities caring for reality, or finding a deeper under- faith, if they’ve become part of a elders do not have chaplains on standing of one's own nature. An particular religious group. staff, so this needs to be a part of individual may spend a lot of time everyone’s responsibilities. thinking about spirituality, but with- Identifying and Addressing out being part of a particular reli- Spiritual Needs Spirituality and Religion gion.” Humankind experiences deep needs Although there is no single, broadly Emile Durkheim (1912) maintained for security, trust, reassurance, love, accepted definition of spirituality, that religion involves a unified sys- inclusion, joy, hope, and accep- many agree that it involves the tem of beliefs and practices relative tance, among others spiritual needs. search for meaning to life. Spiritu- to sacred things. This then evolves How each person feels and experi- ality, in contrast to religion, pertains into a moral community called a ences these is as unique as there are to a sense of relatedness to nature, church (community of faith.) The people on the earth. So, spiritual all humanity, and the Transcendent. defining characteristic of a religion care must be person-centered, Although it need not be the case, is that it is an organized form of uniquely addressing the specific spirituality is often contextualized belief, www.reComparison.com needs of each individual in the spe- within a religious tradition, a spe- suggests. “Someone who is part of cific way he needs them addressed. cific system of belief, worship, and a particular religion will usually Conducting a spiritual assessment

2 can help discern each person’s speak to the senses of those who life. They’ve experimented with needs. It is important to ask about have cognitive impairment and can- music, pet and art therapy, and vis- rather than assume needs. A spiri- not comprehend the meaning of iting children, all of whom she also tual assessment should not be done words. This is true for persons liv- rejects. with a clip in hand, but rather over ing with lifelong disabilities, as time through conversation and rela- well. The hospice staff has had some luck tionship. For someone living with providing essential care at times, dementia, it is best to conduct an Depending on the person’s level of assessing physical needs, providing assessment during the early stages. cognition, further conversations medication, and soothing baths, but If the person with dementia or a might explore such questions as: the hospice chaplain has been lifelong disability is unable to com- What religious or spiritual influ- unable to discern her spiritual municate well, then talk with the ences shaped your life? What pre- needs. All anyone knows about person’s family or caregivers to dis- vents you from exploring and nur- Emily’s faith background is her cern past and present spiritual turing her spirit? church’s name, listed in the chart. and/or religious needs and prac- However, since she has lived in the tices. When people lose the ability to nur- facility for 10 years, she’s been ture their spirits and/or practice unable to attend church, and no one A sample Spiritual Assessment Tool their faith in ways that give them can recall a minister visiting in from When Words Fail: Practical purpose, comfort, peace, and a recent years. Ministry to People with Dementia sense of community, part of provid- and their Caregivers (Berry, 2016) ing holistic care is helping them do One day the facility’s social worker asks: those things. decides to try a new tactic. It is a • What gives you hope? beautiful spring day, so he knocks • What gives you purpose? Case Study #1 on the door to Emily’s room, where • What gives you comfort? she’s sitting in a wheelchair in the • What helps you feel closest to Emily, an 85-year-old woman with semi-dark. When he asks Emily if God and/or most whole? (prayer, debilitating rheumatoid arthritis, she would like to go outside, Emily meditation, nature, art, service pro- COPD, and dementia, has now been surprisingly looks up and clearly jects, family, friends, faith commu- diagnosed with Stage 4 stomach replies, “Yes.” Before Emily can nity involvement, holy scriptures, cancer. She’s been admitted to hos- change her mind, he wheels her out worship, music, or others) pice in the long term care facility under the portico and sits on a • What (if any) religious rituals, where she lives. A lawyer has her bench beside her. “Let’s not talk,” symbols, and practices are impor- POA, and there is no known family. he suggests, “but listen to nature tant to you? (prayer, meditation, around us.” Knowing that Emily holy scripture reading, worship, Emily’s contracted hands and legs was usually sitting near the nurses’ music, icons, candles, scents, or hurt, and she often cries in pain. station where constant noise bom- others) Because she’s prone to sliding out barded her, the chaplain thought of her wheelchair, she can often be perhaps a quiet break would be Thibault and Morgan, in No Act of found sitting by the nurses’ station nice. Love Is Ever Wasted (2009), assert where they can keep an eye on her. that, denied the ability to grasp This is often a noisy place, and she For 30 minutes they sat in silence, words, persons with dementia (or gets visibly upset when things get soaking up the sun and sounds. lifelong disabilities) often relate to chaotic. Although her speech is pre- Gentle breezes swayed the trees, symbols that remind them of the dominantly garbled, with some the sweet scent of flowers wafted presence of God, like the Bible, a “choice” words she’s retained, she through the air, and the laughter of cross or crucifix, icons, statues, routinely rejects caregivers when children playing in a nearby school- flowers, sacred pictures, stained they need to provide hands-on care. yard drifted across the street. glass windows, candles, rosaries, Staff have tried to determine what Emily seemed mesmerized and did and even the smell of incense; all might improve Emily’s quality of not fall asleep, as the chaplain

3 assumed she would. When urinary tract infections, he is rea- the weekly worship service’s prayer lunchtime arrived, the social worker sonably healthy. Although he does time, trying to communicate as best hesitated to bring up the need to not have much controlled use of his as he can. As the minister pulls out return inside, expecting loud objec- arms or legs, he gets along well in John’s board and watches his word tions. Instead, when he told her, his motorized wheelchair. spelling, John shares numerous Emily nodded in agreement. As she prayer requests, spelling them out was wheeled past the nurses’ sta- His speech, however, is almost laboriously as others wait. His tion, people noted the transforma- unintelligible, and because of requests usually focus on the needs tion of her usual anxious expression almost constant movements due to of other residents and staff whom to one of calmness and serenity. the CP, John cannot use a computer he’s obviously been listening to. They watched her wheel by in for communication. Instead, he Everyone is moved by John’s obvi- amazement. uses a pointer attached to a helmet ous concern for them and genuine on his head. With it, he can interest in their wellbeing. This was a new beginning for painstakingly point to letters and Emily. Being outside, where she spell words on a laminated board Because the minister has had to was rarely able to go, nurtured her which someone must remove from limit John’s prayer requests to one spirit. It transported her to a place his wheelchair’s backpack and set per service, so that others would of solace and peace. The social up. Because this type of communi- also have a chance to share, she has worker detailed their initial visit cation is slow going, others often decided to stay after the weekly ser- outside into Emily’s care plan, and don’t take the time, or energy, need- vice and begin spending one-on- other staff began taking her outside ed to listen to him. Communicating one time with John. She’s only for a walk or to sit, when able. The with fellow residents is complicated there part-time each week, for the hospice chaplain and various staff by his disability, as well as theirs. worship service and a Bible study, members began having success as but the minister can tell something they gently tried to assess Emily’s John is an intelligent man whom has been bothering John and wants spiritual needs and found out other others often mistakenly consider to to discern what it is. ways to help her tap into her faith. be mentally challenged because of They discovered that scripture read- his communication difficulties. In their new weekly half-hour ses- ing and hymn singing were impor- Usually kind and with a quiet dis- sions when she can focus on John, tant to Emily, too, both things she position, John’s inability to be the minister learns of his frustration could not initiate on her own due to understood sometimes leads to over not being able to help people dementia and her physical limita- angry outbursts. He’s immediately and feeling useless. Throughout his tions. They began singing old ashamed when this happens and life, prior to living in the facility, hymns or reading scripture together apologizes. Lately, however, his John did visitation of sick people on sunny days outside or rainy days frustrations have been building up with his mother and prayed with inside. Emily began to open up. and something really seems to be her over their needs each day. Until The physical pain was still present, bothering him. now, John says, no one had asked but her ability to cope with it got him about his faith or feelings of better. Her physical affect He used to attend church with his not having a purpose. He expresses improved as her quality of life was mother, and sometimes his eldest relief over just being able to talk enhanced. She lived more joyfully brother, but he hasn’t been in many about this. until her death six months later. years since his mother died and his brother moved out-of-state. He The minister encourages John to Case Study #2 enjoys the facility’s Sunday wor- continue getting prayer requests ship service, though, and staff often from others, praying for them and Born with cerebral palsy, 71-year- find him sitting silently in the assisting her by filling her in each old John has lived in a long term chapel in quiet contemplation. The week on the needs of this congrega- care facility since his mother’s minister has noticed how John’s tion. John expresses joy over this death 15 years ago. Despite chronic become increasingly vocal during newfound ministry and purpose.

