1 00:00:07,200 --> 00:00:09,680 WELCOME TO DAY THREE OF THE 2023 2 00:00:09,680 --> 00:00:10,960 NATIONAL RESEARCH SUMMIT ON 3 00:00:10,960 --> 00:00:13,240 CARE, SERVICES AND SUPPORTS FOR 4 00:00:13,240 --> 00:00:16,840 PERSONS LIVING WITH DEMENTIA AND 5 00:00:16,840 --> 00:00:18,200 THEIR CARE PARTNERS AND 6 00:00:18,200 --> 00:00:18,480 CAREGIVERS. 7 00:00:18,480 --> 00:00:20,720 WE'LL BEGIN OUR DAY BY HEARING 8 00:00:20,720 --> 00:00:23,880 REMARKS OF MEMBERS OF THE LIVED 9 00:00:23,880 --> 00:00:25,720 EXPERIENCE AND STAKEHOLDER 10 00:00:25,720 --> 00:00:27,840 ENGAGEMENT PANELS AND THEN HEAR 11 00:00:27,840 --> 00:00:29,000 FROM THREE DIFFERENT SCIENTIFIC 12 00:00:29,000 --> 00:00:30,360 SESSIONS YOU SEE LISTED HERE. 13 00:00:30,360 --> 00:00:33,200 THE FIRST SESSION FOCUSSED ON 14 00:00:33,200 --> 00:00:34,520 THE DEMENTIA CARE WORKFORCE. 15 00:00:34,520 --> 00:00:36,840 NEXT A SESSION FOCUSSED ON 16 00:00:36,840 --> 00:00:39,400 ECONOMIC IMPACTS, IMPLICATIONS 17 00:00:39,400 --> 00:00:41,600 AND APPROACHES AND THEN WE'LL 18 00:00:41,600 --> 00:00:43,840 CLOSE WITH OUR SESSION FOCUSSED 19 00:00:43,840 --> 00:00:46,080 ON APPROACHES TO PARTICIPATORY 20 00:00:46,080 --> 00:00:49,680 RESEARCH AND DIVERSE RECRUITMENT 21 00:00:49,680 --> 00:00:50,400 AND RETENTION IN DEMENTIA CARE 22 00:00:50,400 --> 00:00:54,840 RESEARCH. 23 00:00:54,840 --> 00:00:57,160 A BRIEF REMINDER ABOUT WAYS TO 24 00:00:57,160 --> 00:00:58,880 PARTICIPATE IN THE SUMMIT IN 25 00:00:58,880 --> 00:00:59,560 PARTICULAR DURING THE QUESTION 26 00:00:59,560 --> 00:01:01,520 AND ANSWER PORTIONS OF THE 27 00:01:01,520 --> 00:01:01,840 SESSIONS. 28 00:01:01,840 --> 00:01:04,520 IF YOU HAVE JOINED THE SUMMIT BY 29 00:01:04,520 --> 00:01:07,080 THE ZOOM WEBINAR, PLEASE ENTER 30 00:01:07,080 --> 00:01:08,560 YOUR QUESTIONS DIRECTLY INTO THE 31 00:01:08,560 --> 00:01:09,160 Q&A BOX. 32 00:01:09,160 --> 00:01:11,680 IF YOU HAVE JOINED US FROM THE 33 00:01:11,680 --> 00:01:15,200 NIH VIDEOCAST, PLEASE CLICK ON 34 00:01:15,200 --> 00:01:19,040 SEND LIVE FEEDBACK, ENTER YOUR 35 00:01:19,040 --> 00:01:20,920 NAME AND E-MAIL ADDRESS AND TYPE 36 00:01:20,920 --> 00:01:23,640 YOUR QUESTION TO BE ADDED TO THE 37 00:01:23,640 --> 00:01:24,080 ZOOM. 38 00:01:24,080 --> 00:01:25,840 THERE MAY BE A SLIGHT DELAY. 39 00:01:25,840 --> 00:01:29,600 WE'LL DO OUR BEST TO GET TO ALL 40 00:01:29,600 --> 00:01:31,520 QUESTIONS SUBMITTED LIVE DURING 41 00:01:31,520 --> 00:01:33,880 THE Q&A DISCUSSION BUT DUE TO 42 00:01:33,880 --> 00:01:36,280 TIME CONSTRICTION WE MAY NOT BE 43 00:01:36,280 --> 00:01:37,560 ABLE TO ANSWER ALL QUESTIONS 44 00:01:37,560 --> 00:01:39,080 DURING THE PROCESS AND 45 00:01:39,080 --> 00:01:39,880 INDIVIDUALS PRESENTING IN THE 46 00:01:39,880 --> 00:01:41,640 SESSION WILL DO THEIR BEST TO 47 00:01:41,640 --> 00:01:43,120 ANSWER YOUR QUESTIONS IN THE Q&A 48 00:01:43,120 --> 00:01:45,200 BUT REGARDLESS ALL QUESTIONS 49 00:01:45,200 --> 00:01:47,280 THAT ARE SUBMITTED OVER THE 50 00:01:47,280 --> 00:01:49,240 COURSE OF THE SUMMIT WILL BE 51 00:01:49,240 --> 00:01:49,800 REVIEWED BY THE SCIENTIFIC 52 00:01:49,800 --> 00:01:55,840 STEERING COMMITTEE. 53 00:01:55,840 --> 00:01:57,800 WITHOUT FURTHER ADO I'M PLEASED 54 00:01:57,800 --> 00:02:00,640 TO INTRODUCE OUR SPEAKERS FROM 55 00:02:00,640 --> 00:02:01,680 THE LIVED EXPERIENCE PANEL IN 56 00:02:01,680 --> 00:02:04,320 THE STAKEHOLDER ENGAGEMENT PANEL 57 00:02:04,320 --> 00:02:06,720 WHO ARE GOING TO BE SHARING SOME 58 00:02:06,720 --> 00:02:09,400 REMARKS TODAY. 59 00:02:09,400 --> 00:02:13,720 I'LL FIRST HAND IT TO WILLETHA 60 00:02:13,720 --> 00:02:17,560 BARNETTE. 61 00:02:17,560 --> 00:02:19,840 IF YOU COULD PLEASE TAKE THE 62 00:02:19,840 --> 00:02:20,360 SLIDES DOWN. 63 00:02:20,360 --> 00:02:20,600 THANK YOU. 64 00:02:20,600 --> 00:02:25,280 TAKE IT AWAY. 65 00:02:25,280 --> 00:02:26,800 >>GOOD MORNING. 66 00:02:26,800 --> 00:02:29,080 ONLY IN RETROSPECT DID I REALIZE 67 00:02:29,080 --> 00:02:34,200 HOW UNPREPARED I WAS FOR THE 68 00:02:34,200 --> 00:02:38,000 FINANCIAL CHALLENGES OF 69 00:02:38,000 --> 00:02:38,760 CAREGIVER AND THE DEMENTIA 70 00:02:38,760 --> 00:02:42,200 DIAGNOSIS I HAPPEN TO SEE IN 71 00:02:42,200 --> 00:02:43,960 MOM'S ELECTRONIC MEDICAL RECORD. 72 00:02:43,960 --> 00:02:46,000 WHEN MOM HIT A ROUGH PATCH AND 73 00:02:46,000 --> 00:02:50,720 COULD NOT AFFORD TO LIVE ON HER 74 00:02:50,720 --> 00:02:53,040 OWN SHE MOVED IN WITH ME FROM A 75 00:02:53,040 --> 00:02:54,360 FEW HOURS AWAY FROM WHAT I 76 00:02:54,360 --> 00:02:56,000 THOUGHT WAS A BRIEF PERIOD. 77 00:02:56,000 --> 00:02:57,680 MOM WAS 65. 78 00:02:57,680 --> 00:03:00,280 I WAS 37 RECENTLY SEPARATED AND 79 00:03:00,280 --> 00:03:04,280 MY DAUGHTER WAS 13. 80 00:03:04,280 --> 00:03:06,800 THAT TEMPORARY STAY STRETCHED TO 81 00:03:06,800 --> 00:03:11,440 MORE THAN 20 YEARS AS SHE 82 00:03:11,440 --> 00:03:12,920 EXPERIENCED MEDICAL SETBACKS. 83 00:03:12,920 --> 00:03:14,920 WITHOUT A PLAN FOR DEALING WITH 84 00:03:14,920 --> 00:03:17,640 THIS POSSIBILITY I FOUND MYSELF 85 00:03:17,640 --> 00:03:19,640 CONSTANTLY IN A REACTIVE RATHER 86 00:03:19,640 --> 00:03:22,920 THAN PROACTIVE POSTURE. 