4 He spends more time listening to “holy moments” that transpire Otwell, P. (2007). Guide to minis- others and sitting quietly at the bed- between anyone and God.” tering to Alzheimer’s patients and side of people who are sick. Staff their families. New York: Taylor begin sharing requests with him, Study Questions and Francis Group. too, and are more intentional about helping him communicate. John 1. How were John’s and Emily’s Post, S and Whitehouse, P. (1999). seems more happy and fulfilled. spiritual needs assessed? How was Spirituality, religion, and their quality of life enhanced when Alzheimer’s disease.” In Vander- Conclusion spiritual needs were addressed? creek, P. Spiritual care for persons 2. Why should assessing the spiritu- with dementia: Fundamentals for Everyone needs the chance to nur- al needs of people be a regular part pastoral practice. Binghamton, ture their spirit, whether through of providing holistic care and what NY: The Haworth Press. conventional religious practices are the benefits? such as worship, scripture reading, 3. What resources are needed to Sapp, S. (1999). To see things as ministry projects, and prayer, or meet the spiritual needs of people? God sees them. In Vandercreek, P. through spiritual disciplines like Are those resources readily avail- Spiritual care for persons with communing with nature, caring for able in care facilities or private dementia: Fundamentals for pas- animals, quiet meditation, or inspi- homes where people with dementia toral practice. Binghamton, NY: rational music. Even with dementia and/or long term disabilities reside? The Haworth Pastoral Press. or a lifelong disability, elders need What changes could to be imple- spiritual care unique to themselves mented to ensure they are avail- Swinton, J. (2012). Dementia: Liv- which may enhance their quality of able? ing in the memory of God. Grand life. Everyone involved in their Rapids, MI: Wm. B. Eerdmans care, family or professional, can References and Recommended Publishing Co. and should take an active role in Readings accessing and addressing spiritual Thibault, J. and Morgan, R. (2009) needs. Berry, K. (2016). When words fail: No act of love is ever wasted: The Practical ministry to people with spirituality of caring for persons “People gradually lose their cogni- dementia and their caregivers. with dementia. Nashville, TN: tion” (but) “they do not lose the Grand Rapids, MI: Kregel Publish- Upper Room Books. presence of their creator within ing. them. Although they may no longer About the Author be able to articulate their faith, the Durkheim, E. (1912). The elemen- essence of their faith lives on in tary forms of religious life. London: Rev. Kathy Berry is the their soul which outlives their body Oxford University Press. Memory Support and its ability to function” (Swin- Chaplain at Westmin- ton, 2012) Fischer, K. (1998). Winter grace. ster Canterbury Rich- Nashville, TN: Upper Room Books. mond in Richmond. “A smile, nod, tear or twinkle in Harris, S. (2005). The end of faith: Previously, Kathy the eye can be revealing,” says Pat Religion, terror, and the future of served as chaplain for Bon Secours Otwell in Guide to Ministering to reason. New York: W.W. Norton & Hospice, the Virginia Home, and Alzheimer’s Patients and Their Co. the Masonic Home in Richmond. Families (2007). “Just because She is the author of When Words those faith experiences cannot be Koenig, H. (2001). The healing Fail: Practical Ministry to People articulated, it does not mean that power of faith: How belief and with Dementia and Their Families, they do not, and cannot, occur at prayer can help you triumph over and its companion, instructional every stage of the dementia disease disease. New York: Simon and DVD. She can be reached at (or lifelong disability). After all, Schuster. [email protected]. words are inadequate to articulate

5 Editorials From the It turns out that these Lewy bodies ing; difficulty planning or keeping Director, Virginia are found in the brains of people track of sequences; disorganized Center on Aging who have Alzheimer’s disease or speech and conversation; difficulty have Parkinson’s disease. It’s the with sense of direction or spatial relationship between DLB and relationships between objects. Edward F. Ansello, Ph.D. Parkinson’s that is significant: some who have Parkinson’s eventually Someone with DLB often has fluc- Lewy Body Dementia develop dementia and some people tuations in concentration, alertness, with DLB eventually develop episodes of confusion, and exces- Dementia isn’t a specific disease in Parkinson’s symptoms; the latter sive daytime sleepiness. Also, as itself but a term that describes a set include various problems with mentioned, parkinsonisms are char- of symptoms that can reflect many movement, like muscle rigidity, acteristic of DLB, including rigidity different and sometimes overlap- shuffling gait, and bent posture, and or stiffness, a shuffling walk, bal- ping conditions or causes. Demen- clinically are called parkinsonisms. ance problems or falls, tremors, tia includes progressive impair- slowness of movement, decreased ments in memory and recognition, A family caregiver or health care facial expression, and a change in changes in personality, and losses provider may notice behaviors in posture. in reasoning ability and self-care the person under consideration. that interfere with daily life. Common early symptoms in While hallucinations and delusions Dementia is the result of brain dis- Alzheimer’s include difficulty are more symptomatic of delirium ease or injury from such causes as remembering recent conversations, than of dementia, individuals with Alzheimer’s disease, Dementia with names, and events; apathy, depres- DLB tend to have these, as well as Lewy Bodies (DLB), vascular sion; perhaps loss of smell. Com- a heightened sensitivity to antipsy- dementia, frontotemporal lobe mon early symptoms with DLB chotic medications that may be dementia, or Traumatic Brain Injury may be similar to Alzheimer’s but used initially to treat these symp- (TBI). with sleep disturbances, hallucina- toms. So these medications can be tions, and parkinsonianisms. The dangerous in people with DLB. So, while Alzheimer’s disease is the movement problems are hallmarks most common and widely known of DLB, “core clinical features.” Sleep disorders are common. A per- cause of dementia, it is not the only son with DLB may act out dreams, cause. Dementia with Lewy Bodies Recently, I participated in a fine sometimes striking or otherwise (DLB), in fact, may be the second webinar hosted by the federal injuring a bed partner. Insomnia most common cause of progressive Health Resources and Services and restless leg syndrome are com- dementia but it is certainly less well Administration (HRSA) which fea- mon. Again the connection of DLB known. tured Angela Taylor, Director of to movement disorders. Programs at the Lewy Body Alzheimer’s and DLB have similar Dementia Association. I am indebt- Lastly, there are distinctive auto- causes in that each is the result of ed to her for much of the following nomic dysfunctions, meaning invol- inappropriate deposits of protein in information. untary or unconscious actions, such the brain, called neurofibrillary tan- as dizziness or fainting, difficulties gles and amyloid Beta plaques in DLB affects men more than with regulating body temperature, Alzheimer’s and called Lewy bod- women, with age of onset being urinary incontinence, constipation, ies in DLB, named after Dr. Fred- anywhere from 50 to 85. and unexplained blackouts or tran- erich Lewy. Lewy discovered the sient loss of consciousness. abnormalities in how the brain Cognitive or brain processing prob- processes the protein alpha-synu- lems with DLB are somewhat simi- All of these symptoms present great clein while working in Dr. lar to those with Alzheimer’s and challenges to family caregivers. Alzheimer’s laboratory in the early include forgetfulness, trouble with More so because there’s so little 1900s. problem solving or analytical think- public awareness of DLB. Caregiv-