87 00:03:22,920 --> 00:03:25,160 JUST THE EXTRAORDINARY COSTS OF 88 00:03:25,160 --> 00:03:27,440 DEALING WITH SPECIAL MEDICAL 89 00:03:27,440 --> 00:03:29,400 SUPPLIES AND DURABLE MEDICAL 90 00:03:29,400 --> 00:03:31,840 EQUIPMENT NEEDED FOR HER 91 00:03:31,840 --> 00:03:36,040 SECURITY AND COMFORT WERE 92 00:03:36,040 --> 00:03:37,000 DAUNTING. 93 00:03:37,000 --> 00:03:39,440 MEDICARE COVERS ONLY 80% OF 94 00:03:39,440 --> 00:03:41,600 MEDICAL EXPENSES AND THE BALANCE 95 00:03:41,600 --> 00:03:44,880 OF 20% COULD BE VERY 96 00:03:44,880 --> 00:03:45,680 UNAFFORDABLE ESPECIALLY IF IT IS 97 00:03:45,680 --> 00:03:49,080 20% OF A LARGE NUMBER. 98 00:03:49,080 --> 00:03:53,080 NOW THOUGH I LOVE MY MOTHER 99 00:03:53,080 --> 00:03:54,640 DEARLY IT WAS ALWAYS SOMETHING 100 00:03:54,640 --> 00:03:58,200 AND THAT SOMETHING ALWAYS HAD A 101 00:03:58,200 --> 00:04:00,240 PRICE SUCH AS HAVING A RAMP 102 00:04:00,240 --> 00:04:04,080 BUILT ON TO MY HOME FOR IMPROVED 103 00:04:04,080 --> 00:04:06,560 HANDICAP ACCESS. 104 00:04:06,560 --> 00:04:09,560 INSTALLING A WALK-IN SHOWER WITH 105 00:04:09,560 --> 00:04:11,800 A SEAT, HIRING HOME HEALTH CARE 106 00:04:11,800 --> 00:04:15,120 WORKERS TO HELP WITH ADLs AND 107 00:04:15,120 --> 00:04:16,280 PURCHASING A NEW VEHICLE TO MAKE 108 00:04:16,280 --> 00:04:18,200 IT EASIER TO TRANSFER HER FROM 109 00:04:18,200 --> 00:04:22,840 WALKER TO CAR SEAT. 110 00:04:22,840 --> 00:04:27,360 BIT BY BIT I CHIPPED AWAY AT MY 111 00:04:27,360 --> 00:04:30,040 RETIREMENT SAVINGS UNTIL THE 112 00:04:30,040 --> 00:04:31,160 BALANCE HOVERED NEAR ZERO. 113 00:04:31,160 --> 00:04:35,200 REPAIRS AND IMPROVEMENTS TO MY 114 00:04:35,200 --> 00:04:37,120 HOME WERE POSTPONED. 115 00:04:37,120 --> 00:04:38,720 SOMETIMES I EVEN PRIORITIZED HER 116 00:04:38,720 --> 00:04:43,160 NEEDS OVER THOSE OF MY OWN 117 00:04:43,160 --> 00:04:46,520 CHRONIC ILLNESS AND A LURING 118 00:04:46,520 --> 00:04:52,120 TRAP I LUCKILY SURVIVED. 119 00:04:52,120 --> 00:04:54,240 WHEN FREQUENT ISSUES COMPOUNDED 120 00:04:54,240 --> 00:04:57,160 THE DEMENTIA DIAGNOSES I 121 00:04:57,160 --> 00:04:58,920 STRUGGLED TO FIND RESOURCES FOR 122 00:04:58,920 --> 00:05:00,120 THE INSTITUTIONAL CARE 123 00:05:00,120 --> 00:05:03,960 RECOMMENDED BY HER MEDICAL 124 00:05:03,960 --> 00:05:05,640 PROVIDERS. 125 00:05:05,640 --> 00:05:10,000 NOT ABLE TO AFFORD A LAWYER I 126 00:05:10,000 --> 00:05:13,960 APPLIED FOR AID AND ATTENDANCE 127 00:05:13,960 --> 00:05:18,400 THROUGH THE VETERAN 128 00:05:18,400 --> 00:05:22,400 ADMINISTRATION'S FATHER'S 129 00:05:22,400 --> 00:05:25,160 WARTIME BENEFITS AND AFTER 130 00:05:25,160 --> 00:05:26,720 BUREAUCRATIC DELAYS AND AFTER 131 00:05:26,720 --> 00:05:28,240 APPROVAL FOR THE SPOUSAL BENEFIT 132 00:05:28,240 --> 00:05:30,720 INITIALLY THAT ALLOWS KNOW FIND 133 00:05:30,720 --> 00:05:35,440 HER RESIDENCY IN A PERSONAL CARE 134 00:05:35,440 --> 00:05:35,800 HOME. 135 00:05:35,800 --> 00:05:37,400 MOM'S FINAL STOP WAS IN A 136 00:05:37,400 --> 00:05:41,000 SKILLED NURSING FACILITY AFTER 137 00:05:41,000 --> 00:05:42,120 BEING HOSPITALIZED FOR THREE 138 00:05:42,120 --> 00:05:50,200 SUCCESSIVE MONTHS. 139 00:05:50,200 --> 00:05:51,160 CAREGIVING DIDN'T END THERE. 140 00:05:51,160 --> 00:05:53,280 THE UNEXPECTED EXPENSES ADDED TO 141 00:05:53,280 --> 00:05:55,680 THOUSANDS OF DOLLARS OVER THE 142 00:05:55,680 --> 00:05:55,880 YEARS. 143 00:05:55,880 --> 00:05:57,120 YES, THERE ARE FINANCIAL 144 00:05:57,120 --> 00:05:58,440 LIABILITIES OF UNPAID FAMILY 145 00:05:58,440 --> 00:06:06,440 CAREGIVING. 146 00:06:06,440 --> 00:06:08,800 THERE WAS SO MUCH TO FIGURE OUT 147 00:06:08,800 --> 00:06:12,640 INCLUDING A FINDING A 148 00:06:12,640 --> 00:06:14,920 GERIATRICIAN TO DESCRIBE 149 00:06:14,920 --> 00:06:16,600 PUZZLING BEHAVIORS EVEN IN THE 150 00:06:16,600 --> 00:06:20,000 INTIMACY OF THE HOME. 151 00:06:20,000 --> 00:06:24,480 MY UNDERSTANDING OF DEMENTIA WAS 152 00:06:24,480 --> 00:06:26,520 OUT OF SYNC WITH THE LIVED 153 00:06:26,520 --> 00:06:28,280 EXPERIENCE AND LIGHT BULB 154 00:06:28,280 --> 00:06:29,760 MOMENTS TOOK TIME AND IT TOOK 155 00:06:29,760 --> 00:06:31,720 TIME TO RECOGNIZE THE SIGNS OF 156 00:06:31,720 --> 00:06:42,000 COGNITIVE DECLINE. 157 00:06:54,240 --> 00:06:57,040 THE ACCUSATORY BEHAVIOR AND 158 00:06:57,040 --> 00:07:00,000 URINARY TRACT INFECTIONS AND 159 00:07:00,000 --> 00:07:00,240 FATIGUE. 160 00:07:00,240 --> 00:07:02,760 THE FINANCIAL CONSEQUENCES OF 161 00:07:02,760 --> 00:07:05,720 BEING UNPREPARED AND YES 162 00:07:05,720 --> 00:07:09,800 UNINFORMED ARE NUMEROUS. 163 00:07:09,800 --> 00:07:14,080 IT SHOULDN'T BE SO HARD. 164 00:07:14,080 --> 00:07:18,600 A UNIFIED VISION FOR PATIENTS, 165 00:07:18,600 --> 00:07:20,720 CAREGIVERS AND PROVIDERS WOULD 166 00:07:20,720 --> 00:07:22,200 CERTAINLY HELP BECAUSE DEMENTIA 167 00:07:22,200 --> 00:07:28,680 IS NO RESPECTER OF AGE, ZIP CODE 168 00:07:28,680 --> 00:07:30,240 OR SOCIO ECONOMIC STATUS. 169 00:07:30,240 --> 00:07:36,320 THANK YOU. 170 00:07:36,320 --> 00:07:38,000 >>THANK YOU, WILLETHA FOR 171 00:07:38,000 --> 00:07:40,640 SHARING YOUR EXPERIENCES AND 172 00:07:40,640 --> 00:07:42,920 THOSE POIGNANT REMARKS. 173 00:07:42,920 --> 00:07:43,640 WE'LL NEXT HEAR FROM DAVE 174 00:07:43,640 --> 00:07:50,560 ARNOLD. 175 00:07:50,560 --> 00:07:51,800 >>GOOD MORNING. 176 00:07:51,800 --> 00:07:54,800 MY NAME IS DAVE ARNOLD AND I WAS 177 00:07:54,800 --> 00:07:55,400 DIAGNOSED WITH ALZHEIMER'S TWO 178 00:07:55,400 --> 00:07:56,440 AND A HALF YEARS AGO. 179 00:07:56,440 --> 00:07:58,760 I WAS FIRST DIAGNOSED WITH MCI 180 00:07:58,760 --> 00:08:01,520 FIVE YEARS AGO. 181 00:08:01,520 --> 00:08:04,480 WHEN I STARTED EXPERIENCING 182 00:08:04,480 --> 00:08:07,080 PROBLEMS WITH MY MEMORY. 183 00:08:07,080 --> 00:08:08,640 MY WIFE NOTICED AT FIRST. 184 00:08:08,640 --> 00:08:11,480 I SEEMED TO LOSE MY NAVIGATIONAL 185 00:08:11,480 --> 00:08:14,360 SKILLS WHICH I USUALLY CAN FIND 186 00:08:14,360 --> 00:08:17,320 MY WAY ANYWHERE I WAS GOING. 187 00:08:17,320 --> 00:08:18,560 I WAS ALWAYS -- I COULDN'T 188 00:08:18,560 --> 00:08:22,400 FIGURE OUT WHERE I WAS GOING AND 189 00:08:22,400 --> 00:08:24,520 HOW I WAS GOING TO GET AROUND. 190 00:08:24,520 --> 00:08:28,120 WHEN I FIRST GOT MY DIAGNOSIS OF 191 00:08:28,120 --> 00:08:30,960 ALZHEIMER'S OF COURSE I WAS VERY 192 00:08:30,960 --> 00:08:31,200 UPSET. 193 00:08:31,200 --> 00:08:34,920 I WAS OBVIOUSLY UPSET AND 194 00:08:34,920 --> 00:08:38,800 DEPRESSED, WORRIED WHETHER I 195 00:08:38,800 --> 00:08:41,560 COULD REMEMBER MY GRANDCHILDREN 196 00:08:41,560 --> 00:08:43,720 AND SEE THEM GRADUATE FROM 197 00:08:43,720 --> 00:08:43,960 SCHOOL. 198 00:08:43,960 --> 00:08:45,640 MY MOTHER HAS ALZHEIMER'S AND 199 00:08:45,640 --> 00:08:47,360 PASSED AT THE AGE OF 73. 200 00:08:47,360 --> 00:08:49,800 I WATCHED HER HEALTH, MEMORY 201 00:08:49,800 --> 00:08:53,760 DECLINE AND A KNEW IT WAS SCARY 202 00:08:53,760 --> 00:08:54,520 FOR HER. 203 00:08:54,520 --> 00:08:57,480 I DON'T WANT TO FORGET WHO MY 204 00:08:57,480 --> 00:08:59,000 FAMILY IS. 205 00:08:59,000 --> 00:09:08,440 I COMPARE IT TO A SONG THAT I 206 00:09:08,440 --> 00:09:11,760 HEARD GLEN CAMPBELL WROTE I'M 207 00:09:11,760 --> 00:09:13,080 NOT GOING TO MISS YOU. 208 00:09:13,080 --> 00:09:14,680 HE SUFFERED FROM ALZHEIMER'S AND 209 00:09:14,680 --> 00:09:16,560 WROTE THE STRONG AND I CAN 210 00:09:16,560 --> 00:09:18,080 IDENTIFY THE LYRICS THAT SAY 211 00:09:18,080 --> 00:09:19,880 YOU'RE NOT THE LAST PERSON I 212 00:09:19,880 --> 00:09:22,760 WILL LOVE, YOU'RE NOT THE LAST 213 00:09:22,760 --> 00:09:24,000 PERSON I WILL RECALL. 214 00:09:24,000 --> 00:09:26,120 I'M NEVER GOING TO KNOW WHAT YOU 215 00:09:26,120 --> 00:09:28,400 GO THROUGH AND ALL THE THINGS 216 00:09:28,400 --> 00:09:30,120 YOU SAY AND DO. 217 00:09:30,120 --> 00:09:33,320 ALL THE HURT AND PAIN AND ALL 218 00:09:33,320 --> 00:09:35,960 THE SELFISHNESS REMAINS, I'M NOT 219 00:09:35,960 --> 00:09:36,960 GOING TO MISS YOU. 220 00:09:36,960 --> 00:09:38,440 AT SOME POINT I WON'T REMEMBER 221 00:09:38,440 --> 00:09:39,000 MY WIFE. 222 00:09:39,000 --> 00:09:41,400 I WON'T REMEMBER MY DAUGHTERS, 223 00:09:41,400 --> 00:09:42,840 MY GRANDCHILDREN BUT WHILE I 224 00:09:42,840 --> 00:09:44,720 CAN, I WANT TO LIVE THE BEST 225 00:09:44,720 --> 00:09:49,080 LIFE I CAN AND I WANT TO REMAIN 226 00:09:49,080 --> 00:09:49,800 POSITIVE AND MAKE A DIFFERENCE 227 00:09:49,800 --> 00:09:53,520 IN THE WORLD. 228 00:09:53,520 --> 00:09:57,600 I AM STILL DRIVING AND HOPE TO 229 00:09:57,600 --> 00:09:58,360 CONTINUE DRIVING AS LONG AS 230 00:09:58,360 --> 00:09:58,600 POSSIBLE. 231 00:09:58,600 --> 00:10:00,800 I'M NOT READY TO GIVE UP MY 232 00:10:00,800 --> 00:10:01,160 INDEPENDENCE. 233 00:10:01,160 --> 00:10:05,600 I WANT TO KEEP MAKING MY DREAMED 234 00:10:05,600 --> 00:10:06,840 COME TRUE AND KEEP CROSSING 235 00:10:06,840 --> 00:10:08,120 THINGS OFF MY BUCKET LIST. 236 00:10:08,120 --> 00:10:11,320 MY WIFE AND I TRAVEL TO HAWAI'I 237 00:10:11,320 --> 00:10:11,960 AND IRELAND IN THE LAST COUPLE 238 00:10:11,960 --> 00:10:15,040 OF YEARS. 239 00:10:15,040 --> 00:10:18,080 THAT'S WHY MY WIFE AND I SHARE 240 00:10:18,080 --> 00:10:21,480 STORIES TO HELP RAISE AWARENESS 241 00:10:21,480 --> 00:10:24,280 IN LIVING WITH ALZHEIMER'S AND 242 00:10:24,280 --> 00:10:24,800 DEMEN 243 00:10:24,800 --> 00:10:25,080 DEMENTIA. 244 00:10:25,080 --> 00:10:28,720 WE ESPECIALLY WANT TO HELP 245 00:10:28,720 --> 00:10:30,080 OTHERS IN OUR SMALL RURAL 246 00:10:30,080 --> 00:10:30,680 COMMUNITY REMAINING IN THEIR 247 00:10:30,680 --> 00:10:34,760 HOLDS. 248 00:10:34,760 --> 00:10:36,640 HOPEFULLY AS LONG AS POSSIBLE. 249 00:10:36,640 --> 00:10:38,560 I WANT TO HELP OTHERS LIVING 250 00:10:38,560 --> 00:10:39,920 WITH THIS HORRIBLE DISEASE. 