6 Editorials er burden occurs early and may be both the person with LBD and the From the higher than in Alzheimer’s disease family caregiver. LBDA offers a Commissioner, because of the disparate symptoms robust array of .information and Virginia Department and the reality that clinicians may resources designed to increase the for Aging and be late in diagnosing what may caregiver’s understanding of the seem like an odd and diverse set of disease. Rehabilitative Services symptoms. LBDA recommends as the current Kathryn A. Hayfield Things are not hopeless, however. treatment strategy the goal of If the individual with DLB is diag- improving quality of life. It states Message from the New nosed early, he or she often is more that many symptoms can be man- DARS Commissioner responsive to interventions than aged or reduced with medications, with a diagnosis later in the pro- as well as with nonpharmacological Hello! gression of the disease. Persons treatments. Because there’s such a with DLB have been found to be strong movement disorder compo- I am pleased to have this opportuni- more responsive to cholinesterase nent of DLB, it recommends that ty to introduce myself to you and to inhibitors, the types of drugs usual- the individual participate in occupa- the community of organizations and ly prescribed for those with tional therapy (OT), physical thera- service providers who strive to Alzheimer’s. Medications for con- py (PT), and speech therapy. Again, make Virginia a better place for trolling parkinsonisms like caregiver education and support are older adults to thrive. dopamine promoters may help. But critical. treatment is a balancing act; med- Some of you may know me already ications for one symptom can wors- If you are caring for someone who from my years at DARS as the en another. has been diagnosed with LBD or if Assistant Commissioner and Direc- you suspect that someone you know tor of the Division of Rehabilitative Caregivers need to be alert, there- may have LBD, visit the associa- Services, where I most recently fore, for medication sensitivities, tion’s website at LBDA.org. oversaw efforts to promote and including the need to minimize the . secure employment of Virginians use of neuroleptics/antipsychotics, The LBDA.org website features with disabilities. My former respon- which are powerful tranquilizers tabs on Support groups; LBD Care- sibilities at DARS included 10 prescribed to reduce confusion, giver Link; Publications; Informa- years as the agency’s liaison to the delusions, and hallucinations; tion about LBD for the general pub- Virginia General Assembly. I led a specifically, avoid older antipsy- lic; Support resources for LBD diverse statewide system of com- chotics like haloperidol. In some- families, including local and virtual munity based programs for the one with DLB, these drugs may support groups, phone and email agency, including brain injury, inde- worsen the individual’s cognition or support; LBD stories written by pendent living, personal assistance behavior, producing apathy or limit- LBD families; Educational services, employment support ser- ing movement, just what’s not resources, such as webinars for vices and our Virginia Assistive desired in someone with DLB. LBD families and healthcare pro- Technology System, a program that fessionals; Research news, includ- in recent years has worked to The Lewy Body Dementia Associa- ing notices of clinical studies that improve awareness among older tion (LBDA) endorses a compre- are now recruiting participants; and Virginians of the many forms of hensive treatment plan, one that other ways to get involved with and their access to assistive tech- includes appropriate medications LBDA. nology that can improve their daily for the person with DLB, a regimen lives. of physical exercise, alertness to medication sensitivities and adverse On a personal level, I also relate to drug effects, and a focused attempt the individuals we serve through to improve the quality of life for

7 Editorials the Department for Aging and became a partner in the No Wrong The April workshop will help equip Rehabilitative Services. My hus- Door (NWD) initiative. I recently participants to assess readiness to band of thirty years, Jay, was diag- attended my first NWD Resource champion and convene a dementia nosed with Parkinson’s disease Advisory Council meeting, which friendly community effort and more than a decade ago. Like others includes representatives from health establish next steps for moving for- with disabilities, he strives to main- and human service agencies, long- ward with a dementia friendly ini- tain his independence and live a full term services and supports tiative in Virginia. Approximately life and we struggle to balance the providers and advocates. I applaud 140,000 individuals with need for safety with the dignity of the group’s vision to transform the Alzheimer’s disease or other risk. Jay wants to direct his own way people access services in their dementias and more than 450,000 care to the maximum extent possi- community by bringing together a care partners live in Virginia, so this ble. Like many families, we face network of partners, the power of initiative is extremely relevant as the difficulty of finding home care technology and the importance of we determine avenues for providing providers who respect his desire for individual choice. much needed support. self-direction and see their role as helping him lead an active life. I am Significantly, HHR Deputy Secre- Later this spring, we will learn the privileged to join my-coworkers at tary Marvin Figueroa has joined the recipients of the 2018 Best Prac- DARS and our many community council. Mr. Figueroa previously tices Awards, which bring attention partners to strengthen the systems was senior policy advisor for Sena- to noteworthy initiatives and available for people to live more tor Mark R. Warner, who as gover- encourage organizations to develop independently and to age graceful- nor advocated for creation of a net- and support programs and services ly. work of service providers for older that assist older adults to age in adults, family caregivers, veterans, their community. Each year, the Gov. Ralph Northam and his cabi- and individuals with disabilities, Commonwealth Council on Aging, net, including fellow physician and regardless of where the individual which advises the Governor on Health and Human Resources first seeks support. Mr. Figueroa issues affecting the 1.6 million Vir- (HHR) Secretary Daniel Carey, advised Sen. Warner on health care ginians ages 60 and older, recog- took office in January and began issues, and he brings that expertise nizes innovative programs that may work on negotiating new legislation to the leadership team as it provides be replicated across the Common- and crafting the Commonwealth’s guidance and oversight for NWD’s wealth. budget. As the General Assembly statewide expansion and long-term session ended without an agree- sustainability. Themes that emerged from this ment, Gov. Northam, who is deter- year’s 13 nominees included care- mined to pass Medicaid expansion, In April, I look forward to address- giving education and respite and called on House and Senate leaders ing the first Dementia Friendly Vir- supports for older adults to age in to return to Richmond April 11th. If ginia Statewide Workshop, held in place. I am sure these same themes indeed Medicaid is expanded, it partnership with LeadingAge Vir- will be among those our advisory will be in no doubt due in large part ginia and n4a. This initiative seeks board members consider as they to Gov. Northam’s desire to to bring states, counties or cities, commence work on the upcoming improve access to health care as he local communities and even neigh- Dementia State Plan and Virginia strives to lead a Commonwealth borhoods together to improve the State Plan, which serve to encour- that works better for all people, no quality of life for individuals living age organizations to develop and matter who they are or where they with dementia and their caregivers. support programs and services that live. Herndon was the first Dementia assist older adults. Friendly community in Virginia and In this, he is joined by Sec. Carey, representatives will report on the In the coming months, I plan to Centra’s former senior vice presi- town’s progress to help provide meet with Virginia’s AAAs and dent and chief medical officer. You inspiration. their leadership and look forward to may recall that Centra last year visiting with many of the groups