251 00:10:39,920 --> 00:10:43,640 I KNOW IN THE FUTURE I WILL NEED 252 00:10:43,640 --> 00:10:45,760 ONE-ON-ONE CARE AND SOMEONE TO 253 00:10:45,760 --> 00:10:47,960 HELP ME BATHE, SHAVE AND FEED 254 00:10:47,960 --> 00:10:48,120 ME. 255 00:10:48,120 --> 00:10:52,520 I WILL NEED SOMEONE TO HELP ME 256 00:10:52,520 --> 00:10:55,200 WITH MY MEDICATIONS AND STAY 257 00:10:55,200 --> 00:10:57,680 WITH ME FOR WHEN MY WIFE LEAVES 258 00:10:57,680 --> 00:11:00,920 OUR HOME. 259 00:11:00,920 --> 00:11:04,200 MY WIFE AND I HAVE LOOKED FOR A 260 00:11:04,200 --> 00:11:06,680 RETIREMENT FACILITY NEAR OUR 261 00:11:06,680 --> 00:11:09,160 HOME THAT HAS INDEPENDENT 262 00:11:09,160 --> 00:11:11,400 ASSISTED LIVING, A NURSING HOME 263 00:11:11,400 --> 00:11:13,840 AND I FEEL COMFORTABLE THAT I 264 00:11:13,840 --> 00:11:16,200 HAVE CHOSEN THE PLACE WHERE I 265 00:11:16,200 --> 00:11:19,760 WILL BE ABLE TO BE HAPPY AND 266 00:11:19,760 --> 00:11:20,920 TAKEN CARE OF AS THE DISEASE 267 00:11:20,920 --> 00:11:25,080 PROGRESSES. 268 00:11:25,080 --> 00:11:28,240 I DO HOPE TO REMAIN IN MY HOME 269 00:11:28,240 --> 00:11:29,480 AS LONG AS POSSIBLE AND CONTINUE 270 00:11:29,480 --> 00:11:29,960 MY JOURNEY LIVING WITH 271 00:11:29,960 --> 00:11:31,520 ALZHEIMER'S. 272 00:11:31,520 --> 00:11:32,520 I AM TRYING TO LIVE THE BEST 273 00:11:32,520 --> 00:11:36,840 LIFE POSSIBLE. 274 00:11:36,840 --> 00:11:41,920 THANK YOU. 275 00:11:41,920 --> 00:11:43,480 >>THANK YOU VERY MUCH, DAVE FOR 276 00:11:43,480 --> 00:11:44,280 SHARING YOUR EXPERIENCES AND 277 00:11:44,280 --> 00:11:47,760 INSIGHT WITH US. 278 00:11:47,760 --> 00:11:52,320 NEXT I'M GOING HAND IT OVER TO 279 00:11:52,320 --> 00:11:55,760 PETRA NILES. 280 00:11:55,760 --> 00:11:59,240 >>GREET INGS FROM THE WEST 281 00:11:59,240 --> 00:11:59,960 COAST. 282 00:11:59,960 --> 00:12:00,640 THANK YOU TO THE NATIONAL 283 00:12:00,640 --> 00:12:01,840 INSTITUTE ON AGING ON HOSTING 284 00:12:01,840 --> 00:12:03,920 THE NATIONAL RESEARCH SUMMIT ON 285 00:12:03,920 --> 00:12:04,600 CARE, SERVICES AND SUPPORTS FOR 286 00:12:04,600 --> 00:12:06,800 PERSONS WITH DEMENTIA AND THEIR 287 00:12:06,800 --> 00:12:07,680 CARE PARTNERS. 288 00:12:07,680 --> 00:12:11,640 I APPRECIATE THE HONOR TO HAVE 289 00:12:11,640 --> 00:12:12,960 PARTICIPATED IN THE STAKEHOLDER 290 00:12:12,960 --> 00:12:15,600 ENGAGEMENT PANEL AND TO GIVE 291 00:12:15,600 --> 00:12:16,200 REMARKS TODAY. 292 00:12:16,200 --> 00:12:19,600 AS A GERONTOLOGIST AND SENIOR 293 00:12:19,600 --> 00:12:23,280 MANAGER OF EDUCATION, OUTREACH 294 00:12:23,280 --> 00:12:23,840 FOR THE AFRICAN AMERICAN 295 00:12:23,840 --> 00:12:24,440 COMMUNITY. 296 00:12:24,440 --> 00:12:28,760 THERE IS A QUOTE BY FIRST LADY 297 00:12:28,760 --> 00:12:31,240 ELEANOR ROOSEVELT AND SAYS DAY 298 00:12:31,240 --> 00:12:33,040 IS THE OLDEST YOU'VE EVER BEEN 299 00:12:33,040 --> 00:12:37,120 AND THE YOUNGEST YOU'LL EVER BE 300 00:12:37,120 --> 00:12:39,240 AGAIN. 301 00:12:39,240 --> 00:12:41,880 FROM A GERONTOLOGICAL 302 00:12:41,880 --> 00:12:43,600 PERSPECTIVE ALL OF US HERE TODAY 303 00:12:43,600 --> 00:12:46,000 AND WHO HAVE JOINED DAY ONE AND 304 00:12:46,000 --> 00:12:49,560 DAY TWO HAVE HEARD SOME VERY 305 00:12:49,560 --> 00:12:50,960 IMPORTANT INFORMATION THAT 306 00:12:50,960 --> 00:12:53,560 INDIVIDUALLY WE CAN ALL MAKE 307 00:12:53,560 --> 00:13:01,000 SOME INFORMED DECISIONS NOW. 308 00:13:01,000 --> 00:13:04,440 HOPEFULLY RATHER THAN LATER. 309 00:13:04,440 --> 00:13:06,960 FROM MY PERSPECTIVE CONSIDERING 310 00:13:06,960 --> 00:13:08,920 HAIR, USING A MULTI-DISCIPLINARY 311 00:13:08,920 --> 00:13:10,720 APPROACH IS EXTREMELY BENEFICIAL 312 00:13:10,720 --> 00:13:13,440 NOT ONLY TO THE PERSON WITH THE 313 00:13:13,440 --> 00:13:16,280 DIAGNOSIS OF DEMENTIA BUT THE 314 00:13:16,280 --> 00:13:19,920 FAMILY MEMBERS AND EVEN THE 315 00:13:19,920 --> 00:13:20,680 HEALTH PROFESSIONALS INVOLVED 316 00:13:20,680 --> 00:13:24,520 AND ENGAGED WITH THE CARE. 317 00:13:24,520 --> 00:13:25,800 IT'S ALSO IMPORTANT TO CONSIDER 318 00:13:25,800 --> 00:13:29,000 WHEN YOU ARE THINKING OF A 319 00:13:29,000 --> 00:13:30,400 MULTI-DISCIPLINARY APPROACH, WHO 320 00:13:30,400 --> 00:13:36,480 IS MISSING FROM THE MODEL. 321 00:13:36,480 --> 00:13:38,480 IT'S ALSO IMPORTANT TO CONSIDER 322 00:13:38,480 --> 00:13:41,400 AN INTERORGANIZATIONAL MODEL, A 323 00:13:41,400 --> 00:13:42,520 COLLABORATIVE OR NETWORK WHO 324 00:13:42,520 --> 00:13:44,560 CONSISTS OF THOSE WHO LIVE IN 325 00:13:44,560 --> 00:13:46,720 THE COMMUNITY THAT THEY SERVE. 326 00:13:46,720 --> 00:13:49,960 THEY PROVIDE SERVICES, THEY ARE 327 00:13:49,960 --> 00:13:52,080 AWARE OF THE GAPS, THE BARRIERS 328 00:13:52,080 --> 00:13:53,640 AND CAN ASSIST IN GIVING 329 00:13:53,640 --> 00:13:56,960 FEEDBACK TO RESEARCHERS 330 00:13:56,960 --> 00:13:59,200 REGARDING STRATEGIES THAT CAN 331 00:13:59,200 --> 00:14:04,760 INCREASE CULTURALLY TAILORED 332 00:14:04,760 --> 00:14:08,240 WORK AND THEY'RE ALSO IMPORTANT 333 00:14:08,240 --> 00:14:09,560 IN GIVING FEEDBACK REGARDING 334 00:14:09,560 --> 00:14:12,400 TERMS USED THAT MAY OR MAY NOT 335 00:14:12,400 --> 00:14:18,360 BE BENEFICIAL TO OUR COMMUNITY. 336 00:14:18,360 --> 00:14:21,080 THEY CONSISTENT OF TRUSTED 337 00:14:21,080 --> 00:14:22,120 SOURCES. 338 00:14:22,120 --> 00:14:26,520 ANOTHER QUOTE I'LL READ IS FIRST 339 00:14:26,520 --> 00:14:28,720 LADY CARTER SAID THERE'S FOUR 340 00:14:28,720 --> 00:14:30,360 TYPES OF PEOPLE IN THE WORLD. 341 00:14:30,360 --> 00:14:34,160 THOSE WHO HAVE BEEN A CAREGIVER, 342 00:14:34,160 --> 00:14:36,080 THOSE WHO ARE CURRENTLY 343 00:14:36,080 --> 00:14:40,520 CAREGIVERS AND THOSE WHO WILL BE 344 00:14:40,520 --> 00:14:41,960 A CAREGIVER AND THOSE WHO WILL 345 00:14:41,960 --> 00:14:45,280 NEED A CAREGIVER. 346 00:14:45,280 --> 00:14:47,760 FROM THAT PERSPECTIVE WE SHOULD 347 00:14:47,760 --> 00:14:48,880 CONSIDER THE WORKFORCE. 348 00:14:48,880 --> 00:14:53,520 WHO DO WE HAVE THAT WILL TAKE OF 349 00:14:53,520 --> 00:14:57,880 US, TRAINED, COMPETENT, CARING, 350 00:14:57,880 --> 00:14:59,560 COMPASSIONATE INDIVIDUALS WHO 351 00:14:59,560 --> 00:15:00,720 CAN CENTER THEMSELVES WHILE 352 00:15:00,720 --> 00:15:02,720 THEY'RE CARING FOR OTHERS? 353 00:15:02,720 --> 00:15:04,400 WE MUST CONSIDER GENERATIONS SO 354 00:15:04,400 --> 00:15:07,520 THE GENERATIONS THAT ARE HERE 355 00:15:07,520 --> 00:15:10,720 TODAY CONSIDER THOSE WHO ARE 356 00:15:10,720 --> 00:15:13,280 COMING BEHIND US. 357 00:15:13,280 --> 00:15:16,080 AN ORGANIZATION CALLED THE YOUTH 358 00:15:16,080 --> 00:15:16,840 MOVEMENT AGAINST ALZHEIMER'S I 359 00:15:16,840 --> 00:15:18,240 BELIEVE POSSESSES THE ABILITY TO 360 00:15:18,240 --> 00:15:22,920 INFLUENCE THE WORKFORCE. 361 00:15:22,920 --> 00:15:25,200 THEY CAN BE CONSIDERED ALSO A 362 00:15:25,200 --> 00:15:29,000 PIPELINE TO PROFESSIONALS. 363 00:15:29,000 --> 00:15:32,960 THEY CAN COVER FROM CAREGIVING, 364 00:15:32,960 --> 00:15:35,920 GERIATRICIANS, NEUROOLOGIST, 365 00:15:35,920 --> 00:15:37,800 NEUROPSYCHOLOGISTS RESEARCHERS 366 00:15:37,800 --> 00:15:39,040 AND MANY MORE BUT WE HAVE TO 367 00:15:39,040 --> 00:15:42,200 CONSIDER THEM AND INCLUDE THEM 368 00:15:42,200 --> 00:15:44,000 NOW. 369 00:15:44,000 --> 00:15:47,000 SOME OF THE SUCCESSES FROM 370 00:15:47,000 --> 00:15:49,560 ALZHEIMER'S LOS ANGELES IS THE 371 00:15:49,560 --> 00:15:51,200 DEVELOPMENT OF AN ALL DIRECT 372 00:15:51,200 --> 00:15:51,600 CONNECT. 373 00:15:51,600 --> 00:15:53,680 A TOOL THAT ALLOWS CARE 374 00:15:53,680 --> 00:15:56,280 PROVIDERS TO DIRECTLY LINK 375 00:15:56,280 --> 00:16:01,320 PATIENTS AND FAMILIES TO 376 00:16:01,320 --> 00:16:06,720 ALZHEIMER'S LOS ANGELES. 377 00:16:06,720 --> 00:16:07,840 IMPROVING COORDINATION AND 378 00:16:07,840 --> 00:16:09,760 HEALTH EQUITY. 379 00:16:09,760 --> 00:16:11,360 IT'S IMPORTANT TO CONSIDER 380 00:16:11,360 --> 00:16:13,520 CAREGIVERS AND NOT JUST WOMEN. 381 00:16:13,520 --> 00:16:15,600 MEN ARE CAREGIVERS TOO. 382 00:16:15,600 --> 00:16:20,880 IN DOING SO I CONSIDER AFRICAN 383 00:16:20,880 --> 00:16:24,120 AMERICAN MEN WHOSE JOURNEY HAS 384 00:16:24,120 --> 00:16:28,120 BEEN SO CHALLENGED AND CREATED 385 00:16:28,120 --> 00:16:28,800 AN AFRICAN AMERICAN GROUP CALLED 386 00:16:28,800 --> 00:16:29,800 BROTHER TO BROTHER. 387 00:16:29,800 --> 00:16:33,840 WE ALSO CREATED AN EASY TO READ 388 00:16:33,840 --> 00:16:36,080 CAREGIVER TIP SHEETS IN ENGLISH, 389 00:16:36,080 --> 00:16:37,520 SPANISH AND CHINESE ON COMMON 390 00:16:37,520 --> 00:16:39,960 CONCERNS REGARDING CARE SUCH AS 391 00:16:39,960 --> 00:16:41,960 BATHING, SUNDOWNING, DRIVING AND 392 00:16:41,960 --> 00:16:46,200 MANY MORE TOPICS. 393 00:16:46,200 --> 00:16:49,160 WE ALSO HAVE AVAILABLE MASTER'S 394 00:16:49,160 --> 00:16:50,600 LEVEL CARE CONSULTANTS WHO WILL 395 00:16:50,600 --> 00:16:53,560 SPEAK WITH FAMILIES, HAVE FAMILY 396 00:16:53,560 --> 00:16:54,640 MEETINGS, REGARDING CARE AND 397 00:16:54,640 --> 00:16:54,880 PLANNING. 398 00:16:54,880 --> 00:16:57,200 THE SUMMIT IS A MOVEMENT. 399 00:16:57,200 --> 00:16:57,640 THE WORK CONTINUES. 400 00:16:57,640 --> 00:17:04,080 THANK YOU. 401 00:17:04,080 --> 00:17:08,040 >>THANK YOU, PETRA. 402 00:17:08,040 --> 00:17:11,320 THANK YOU SO MUCH, WILLETHA, 403 00:17:11,320 --> 00:17:13,840 DAVE AND PETRA FOR SHARING THE 404 00:17:13,840 --> 00:17:16,040 PERSONAL AND MOVING REMARKS. 405 00:17:16,040 --> 00:17:17,240 FOR YOUR SIGNIFICANT 406 00:17:17,240 --> 00:17:18,720 CONTRIBUTIONS TO THE SUMMIT. 407 00:17:18,720 --> 00:17:20,200 HEARING FROM AND LEARNING FROM 408 00:17:20,200 --> 00:17:22,880 THE LIVED EXPERIENCES YOU HAVE 409 00:17:22,880 --> 00:17:25,800 SO GENEROUSLY SHARED IS 410 00:17:25,800 --> 00:17:29,080 ESSENTIAL TO THE EFFORTS WE'RE 411 00:17:29,080 --> 00:17:30,160 DISCUSSING TO ADVANCE DEMENTIA 412 00:17:30,160 --> 00:17:31,560 CARE AND CAREGIVING SCIENCE AND 413 00:17:31,560 --> 00:17:33,320 WANT TO THANK EVERYONE WHO 414 00:17:33,320 --> 00:17:34,680 CONTRIBUTED IN THIS WAY AND TO 415 00:17:34,680 --> 00:17:36,760 THE MANY PARTICIPANTS AT THE 416 00:17:36,760 --> 00:17:37,960 SUMMIT AS WELL GENEROUSLY 417 00:17:37,960 --> 00:17:40,360 SHARING THEIR LIVED EXPERIENCE 418 00:17:40,360 --> 00:17:41,600 TO HELP GUIDE THESE EFFORTS. 