8 Editorials and service partners who comprise Alzheimer’s Disease day, June 1, 2018, 9:00 a.m. to the backbone of our Common- and Dementia Care 5:00 p.m. George Mason Universi- wealth’s efforts. ty, Peterson Family Health Sciences Seminar Hall, Room 2409, 4400 University I look forward to joining you in cel- Drive, Fairfax, VA 22030. ebrating May as Older Americans Take the path to certification as a Month to promote this year’s Certified Dementia Practitioner Cost: $25 for the student hand- theme, “Engage at Every Age.” (CDP) through the National Coun- book. Course fee is graciously cov- cil of Certified Dementia Practi- ered by Virginia Geriatric Educa- Visit DARS’ updated Office for tioners. Professionals from non- tion Center, Geriatrics Workforce Aging Services web page at profit organizations, county govern- Enhancement Program. www.vda.virginia.gov and its new ment, and faith based organizations providers’ portal at are invited to attend, along with any Trainer: Christi Clark, ALA, https://sp.wwrc.net/VDAproviders. family caregivers. CMIS, CDP, CADDCT, is the Assistant Director at Insight Memo- This is the required seminar for ry Care Center and has over 15 those pursuing CDP certification, to years of experience in long term qualify through the National Coun- care. Christi is a licensed Assisted cil of Certified Dementia Practi- Living Facility Administrator, tioners, and is made possible and where she has worked in both mar- very affordable with the help of our keting and operations roles. As a partners. To see if you qualify, Certified Memory Impairment Spe- please visit the NCCDP website at cialist, Certified Dementia Practi- www.nccdp.org. You are also wel- tioner, and Certified Alzheimer’s 2018 DARS Meeting come to just come for the educa- Disease and Dementia Care Trainer Calendar tion. Lunch will be provided, through the National Council of thanks to AARP. Certified Dementia Practitioners, Commonwealth Council on Aging she has dedicated the last 10 years July 11, September 19, and What: The seminar will cover the working specifically with those December 19 following modules: Diagnosis, affected with various forms of Prognosis, Treatment, Communica- memory impairment, their families, Alzheimer’s Disease and Related tion, Feelings, Depression, Repeti- : and the community. Disorders Commission tive Behavior, Paranoia, Hallucina- June 19, August 21, and December 11 tions, Wandering, Hoarding, Registration: Go to Public Guardian and Conservator Aggressive Behaviors, Catastrophic InsightMCC.org/CDP-GMU. Advisory Board Reactions, Intimacy and Sexuality, You can also register by calling June 21, September 6, and Personal Care, Pain, Nutrition, Cathy Tompkins at (703) 993-2838. November 8 Activities, Environment, Staff and Space is Limited. Payment for the Family Support, Diversity and Cul- student handbook must be received tural Competence, Spiritual Care, one week in advance of the class to and End of Life. ensure course enrollment. No form Visit Our Websites of taping is allowed nor are laptops When and Where: The same pro- permitted in the seminar. Ques- Virginia Center on Aging gram is often on two dates. Satur- tions? Please contact Cathy Tomp- www.sahp.vcu.edu/vcoa day, May 12, 2018, 9:00 a.m. to kins at (703) 993-2838 or 5:00 p.m., Insight Memory Care [email protected]. Virginia Department for Aging Center Mazawey Education and and Rehabilitative Services Support Center, 3955 Pender Drive, www.vda.virginia.gov Suite 100 Fairfax, VA 22030; Fri-

9 COMMONWEALTH OF VIRGINIA Alzheimer’s and Related Diseases Research Award Fund Delayed Final Project Report from the 2016-2017 Alzheimer’s Research Award Fund

The Alzheimer's and Related Diseases Research Award Fund (ARDRAF) was established by the Virginia General Assembly in 1982 and is administered by the Virginia Center on Aging at Virginia Commonwealth University. The awards this year were enhanced by a $25,000 donation from Mrs. Russell Sullivan of Fredericksburg, in memory of her husband who died of dementia. Sullivan awards are indicated by an asterisk (*). Summaries of two delayed final project reports submitted by investigators funded during the 2016-2017 round of competition are given below. To receive the full reports, please contact the investigators or the ARDRAF administrator, Dr. Constance Coogle ([email protected]).

UVA Matthew J. Barrett, MD, MSc, Jason Druzgal, MD, PhD, and Scott Sperling, PsyD Nucleus Basalis of Meynert Degeneration in Parkinson Disease Cognition Dementia in Parkinson disease (PD) is a major source of morbidity. Degeneration of the nucleus basalis of Meynert (NBM) contributes to dementia in PD via loss of cholinergic innervation to the neocortex. The NBM has been identified as a potential intervention point to treat dementia in PD, and deep brain stimulation has been pro- posed as a potential therapy. As a preliminary step toward testing this therapy in PD, we determined whether MRI measures of NBM volume correlate with cognition in PD. Because it is difficult to accurately measure the NBM using MRI, we measured cholinergic nucleus 4 (Ch4) of the basal forebrain, which includes the NBM, using available cytoarchitectonic maps. The investigators found that reduced Ch4 density was associated with worse global cognition and worse performance on measures of attention, processing speed, and visuospatial function in early-stage and late-stage PD cohorts. The finding of a significant association between Ch4 density and cognitive measures in an early-stage PD cohort supports an early intervention targeting this region to prevent future degen- eration. The investigation to identify a genetic marker as a predictor of Ch4 density continues, but preliminary data indicate there is no relationship between the APOE e4 allele, a risk factor for Alzheimer disease, and Ch4 density. The results provide evidence that reduced Ch4 density identifies more advanced PD, i.e., more advanced extra-nigral pathology. Future research will investigate whether Ch4 density may serve as a surrogate biomarker in PD. (Dr. Barrett may be contacted at 434/243-2012, [email protected]; Dr. Druzgal may be contacted at (434) 982-1736, [email protected]; Dr. Sperling may be contacted at (434) 982-1012, [email protected].)