419 00:17:41,600 --> 00:17:43,720 I ADDITIONALLY WANT TO REMIND 420 00:17:43,720 --> 00:17:45,640 EVERYONE THERE ARE SUMMARIES 421 00:17:45,640 --> 00:17:47,720 AVAILABLE ONLINE THAT DETAIL THE 422 00:17:47,720 --> 00:17:51,360 OUTCOMES OF BOTH THE LIVED 423 00:17:51,360 --> 00:17:52,040 EXPERIENCE PANEL AND THE 424 00:17:52,040 --> 00:17:53,440 STAKEHOLDER ENGAGEMENT PANEL AND 425 00:17:53,440 --> 00:17:58,600 WE ENCOURAGE YOU DO ACCESS AND 426 00:17:58,600 --> 00:18:03,800 REVIEW THE SUMMARIES IN GREATER 427 00:18:03,800 --> 00:18:05,120 DETAIL. 428 00:18:05,120 --> 00:18:13,360 AND WE'LL TRANSITION TO THE 429 00:18:13,360 --> 00:18:16,920 DEMENTIA CARE WORKFORCE 430 00:18:16,920 --> 00:18:21,320 CO-CHAIRED BY JOANNE SPETZ AND 431 00:18:21,320 --> 00:18:24,000 ELENA FAZIO. 432 00:18:24,000 --> 00:18:25,200 >>SO THANK YOU VERY MUCH FOR 433 00:18:25,200 --> 00:18:29,280 OUR ENGAGEMENT IN THIS AND I 434 00:18:29,280 --> 00:18:31,200 WILL GET US GOING RIGHT AWAY TO 435 00:18:31,200 --> 00:18:34,440 TALK ABOUT THE WORKFORCE. 436 00:18:34,440 --> 00:18:36,440 THE DEMENTIA CARE WORKFORCE 437 00:18:36,440 --> 00:18:37,440 PROVIDES CARE FOR PEOPLE LIVING 438 00:18:37,440 --> 00:18:38,520 WITH DEMENTIA AND IT'S PROVIDED 439 00:18:38,520 --> 00:18:40,160 IN MANY SETTINGS. 440 00:18:40,160 --> 00:18:41,000 OUR PRESENTATIONS WILL TOUCH ON 441 00:18:41,000 --> 00:18:43,120 THIS. 442 00:18:43,120 --> 00:18:45,840 WE FIND THE WORKFORCE IN NURSING 443 00:18:45,840 --> 00:18:47,920 HOMES AND ASSISTED LIVING 444 00:18:47,920 --> 00:18:48,680 FACILITIES AS WELL AS HOME 445 00:18:48,680 --> 00:18:51,720 HEALTH AND HOME CARE AGENCIES 446 00:18:51,720 --> 00:18:52,720 AND PRIVATELY HIRED INDIVIDUALS 447 00:18:52,720 --> 00:18:54,560 WORKING IN THE HOME. 448 00:18:54,560 --> 00:18:55,800 WE ALSO FIND THE WORKFORCE 449 00:18:55,800 --> 00:18:59,880 SERVING IN PRIMARY CARE AND 450 00:18:59,880 --> 00:19:02,000 SPECIALTY PRACTICES INCLUDING 451 00:19:02,000 --> 00:19:04,600 PSYCHIATRY, GERO PSYCHIATRY AND 452 00:19:04,600 --> 00:19:05,560 ONCOLOGY AND OTHER FIELD AND 453 00:19:05,560 --> 00:19:07,840 FIND THEM IN HOSPITALS, 454 00:19:07,840 --> 00:19:09,480 EMERGENCY DEPARTMENTS AND URGENT 455 00:19:09,480 --> 00:19:09,680 CARE. 456 00:19:09,680 --> 00:19:10,920 SOME PANELS YESTERDAY AND THE 457 00:19:10,920 --> 00:19:12,120 DAY BEFORE TOUCHED ON THE 458 00:19:12,120 --> 00:19:14,880 DIFFERENT CARE SETTINGS AND THE 459 00:19:14,880 --> 00:19:15,960 IMPORTANCE OF THESE DIFFERENT 460 00:19:15,960 --> 00:19:18,680 CARE SETTINGS ACROSS THE 461 00:19:18,680 --> 00:19:20,120 CONTINUUM OF SUPPORT. 462 00:19:20,120 --> 00:19:21,840 THERE ARE ALSO MULTIPLE HEALTH 463 00:19:21,840 --> 00:19:22,840 PROFESSIONALS IMPORTANT FOR CARE 464 00:19:22,840 --> 00:19:25,720 FOR PEOPLE LIVING WITH DEMENTIA. 465 00:19:25,720 --> 00:19:27,560 RANGING FROM LICENSED 466 00:19:27,560 --> 00:19:28,760 PROFESSIONS SUCH AS REGISTERED 467 00:19:28,760 --> 00:19:30,240 NURSES AND PHYSICIANS THROUGH 468 00:19:30,240 --> 00:19:31,960 THE UNLICENSED PHYSICIANS SUCH 469 00:19:31,960 --> 00:19:35,160 AS HOME CARE AIDS AND NURSING 470 00:19:35,160 --> 00:19:40,080 HOME ASSISTANTS NOT LICENSED BUT 471 00:19:40,080 --> 00:19:40,680 CERTIF 472 00:19:40,680 --> 00:19:40,960 CERTIFIED. 473 00:19:40,960 --> 00:19:43,080 THE PRESENTATIONS TODAY FOCUS ON 474 00:19:43,080 --> 00:19:45,720 DIRECT CARE WORKERS ACROSS THESE 475 00:19:45,720 --> 00:19:47,280 DIFFERENT SETTINGS. 476 00:19:47,280 --> 00:19:48,920 CERTIFIED NURSING ASSIST AND 477 00:19:48,920 --> 00:19:51,280 THES, HOME HEALTH ASSISTS, 478 00:19:51,280 --> 00:19:52,960 PERSONAL CARE ASSISTANTS AND 479 00:19:52,960 --> 00:19:54,440 MEDICATION AIDS. 480 00:19:54,440 --> 00:19:57,000 THESE WORKERS ARE GENERALLY 481 00:19:57,000 --> 00:19:58,200 UNLICENSED PROFESSIONS. 482 00:19:58,200 --> 00:20:01,280 THEY MAY BE CERTIFIED AND THE 483 00:20:01,280 --> 00:20:03,000 MOST NUMEROUS OF THE OCCUPATIONS 484 00:20:03,000 --> 00:20:04,200 AS WE'LL LEARN IN THE 485 00:20:04,200 --> 00:20:05,600 PRESENTATION IN A FEW MINUTES. 486 00:20:05,600 --> 00:20:10,200 AS I GROUP WE CALL THESE DIRECT 487 00:20:10,200 --> 00:20:13,280 CARE WORKERS AND THESE 488 00:20:13,280 --> 00:20:14,200 PROFESSIONALS INTERSECT WITH 489 00:20:14,200 --> 00:20:17,400 OTHER LICENSED AND UNLICENSED 490 00:20:17,400 --> 00:20:19,000 AND FOUND IN THE HEALTH CARE 491 00:20:19,000 --> 00:20:19,840 SETTINGS OF PEOPLE LIVING WITH 492 00:20:19,840 --> 00:20:29,600 DEMENTIA. 493 00:20:29,600 --> 00:20:30,800 THERE'S RESOURCES I'LL POINT YOU 494 00:20:30,800 --> 00:20:31,000 TO. 495 00:20:31,000 --> 00:20:35,760 THE FIRST IS A NOTICE OF SPECIAL 496 00:20:35,760 --> 00:20:38,680 INTEREST BY NIA ON THE DEMENTIA 497 00:20:38,680 --> 00:20:40,240 WORKFORCE FOR THOSE LIVING WITH 498 00:20:40,240 --> 00:20:43,200 ALZHEIMER'S DISEASE AND RELATED 499 00:20:43,200 --> 00:20:44,040 DEMENTIAS. 500 00:20:44,040 --> 00:20:46,080 WE HAVE ESTABLISHED THE 501 00:20:46,080 --> 00:20:51,440 WORKFORCE ANALYSIS AND AWARD 502 00:20:51,440 --> 00:20:57,720 NETWORK THAT WAS AND SEVERAL 503 00:20:57,720 --> 00:21:08,280 PEOPLE INVOLVED INCLUDING ME AND 504 00:21:13,400 --> 00:21:14,400 SURVEYS THAT WOULD EXPAND ON THE 505 00:21:14,400 --> 00:21:17,480 WORKFORCE AND ENABLE THE DATA TO 506 00:21:17,480 --> 00:21:18,640 BE LINKED WITH INFORMATION ABOUT 507 00:21:18,640 --> 00:21:19,800 THE OUTCOMES OF PEOPLE LIVING 508 00:21:19,800 --> 00:21:21,640 WITH DEMENTIA. 