William & Oliver Kerscher, PhD, and Munira Basrai, PhD* Mary STUbL-Dependent Clearance of Transcriptionally-Active, Aggregate-Prone Proteins from the Nucleus Altered gene expression is a hallmark of neurodegenerative disorders including Huntington’s Disease. The main goal of this study was to investigate if STUbLs, a unique class of involved in targeted protein degrada- tion, can prevent the abnormal transcriptional activity associated with a mutant, aggregation-prone fragment of huntingtin (mHtt), the causative agent of Huntington’s disease. Specifically, as part of this project the investiga- tors examined: 1) the physical interaction of STUbLs with mHtt, 2) the effect that STUbLs have on the transcrip- tional activity of mHtt in a tissue culture model of Huntington’s disease, and 3) whether these enzymes counteract the abnormal transcriptional activity of mHtt on a genome-wide scale. It was found that increasing the levels of STUbLs reduces the chromatin association of mHtt aggregates. Furthermore, STUBLs specifically reduced mHtt- induced transcription in unique reporter gene assays. Whole-genome mRNA sequencing of mHtt-expressing cells, with and without STUbLs, were also completed. As a next step, bioinformatic analysis of these transcriptome data will be used to identify the endogenous gene targets of chromatin associated mHtt. Overall, the results are consistent with the investigators' model that STUbLs may be neuro-protective and the exciting new finding that enhanced STUbL expression levels can reduce the chromatin association and abnormal transcriptional activity of mHtt. These results implicate RNF4, an involved in targeted protein degradation, as an important player and potential therapeutic target for Huntington’s Disease.(Dr. Kerscher may be contacted at (757) 221-2229, [email protected]; Dr. Basrai may be contacted at (301) 402-2552, [email protected].)

10 Ruth Anne Young The Action Alliance noted Ruth Richmond 7th District Council- Recognized with Nexus Anne was being honored with the woman Dr. Cynthia Newbille in Nexus Award “for being an indi- summer of 2017. Rhodes’ project Award vidual who has created a high level successes include six community of cooperation among members of flu shot clinics, City Council VCoA’s Ruth Anne the justice system and/or other sys- involvement in the East End initia- Young has labored in tems within a local community. You tive, partnerships established with the field of abuse in exemplify the collaboration and health and wellness organizations, later life, working unity of purpose in bringing togeth- and creation of an inclusive legisla- tirelessly over the er diverse individuals and disci- tive packet for the 2018 General years to confront plines to create a community that Assembly. elder abuse, neglect, and exploita- promotes safety for victims and tion. She has staffed federal and accountability for perpetrators.” Rhodes’ full report can be found at state- funded projects to train ser- agewellva.com. Project updates are vice providers, law enforcement, We, too, honor Ruth Anne. given at Age Wave Neighborhood prosecutors, judges and others in Livability Action Team meetings. effective strategies to prevent or To join this action team, contact respond to abuse in later life. She Ken Lantz at currently staffs a project funded by Age Wave Engages [email protected]. the Virginia Department of Crimi- Communities through nal Justice Services to partner with Wish Fulfillment Project High- the Virginia Supreme Court to edu- Scholar Projects lights Community Generosity cate district and circuit judges on matters related to adjudicating such by Catherine MacDonald, VCU Gerontology master degree cases. Greater Richmond Age Wave candidate Nicole Hunt has launched an innovative project on person- Ruth Anne’s efforts have been rec- The Greater Richmond Age Wave centered care. As the Age Wave ognized. The Virginia Sexual and Scholar Program joins students and Wish Advocate Scholar, Hunt is Domestic Violence Action Alliance community partners to design, working to acknowledge, identify, named her recipient of its 2017 develop, and implement projects in and carry out the wishes and Nexus Catalyst Award. In its notifi- the region and beyond. Students dreams in long-term care facilities cation, the Action Alliance stated it achieve learning goals while part- that may not be addressed because was “absolutely delighted to honor ners benefit from their skills and of budget restrictions, transporta- you for your exceptional and inspir- gerontological expertise. The fol- tion, and/or physical limitations. ing work on behalf of survivors of lowing are updates from several Hunt has named the project sexual and intimate partner vio- past and current Scholars; other “Dreams are Forever.” lence in Virginia.” projects are currently underway. To learn more about the Age Wave Wishes from long-term care resi- A “catalyst” is one whose enthusi- Scholar program or to sponsor a dents at the Trio Healthcare-Eliza- asm and energy precipitates signifi- Scholar, contact Catherine Mac- beth Adam Crump Health and cant positive change. The Catalyst Donald at [email protected]. Rehabilitation Center are sponsored Awards recognize individuals by Anthem HealthKeepers Plus. and/or organizations who have Age Wave City Council Scholar made superior contributions to Launches East End Initiative, So far, wish recipients have enjoyed improving services for survivors of Invites Collaboration chess lessons, a comedy show, a sexual and intimate partner vio- projector to watch movies, and din- lence and creating a Virginia free of Age Wave City Council Scholar ner out with the family. Next up: violence. Annie Rhodes, a VCU Gerontology graduate, began collaborating with - Continued on page 17

11 The Virginia Center on Aging’s 32nd Annual Legislative Breakfast

VCoA hosted its 32nd annual breakfast on January 24, 2018, at St. Paul’s Episcopal Church in Richmond. Atten- dance was large and lively. We welcomed members of the General Assembly, their staffs, the Executive Branch, state departments, Councils, and colleagues in agencies and organizations across Virginia. This year we recog- nized Delegate Ken Plum as calendar 2017 was the 35th year of the Alzheimer's and Related Diseases Research Award Fund (ARDRAF) which he patroned in the General Assembly.

VCoA hosts this annual breakfast to inform the General Assembly, which created it in 1978, of progress in meet- ing our three fundamental mandates: interdisciplinary studies, research, and information and resource sharing. We take this opportunity each January to review our activities in the calendar year just concluded. As has been the case for so long, partnerships with many others enabled us to achieve success in helping older Virginians and their families. VCoA trained, consulted, researched, or collaborated in every region of the Commonwealth in calendar year 2017. We were honored to have Attorney General Herring welcome attendees.

You can see our 2018 Legislative Breakfast Power Point presentation by visiting our website at www.sahp.vcu.edu/vcoa.

Top Left: Courtney O'Hara, VCoA; Rick Jackson, Riverside Center for Excellence in Aging and Lifelong Health (CEALH); Ruth Anne Young, VCoA Top Center: Jenni Mathews, VCoA, gives Thelma Watson, Senior Connections, her name tag at the VCoA reception table Top Right: Jessica Samet, Alzheimer's Association and Devin Bowers, Department for Aging and Rehabilitative Services Bottom Left: Dean Joe DiPiro and Patty Slattum, VCU School of Pharmacy; and Charlotte Arbogast, DARS Bottom Center: Catherine Dodson, VCoA, and Senator Emmett and Sharon Hanger Bottom Right: Bill Massey, Peninsula Agency on Aging; Justine Young, Piedmont Senior Services; and Senator Monty Mason

12 Top Left: Cathy Tompkins, George Mason University; Christi Clark, Insight Memory Care Center; Megumi Inoue, GMU; and Emily Ihara, GMU Top Center: Senator Creigh Deeds and Catherine Dodson, VCoA Top Right: Ed Ansello, VCoA, and Attorney General Mark Herring Middle Left: Harvey Chambers, Anthem; Brian Beck and Regina Sayers, Appalachian Agency for Senior Citizens Middle Center: Wayne Phillips, Lifelong Learning Institute of Chesterfield (LLI); Kimberly Rideout, Chesterfield TRIAD; Debbie Preston, Chesterfield Senior Advocate; and Rachel Ramirez, LLI Middle Right: John Skirven, Senior Services of Southeastern Virginia; Delegate Ken Plum; Bobby Vassar, Bay Aging; and Rick Jackson, CEALH Bottom Left: Attendees at the VCoA Legislative Breakfast Bottom Center:Attorney General Mark Herring gives the Welcome Bottom Right: Delegates Betsy Carr, Kathleen Murphy, and Karrie Delaney