509 00:21:21,640 --> 00:21:23,200 AND YOU CAN FIND MORE 510 00:21:23,200 --> 00:21:29,360 INFORMATION AT THE ADRD RESEARCH 511 00:21:29,360 --> 00:21:30,880 IMPLEMENTATION MILESTONE 13.J 512 00:21:30,880 --> 00:21:33,440 WEB PAGE AND OTHER WE HAVE PAGES 513 00:21:33,440 --> 00:21:34,720 THAT HAVE INFORMATION ABOUT NIA 514 00:21:34,720 --> 00:21:36,440 PRIORITIES. 515 00:21:36,440 --> 00:21:40,880 OUR SPEAKERS ARE BIANCA FROGNER, 516 00:21:40,880 --> 00:21:43,880 JASMINE TRAVERS AND JENNIFER 517 00:21:43,880 --> 00:21:44,120 RECKREY. 518 00:21:44,120 --> 00:21:47,920 THESE SPEAKERS ARE GOING TO 519 00:21:47,920 --> 00:21:50,920 TOUCH ON DIFFERENT ASPECTS AND 520 00:21:50,920 --> 00:21:51,960 SETTINGS FOCUSSING ON DIRECT 521 00:21:51,960 --> 00:21:53,640 CARE WORKERS. 522 00:21:53,640 --> 00:21:55,800 FIRST DR. FROGNER WILL PROVIDE A 523 00:21:55,800 --> 00:21:56,960 GENERAL OVERVIEW OF THE 524 00:21:56,960 --> 00:21:58,200 WORKFORCE ACROSS ALL THE 525 00:21:58,200 --> 00:21:59,160 PROFESSIONS AND SETTINGS. 526 00:21:59,160 --> 00:22:01,240 THEN DR. TRAVERS WILL TALK ABOUT 527 00:22:01,240 --> 00:22:03,840 DIRECT CARE WORKERS IN NURSING 528 00:22:03,840 --> 00:22:05,840 HOMES AND DR. RECKREY WILL SPEAK 529 00:22:05,840 --> 00:22:08,080 ABOUT HOME-BASED DEMENTIA CARE. 530 00:22:08,080 --> 00:22:13,800 WE HAVE TWO PANELISTS, MELISSA 531 00:22:13,800 --> 00:22:15,680 MYERS-BRISTOL WITH THE CLAYTON 532 00:22:15,680 --> 00:22:18,160 COUNTY SERVICES DEPARTMENT AND 533 00:22:18,160 --> 00:22:21,920 DAVID GRABOWSKI AT HARVARD 534 00:22:21,920 --> 00:22:22,200 UNIVERSITY. 535 00:22:22,200 --> 00:22:23,400 I'LL HAND IT OVER TO DR. FROGNER 536 00:22:23,400 --> 00:22:33,520 THEN. 537 00:22:35,160 --> 00:22:35,760 >>THANK YOU. 538 00:22:35,760 --> 00:22:39,000 I'M A DIRECTOR AT THE CENTER FOR 539 00:22:39,000 --> 00:22:40,120 WORKFORCE STUDIES AND PROFESSOR 540 00:22:40,120 --> 00:22:42,720 OF DEPARTMENT OF FAMILY MEDICINE 541 00:22:42,720 --> 00:22:43,680 AT UNIVERSITY OF WASHINGTON AND 542 00:22:43,680 --> 00:22:45,360 I'LL START BY TALKING ABOUT WHAT 543 00:22:45,360 --> 00:22:47,200 WE KNOW AND DON'T KNOW ABOUT THE 544 00:22:47,200 --> 00:22:48,880 DEMENTIA CARE WORKFORCE. 545 00:22:48,880 --> 00:22:52,480 AT A HIGH LEVEL THERE ARE ABOUT 546 00:22:52,480 --> 00:22:53,400 17 MILLION WHO WORK IN HEALTH 547 00:22:53,400 --> 00:22:53,720 CARE. 548 00:22:53,720 --> 00:22:55,800 THIS IS BASED ON DATA THE BUREAU 549 00:22:55,800 --> 00:22:57,600 OF LABOR STATISTICS OF THE 550 00:22:57,600 --> 00:23:01,280 DEPARTMENT OF LABOR ONE OF THE 551 00:23:01,280 --> 00:23:01,840 BIGGEST GROUPS THAT TRACKS 552 00:23:01,840 --> 00:23:03,840 EMPLOYMENT ACROSS THE ECONOMY. 553 00:23:03,840 --> 00:23:06,800 NOW, ACCORDING TO THE WAY WE 554 00:23:06,800 --> 00:23:08,600 CODE INDUSTRIES AND TRACK 555 00:23:08,600 --> 00:23:11,520 EMPLOYMENT, THERE REALLY ISN'T 556 00:23:11,520 --> 00:23:13,120 AN INDUSTRY CALLED THE DEMENTIA 557 00:23:13,120 --> 00:23:13,880 CARE INDUSTRY. 558 00:23:13,880 --> 00:23:19,560 INSTEAD WE HAVE TO RELY ON CODES 559 00:23:19,560 --> 00:23:22,680 MORE FOCUSSED ON WHERE HEALTH 560 00:23:22,680 --> 00:23:23,880 CARE IS BEING DELIVERED AND ONE 561 00:23:23,880 --> 00:23:26,080 WAY TO BREAK DOWN WHO WORKS IN 562 00:23:26,080 --> 00:23:26,400 HEALTH CARE. 563 00:23:26,400 --> 00:23:28,440 OUT OF THE 17 MILLION WE'RE ABLE 564 00:23:28,440 --> 00:23:30,520 TO TRACK IN HEALTH CARE A THIRD 565 00:23:30,520 --> 00:23:32,520 WORK IN HOSPITALS. 566 00:23:32,520 --> 00:23:34,600 ANOTHER THIRD WORK IN AMBULATORY 567 00:23:34,600 --> 00:23:37,640 CARE SETTINGS INDICATED BY THE 568 00:23:37,640 --> 00:23:39,240 GREN BOX ON YOUR SCREEN. 569 00:23:39,240 --> 00:23:41,640 -- GREEN BOX AND ANOTHER THIRD 570 00:23:41,640 --> 00:23:45,240 WORK IN A LONG-TERM CARE SETTING 571 00:23:45,240 --> 00:23:47,120 WHICH MAY INCLUDE NURSING CARE 572 00:23:47,120 --> 00:23:49,080 FACILITIES, SKILLED NURSING AND 573 00:23:49,080 --> 00:23:50,320 RESIDENTIAL AND CONTINUING CARE 574 00:23:50,320 --> 00:23:52,880 WHERE YOU TEND TO FIND PLACES 575 00:23:52,880 --> 00:23:56,600 LIKE ASSISTS LIVING LOCATED IN 576 00:23:56,600 --> 00:23:58,160 THE BUCKET THEN YOUR HOME HEALTH 577 00:23:58,160 --> 00:23:59,280 CARE SERVICES. 578 00:23:59,280 --> 00:24:01,240 IT DOES NOT INCLUDE PEOPLE 579 00:24:01,240 --> 00:24:03,040 WORKING IN PRIVATE HOUSEHOLDS 580 00:24:03,040 --> 00:24:10,800 MANY CAREGIVERS WORK. 581 00:24:10,800 --> 00:24:12,320 ANOTHER WAY TO BREAK IT DOWN IS 582 00:24:12,320 --> 00:24:13,360 IN THEIR OCCUPATION. 583 00:24:13,360 --> 00:24:18,120 I HIGHLIGHTED A FEW KEY 584 00:24:18,120 --> 00:24:20,320 OCCUPATIONS WE TEND TO SEE IN 585 00:24:20,320 --> 00:24:22,120 THE DEMENTIA CARE WORKFORCE. 