13 Sugar Is Everywhere: sugar? The list may surprise you. • high corn Other Names for • The following is a summary of • honibake words that really mean added sugar; • honi bake it was first published online in the • honi-bake Consumers are waking up to the journal Lancet by Barry Popkin and • honi flake, honi-flake reality that added sugar is virtually Corinna Hawkes in “Sweetening of • invert sugar everywhere in our food, from the the Global Diet, Particularly Bever- • inverted sugar obvious places like sodas, , ages: Patterns, Trends, and Policy • isoglucose and desserts to the less obvious like Responses.” Note that “juice con- • isomaltulose tomato sauce, yogurt, and meats. centrate” alone in this list can refer • juice concentrate (over 50 After years of dismissing added to over 50 sources, from apple juice varieties) as a health risk, focusing to chokeberry to fig or watermelon • kona ame, kona-ame instead on saturated fat as the cul- juice. • prit, nutritional scientists and health • liquid sweetener care providers are advising us to be Ingredients That Mean • wary of added sugars in our diets. Added Sugar • malt sweetener They carry the prospect of ominous • malt syrup consequences like high blood pres- • agave juice, , sap, or syrup • sure, diabetes, and heart disease. • beet sugar • maple Sugars not only deliver calories • • empty of vitamins, fiber, and other • • nutrients , but they also “crowd • cane juice • mizu ame, mizu-ame, out” healthier foods in a person’s • cane sugar • diet. • cane syrup • nulomoline • clintose • The American Heart Association • confectioners powdered sugar • rice syrup recommends that we consume less • confectioners sugar • sorghum than 100 calories (women) or 150 • corn syrup • sorghum syrup calories (men) of added sugar a day, • corn sweet • sweetener but one 12-ounce can of soda car- • corn sweetener • ries about 9 teaspoons of sugar and • • puts most of us at or over the limit. • • sucrovert • dextrose • A study by Yang et al, published in • drimol, dri mol, dri-mol • sugar invert JAMA Internal Medicine in 2014 • drisweet, dri sweet, dri-sweet • sweet n neat found that most US adults con- • dried raisin sweetener • table sugar sumed more than 10% of their total • edible lactose • calories from added sugars, while • evaporated cane juice • 10% of adults consumed 25% of • flo malt, flo-malt, flomalt • tru sweet more from added sugars. “Regular • fructose • turbinado sugar consumption of sugar-sweetened • fructose sweetener • versatose beverages (≥7 servings/wk) was • glaze and icing sugar associated with increased risk of • glaze icing sugar CVD (cardiovascular disease) mor- • tality.” The higher the consumption, • gomme the greater the risk. • granular sweetener • granulated sugar So where are we getting added • hi-fructose corn syrup

14 Museum Events for See Me at the Freer/Sackler. The Lifelong Learning Persons Living with Freer Gallery of Art and Arthur M. Institute Fall Catalog Sackler Gallery preserve and share Dementia and their the treasures of Asia, making The Lifelong Learning Care Partners inspiring connections between Asia, Institute (LLI) in America, and the world. This group Chesterfield will be by Devin Bowers meets on the third Wednesdays of releasing its Summer DARS Dementia Services each month. Catalog on Friday, April 13th, on Coordinator site and online, and its Fall Catalog on site and online on Friday, August The Smithsonian Institute has 10th. The LLI is a member-sup- developed several tours for people ported organization operated exclu- living with dementia and their fami- sively for the education and social lies or care partners. enrichment of adults ages 50 and older. See Me at the National Museum of African Art. The experience of Entrance to the Smithsonian is free; LLI, founded and co-sponsored by looking closely allows us to appre- however, registration for these pro- the Virginia Center on Aging, ciate beauty, exchange ideas, share grams is required. Participants may Chesterfield County Public memories or simply respond to the register by emailing [email protected] Schools, and Chesterfield County work in front of us. We invite indi- or by calling (202) 633-2921. For maintains a rich growth environ- viduals living with dementia, additional infomation, such as ment for mid-life and older adults. together with their family members group size or time concerns, please In 2017, the LLI offered 645 class- or care partners, to join us for an contact Ashley Grady at es in three full sessions of daytime interactive and multi-sensory tour [email protected]. nonresidential college-level courses of the museum. This group meets and related activities, taught by 218 on the fourth Tuesday of each instructors. The LLI had a total of month. 1261 members in 2017, represent- ing 47 different zip codes. See Me at the National Portrait Gallery. The Gallery tells the story Would You Like to Class categories include: Art, of America by portraying the peo- Receive Age in Action Music, Drama, Dance, Computers, ple, including artists, politicians, Technology, Math, Science, Eco- scientists, inventors, activists, and Electronically? nomics, Finance, Fitness, Health, performers, who shape the nation's Wellness, History, Humanities, history, development and culture. We currently publish Age in International Studies, Languages, This group meets on the second Action in identical print and PDF Literature, Poetry, Film, Leisure Tuesday of each month. verions. We are transitioning to an electronic version only. You Activities, Life Services, Philoso- phy, Religious Studies, Special See Me at tbe Smithsonian Amer- can subscribe at no cost. Simply Events, Weekly Group Activities, ican Art Museum. This museum's email us and include your first and and more. Stop by between 8:00 collection captures the aspirations, last names and email address. If a.m. and 4:00 p.m. to pick up your character, and imagination of the you now receive hard copies by copy. You may also view the cata- American people throughout three postal mail, please consider log online at centuries, revealing key aspects of switching to email distribution. www.LLIChesterfield.org. America's rich artistic and cultural Send an email listing your present history. This group meets on the postal address and email address first Wednesday of each month. for future deliveries. Send requests to [email protected].

15 Modern Senior Travel who have identified preferences or as important, and that’s a subject and VCU Road Scholar have dietary restrictions. In addi- well suited for classroom settings. tion, Baby Boomers may well have higher standards for dining (we try A VCU Road Scholar program that by Jeffrey Ruggles not to say: “are pickier”). The we have redesigned to reflect the expectation today is that special new thinking is “Choose Your Pace: When it began, the educational needs or preferences will be accom- Hiking in Shenandoah National travel program that today goes by modated. So, Road Scholar has Park.” It takes place at Big Mead- Road Scholar was called Elderhos- taken the approach that the cus- ows Lodge, located atop the Blue tel. Many people still know it by tomer is always right. Ridge overlooking Page Valley and that name (and it is not incorrect: the South Fork of the Shenandoah Elderhostel, Inc. is the non-profit Significant River. Food has never been an issue organization that has Road Scholar change has at Big Meadows, where the airy and as its trade name). Just as the pro- come, as timbered Spottswood Dining Room gram name has changed, so has well, to the features quality choices (and large there been an evolution of the kind type of portions). The revisions we’ve of travel experience that older content made are to the program content, adults seek and Road Scholar that Road Scholar programs offer. It which has moved from a combina- endeavors to provide. used to be that the typical structure tion of classes and hikes to primari- was a week-long program with ly hiking experiences. The remade A few Road Scholar programs may three academic-style topics present- program also incorporates the still take place in the summer, offer- ed daily in classroom settings at a “Choose Your Pace” model, which ing stays in college dormitories and campus or retreat center. The first allows participants to select dining in the campus cafeteria. For evolution was to examine just a sin- between two levels of activity: one the most part, however, that model gle subject in depth over the week. set of hikes that are longer and has been set aside. The older adult Now programs are shifting away more difficult, and a second set eas- of 30-40 years ago had different from the classroom altogether ier and not so long. A couple of notions about travel than a counter- toward experiential learning. In hikes at the beginning of the pro- part of today, when the Baby Boom practical terms, this translates to gram that include the whole group cohort is affecting what Road learning by doing or by going. Edu- should help participants self-define Scholar presents. The 2010s older cation remains essential to Road their ability level relative to the traveler prefers a private room, Scholar but it now takes many group. The Big Meadows revisions goes in all seasons, and looks for a forms. Within Road Scholar there will probably skew participation higher quality of dining. Of course, are still classroom-oriented pro- somewhat younger, which is in college cafeterias are quite a bit grams but, rather than being the keeping with other successful Road better than they used to be, too. standard format, they are now a Scholar National Park programs. As specialty category. VCU Road Scholar looks forward Of all the things that set the Baby to preparing programs for 2019 and Boomers apart from their predeces- Over the years VCU Road Scholar 2020, one aim will be for a larger sors, the most pronounced is proba- has been primarily a provider of portion of experiential education in bly food. Baby Boomers pay more academic classroom programs, the mix, yet still working to design attention to what they are eating even while our lodgings were programs that are appropriate and and how it tastes. Ever more people hotels. In part, this reflected the “no enjoyable for older and less mobile have become aware of food items need to fix what ain’t broke” phi- participants. that they shouldn’t eat or prefer to losophy. Another reason has been avoid. Road Scholar tour providers the Road Scholar emphasis on fea- For more information about our have to work with the kitchens that turing what is unique or special VCU Road Scholar programs, feed their participants to ensure that about each locality. Being in Vir- please call (804) 828-1525 or email meal options are available for those ginia, VCU has always seen history [email protected].

16 Age Wave, continued Personal Vehicles (transportation 40th Anniversary Brand counseling and empowerment for Refresh for VCoA exercise equipment requested for older drivers); Public Transporta- tion Expansion; Autonomous Vehi- increasing strength and endurance. by Jessica Lyon, VCoA cles; and Medicaid Expansion. Wish fulfillment serves more than Communications Specialist just a momentary purpose. Hunt aims to help reduce generalized To learn more about the study and decline caused by social isolation in the Greater Richmond Age Wave’s long-term care facilities by promot- advocacy work, visit ing activity, socialization, engage- agewellva.com. ment, fun, and person-centeredness. We at the Virginia Center on Aging Student Team Seeks to Create a are celebrating the 40th anniversary NORC in Richmond’s 6th Dis- Age Wave Scholar Research Pro- of our dynamic organization. This trict vides Guidance for Transporta- significant milestone inspired a tion Advocacy fresh, new look for the center’s Age Wave’s first Age Wave Scholar logo. Our leadership agreed that the team is working with community A recent project by Age Wave 40th anniversary serves as the per- advocates and Councilwoman Ellen Transportation Liaison Scholar Sara fect time to unveil the new brand- Robertson to identify how the Morris, a VCU Gerontology gradu- ing. The redesigned logo combines Green Park neighborhood of High- ate, has shed light on regional trans- the national advocacy colors of our land Park can become a naturally portation issues and helped estab- four program areas, each gradually occurring retirement community lish a regional transportation advo- blending into the next to show that (NORC). VCU Gerontology master cacy agenda. we are united in the same purpose, degree candidates Emily Daidone, which is to improve the quality of Evelyn Beaumont, and Caitlin As part of her master degree course life for all older Virginians. work, Morris created and adminis- Lange are the Age Wave Scholar Project Lead, Age Wave Richmond tered a Transportation Preferences The bright blue color represents our City Scholar, and Age Wave Survey to 177 greater Richmond Geriatrics Education program, Research Scholar, respectively. residents, ages 52 to 96; she used a which works to train individuals in The team has completed a review convenience sampling to distribute interprofessional geriatrics and of the literature, met with commu- the surveys to two older adult mem- gerontology. The magenta or red- nity advocates, and is currently bership organizations: The Lifelong dish purple color represents our designing a community survey Learning Institute located in Abuse in Later Life program, which combining evidence-based best Chesterfield County and the Senior strives to strengthen an interdisci- practices and community identified Center of Greater Richmond, a vir- plinary community response to need. Future phases are currently in tual senior center with multiple elder abuse, neglect, and exploita- development, so stay tuned. locations primarily located in the tion. The deep violet or bluish pur- City of Richmond. ple color represents our Dementia Age Wave is jointly managed by Research program, which funds VCU Gerontology and Senior Con- Combining findings from Morris’ seed research grants into the causes, nections, the Capital Area Agency survey, community validation and consequences and treatment of on Aging. network experts in the region, Age Alzheimer’s disease and other Wave identified the following seven dementias. The bright green color transportation pillars to support represents our Lifelong Learning through advocacy at state and local program, which encompasses both levels: On-Demand Services; Vol- our Lifelong Learning Institute in unteer Driving; Transportation Chesterfield and our VCU Road Companies (private and nonprofit); Scholar adventures across Virginia.

17 Calendar of Events May 3, 2018 May 24, 2018 June 19, 2018 Spring Appalachian Oral Health Hands on Hands: Habilitation Helping through the Journey of Forum. Provided by the Virginia Therapy and Dementia Care. Con- Dementia: The Right Care at the Rural Health Association in part- ference presented by Norfolk State Right Time. 8:00 a.m. - 4:00 p.m. nership with the Virginia Oral University with keynoter Paul Germanna Community College, Health Coalition and the Virginia Raia, PhD. 8:30 a.m. - 4:00 p.m. Culpeper Campus. Partial funding Department of Health. Abingdon. Norfolk State University, NSU Vir- from Virginia Geriatric Training For information, visit ginia Beach Higher Education Cen- and Education Award Fund. For www.vrha.org/calendar_ ter. For information, call (757) 368- information, contact (540) 825- content_396_3733152500.pdf. 4152 or (757) 823-8122 or email: 3100 x3416 or [email protected]. [email protected] or May 4-6, 2018 [email protected]. June 24-26, 2018 Women's Health 2018: Translating Technology Connecting the Health- Research Into Clinical Practice. May 30-June 1, 2018 care Eco-System. 14th Long Term Presented by the VCU Institute for 24th Annual Virginia Coalition for and Post Acute Care (LTPAC) Women's Health and VCU Health the Prevention of Elder Abuse Health IT Summit, Presented by Continuing Medical Education, in Conference. 4 Diamond Kingsmill LeadingAge. Washington Hilton special collaboration with Journal Resort, Williamsburg. For informa- Hotel, Washington, DC. For infor- of Women's Health and the Acade- tion, visit www.vcpea.org/ mation, visit https://leadingage.org/ my of Women's Health. Crystal vcpea-conference-information. ltpac-hit-summit. Gateway Marriott, Arlington. For information, visit June 4, 2018 July 23-26, 2018 https://vcu.cloud-cme.com/aph. Annual Conference on Aging with Mobilize: Resistance through aspx?EID=5196&P=5. Lifelong Disabilities. Presented by Action. 2018 Conference on Inde- the Area Planning and Services pendent Living presented by the May 4, 2018 Committee (APSC) . Doubletree National Council on Independent Community Engagement Show- by Hilton, Richmond Midlothian. Living. Grand Hyatt, Washington, case. Presented by VCU Gerontol- For information email DC. For information, visit ogy and the Greater Richmond Age [email protected]. www.ncil.org. Wave. Triple Crossing - Fulton, Age in Action Richmond. For information, visit June 6-7, 2018 Volume 33 Number 2 agewellva.com. Annual Alzheimer's Education Spring 2018 Conference at James Madison Uni- May 15, 2018 versity. Presented by the Edward F. Ansello, Ph.D. Webinar: Assistive Technology and Alzheimer's Association, Central Director, VCoA Aging with a Disability. Presented and Western Virginia Chapter. Fes- Kathy Hayfield by Assistive Technology in New tival Conference and Student Cen- Commissioner, DARS Hampshire. This session will dis- ter, Harrisonburg. Registration at cuss and demonstrate assistive www.alz.org or at (800) 272-3900. Kimberly S. Ivey, M.S. technology solutions to enable Editor individuals who experience various June 15, 2018 Age in Action is published quarter- disabilities to age in place.3:00 Southwest Virginia World Elder ly. Submissions, responses to case p.m. - 4:00 p.m. $25 fee. For Abuse Awareness Day Conference. studies, and comments are invited information, visit Sponsored by the Virginia Tech and may be published in a future issue. Mail to: Editor, Age in Action, https://iod.unh.edu/atwebinar18? Center for Gerontology. Wythe- P.O. Box 980229, Ricmond, VA mc_cid=b019f1f126&mc_eid ville Meeting Center, Wytheville. 23298-0229. Fax: (804) 828-7905. =31425fd76d For information, visit https:// Email [email protected]. virginiatech.qualtrics.com/jfe/form/ Summer 2018 Issue Deadline: SV_78V4z5YNnW9zm3r June 15, 2018 18 Virginia Center on Aging Virginia Department for Aging and at Virginia Commonwealth University, Richmond, Virginia Rehabilitative Services www.sahp.vcu.edu/vcoa www.vadars.org

Staff: Staff: Director Commissioner: Kathy Hayfield Edward F. Ansello, PhD Wendy Boggs, No Wrong Door Expansion Coordinator Road Scholar Coordinators Tanya Brinkley, Service Referral Administrative Assistant Catherine Dodson, MS - Richmond Brenda Cooper, Program and Compliance Analyst Barbara Wright - Staunton Marcia DuBois, Director, Division for Community Living Associate Director for Research Leonard Eshmont, Home &Community-Based Services Systems Constance L. Coogle, PhD Director Road Scholar Program Administrator Jacqueline Freeze, External Aging Services Auditor Jeffrey Ruggles, MFA Bet Gray, Business Systems Analyst/ASAPS Program Project Director Megan Grey, ESSP Contracted Services Specialist Paula Knapp Kupstas, PhD Liz Havenner, Program Coordinator/Caregivers Executive Director, Lifelong Learning Institute April Holmes, Coordinator of Prevention Programs Rachel Ramirez David Hominik, Legal Services Developer Assistant Director, Virginia Geriatric Education Center Michele James, No Wrong Door Trainer Bert Waters, PhD Georgie Lewis, Customer Service Specialist Project Coordinators Sara Link, No Wrong Door Policy Advisor & Lead Strategist Courtney O’Hara, MEd Nancy Lo, GrandDriver Coordinator Ruth Anne Young, MEd Amy Marschean, Senior Policy Analyst Research Associates Patti Meire, Public Guardian Program Coordinator Sung Hong, PhD Christy Miller, I.T. Business Analyst Sarah Marrs, PhD Kathy Miller, Director of Programs Myra G. Owens, PhD Carolyn Mines, No Wrong Door Help Desk Administrator Research Assistant Beverly Morgan, CDSME Program Coordinator Jenni Mathews Erika Okonsky, No Wrong Door Expansion Specialist Madeline McIntyre Andi Platea, CDSME Coordinator Administrative and Research Assistant Rosemary Seltzer, No Wrong Door Governance Specialist Jessica Lyon Annette Sherman, Senior Systems Analyst/ASAPS Editor, Age in Action Cecily Slasor, Administrative Program Assistant Kimberly S. Ivey, MS Pam Smith, VICAP Director Betty Vines, Public Guardian Program Assistant Advisory Committee: Frank Baskind, PhD Commonwealth Council on Aging: Russell H. Davis, PhD Members Joseph T. DiPiro, PharmD Kyle R. Allen, DO, AGSF Cecil Drain, PhD Beth Barber, Chair Marcia DuBois Mitchell Patrick Davis Madeline L. Dunstan, MS David M. Farnum James Hinterlong, PhD Joni C. Goldwasser Paul G. Izzo, JD Carter Harrison Christine Jensen, PhD Valerie L’Herrou, JD Adrienne Johnson, MS Richard W. Lindsay, MD Richard W. Lindsay, MD Shewling Moy Christopher M. McCarthy, Esq Diana M. Paguaga Hon. Jennifer L. McClellan Valerie Price, Vice-Chair Sherry Peterson, MSW Roberto Quinones Robert L. Schneider, PhD, Chairman Kathryn B. Reid Ralph E. Small, PharmD Beverley Soble Beverley Soble Vernon Wildy Thelma Bland Watson, PhD Veronica Williams Erica Wood, Esq Ex Officio Members The Hon. William A. Hazel, Jr., MD , Secretary of Health and Human Resources Leigh Wade, VAAAA James A. Rothrock, DARS Terry A. Smith, DMAS Tara Ragland, VDSS

19 Virginia Commonwealth University Nonprofit Organization Age in Action U.S. POSTAGE PAID Virginia Center on Aging Permit No. 869 Box 980229 RICHMOND, VIRGINIA Richmond, VA 23298-0229 Return Service Requested

Community Integration for Individuals with Lifelong Disabilities The 14th Annual Conference of the Area Planning and Services Committee for Aging with Lifelong Disabilities (APSC)

June 4, 2018 Doubletree by Hilton, 1021 Koger Center Boulevard, Richmond 8:15 a.m. – 4:30 p.m.

Keynote Address: Supporting Successful Aging in People with Lifelong Disabilities, by Dr. Elizabeth Perkins, Associate Director of the Florida Center for Inclusive Communities (FCIC), the University of South Florida’s University Center for Excellence in Developmental Disabilities, President-Elect of the American Association on Intellectual and Developmental Disabilities (AAIDD), and highly published author.

Session Topics Include: • Engage me: The how to’s of community integration • Outdoor activities for individuals with lifelong disabilities • Financial exploitation and lifelong disabilities • A speech therapist’s guide to physiological changes with aging, and issues with swallowing, choking, and special diets • Outreach to special populations through Live Well Virginia! workshops • The arts as tools for caregivers • Social Security benefits for individuals with lifelong disabilities

Registration fee of $40 includes materials, lunch, and breaks. For information and registration, please go to www.apsc2018.eventbrite.com or contact [email protected].

Virginia Commonwealth University is an equal opportunity/affirmative action institution and does not discriminate on the basis of race, gender, age, religion, ethnic origin, or disability. If special accommodations are needed, please contact Dr. Edward F. Ansello, VCoA, at (804) 828-1525.