586 00:24:22,120 --> 00:24:24,120 AMONG THEM ARE R.N.s AND 587 00:24:24,120 --> 00:24:28,080 REGISTERED NURSES AND THAT IS A 588 00:24:28,080 --> 00:24:32,880 SINGLE LARGEST OCCUPATIONAL 589 00:24:32,880 --> 00:24:43,440 GROUP ABOUT 17% OF THE AND THE 590 00:24:44,480 --> 00:24:45,040 LARGEST BUCKET IS OUR HEALTH 591 00:24:45,040 --> 00:24:46,480 CARE SUPPORT WORKERS IN WHICH 592 00:24:46,480 --> 00:24:48,960 YOU'LL FIND MANY DIRECT CARE 593 00:24:48,960 --> 00:24:50,640 WORKERS THAT JOANNE MENTIONED 594 00:24:50,640 --> 00:24:52,160 INCLUDING YOUR NURSING ASSIST 595 00:24:52,160 --> 00:24:58,520 AND THES, HOME HEALTH AIDS AND 596 00:24:58,520 --> 00:24:59,960 HOME/PERSONAL CARE AIDES. 597 00:24:59,960 --> 00:25:01,880 HAVE YOU YOU HAVE YOUR 598 00:25:01,880 --> 00:25:04,600 PHYSICIANS, PHARMACISTS, 599 00:25:04,600 --> 00:25:05,280 OCCUPATIONAL THERAPISTS, 600 00:25:05,280 --> 00:25:10,880 PHYSICAL THERAPISTS AND SOCIAL 601 00:25:10,880 --> 00:25:13,440 WORKERS. 602 00:25:13,440 --> 00:25:16,240 IDENTIFYING WHO PLAYS WHAT ROLE 603 00:25:16,240 --> 00:25:23,680 TO PEOPLE WITH DEMENTIA IS 604 00:25:23,680 --> 00:25:26,360 DIFFICULT AND FAMILY MEMBERS WHO 605 00:25:26,360 --> 00:25:26,920 CARE FOR PEOPLE LIVING WITH 606 00:25:26,920 --> 00:25:30,120 DEMENTIA. 607 00:25:30,120 --> 00:25:32,880 I WANT TO FOCUS ON THE LONG-TERM 608 00:25:32,880 --> 00:25:39,120 CARE SETTINGS IN WHICH WE FIND 609 00:25:39,120 --> 00:25:43,840 PATIENTS LIVING WITH DEMENTIA 610 00:25:43,840 --> 00:25:46,840 WHEN WE LOOK AT THE EDUCATION OF 611 00:25:46,840 --> 00:25:47,840 HEALTH CARE WORKERS IN GENERAL 612 00:25:47,840 --> 00:25:49,840 THEY MAP TO THE REST OF THE 613 00:25:49,840 --> 00:25:50,920 ECONOMY GENERALLY HEALTH CARE 614 00:25:50,920 --> 00:25:53,160 HAS MORE EDUCATED INDIVIDUALS 615 00:25:53,160 --> 00:25:54,880 WORKING IN THIS INDUSTRY IN PART 616 00:25:54,880 --> 00:25:57,200 BECAUSE OUR PHYSICIANS ARE SOME 617 00:25:57,200 --> 00:25:59,480 OF THE MOST HIGHLY EDUCATED 618 00:25:59,480 --> 00:26:00,160 WORKERS IN THE ECONOMY THEREFORE 619 00:26:00,160 --> 00:26:04,600 THEY SKEW THE DISTRIBUTION. 620 00:26:04,600 --> 00:26:06,040 IF YOU LOOK AT THE LONG-TERM 621 00:26:06,040 --> 00:26:07,040 SETTINGS OF NURSING HOME 622 00:26:07,040 --> 00:26:09,960 FACILITIES THIS IS WHERE YOU 623 00:26:09,960 --> 00:26:14,680 FIND THE HIGHEST PERCENTAGE, 80% 624 00:26:14,680 --> 00:26:17,680 OF WORKERS WITH LESS THAN A 625 00:26:17,680 --> 00:26:18,840 BACHELOR'S DEGREE OF EDUCATION. 626 00:26:18,840 --> 00:26:21,480 THE SAME GROUP OF PEOPLE, 627 00:26:21,480 --> 00:26:22,640 ESPECIALLY A DIVERSE GROUP. 628 00:26:22,640 --> 00:26:24,080 WE TALK HOW HEALTH CARE IS NOT 629 00:26:24,080 --> 00:26:24,440 VERY DIVERSE. 630 00:26:24,440 --> 00:26:26,760 IF YOU LOOK AT THE TOP TWO 631 00:26:26,760 --> 00:26:28,680 LINES, HEALTH CARE IS VERY 632 00:26:28,680 --> 00:26:29,760 SIMILARLY DISTRIBUTED AS THE 633 00:26:29,760 --> 00:26:32,440 REST OF THE ECONOMY WITH 634 00:26:32,440 --> 00:26:33,560 SLIGHTLY LESS REPRESENTATION OF 635 00:26:33,560 --> 00:26:34,440 HISPANIC HEALTH CARE WORKERS. 636 00:26:34,440 --> 00:26:37,200 HOWEVER, IF YOU LOOK AT THE 637 00:26:37,200 --> 00:26:39,160 LONG-TERM CARE INDUSTRIES AGAIN 638 00:26:39,160 --> 00:26:40,400 WHERE PATIENTS LIVING WITH 639 00:26:40,400 --> 00:26:41,560 DEMENTIA TEND TO BE CARED FOR 640 00:26:41,560 --> 00:26:43,960 MOST WE TEND TO SEE MORE 641 00:26:43,960 --> 00:26:45,760 DIVERSITY THERE WITH HOME HEALTH 642 00:26:45,760 --> 00:26:50,680 HAVING GREATER THAN 50% OF THE 643 00:26:50,680 --> 00:26:52,720 WORKFORCE BEING SOMETHING OTHER 644 00:26:52,720 --> 00:26:54,160 THAN A WHITE RACE THIS IS WHERE 645 00:26:54,160 --> 00:26:56,160 YOU HAVE A HIGHER PERCENTAGE OF 646 00:26:56,160 --> 00:26:57,720 WORKERS WHO MAY BE BLACK OR 647 00:26:57,720 --> 00:26:58,440 HISPANIC OR ANOTHER RACE OR 648 00:26:58,440 --> 00:27:03,320 ETHNICITY. 649 00:27:03,320 --> 00:27:04,920 IN LONG-TERM CARE WE TEND TO 650 00:27:04,920 --> 00:27:06,320 FIND HEALTH CARE WORKERS 651 00:27:06,320 --> 00:27:07,880 STRUGGLING A LOT FINANCIALLY. 652 00:27:07,880 --> 00:27:13,360 THEY TEND TO HAVE QUITE A FEW 653 00:27:13,360 --> 00:27:15,800 SOCIO ECONOMIC RISK FACTORS SUCH 654 00:27:15,800 --> 00:27:17,160 AS EARNING FAIRLY LOW WAGES 655 00:27:17,160 --> 00:27:19,600 WHICH IS SOMETHING YOU'LL HEAR 656 00:27:19,600 --> 00:27:20,600 OFTEN IN THE NEXT COUPLE 657 00:27:20,600 --> 00:27:20,920 PRESENTATIONS. 658 00:27:20,920 --> 00:27:22,560 ONE POINT I WANTED TO BRING UP 659 00:27:22,560 --> 00:27:24,560 IS THE WORKERS THEMSELVES IN 660 00:27:24,560 --> 00:27:30,280 LONG-TERM CARE TEND TO ALSO BE 661 00:27:30,280 --> 00:27:30,560 UNINSURED. 662 00:27:30,560 --> 00:27:34,720 WE HAVE A HIGH RATE OF UNINSURED 663 00:27:34,720 --> 00:27:36,040 A LITTLE BIT HIGHER THAN WE SEE 664 00:27:36,040 --> 00:27:37,480 IN THE ECONOMY IN GENERAL AND 665 00:27:37,480 --> 00:27:41,240 IT'S CONCERNING WHEN WE SEE 666 00:27:41,240 --> 00:27:43,080 FULL-TIME WORKERS THE MOST IN 667 00:27:43,080 --> 00:27:44,520 LONG-TERM CARE WHERE 13% OF THEM 668 00:27:44,520 --> 00:27:48,000 ARE UNINSURED. 669 00:27:48,000 --> 00:27:49,880 SO IN SOME WAYS SOME OF THE 670 00:27:49,880 --> 00:27:50,920 CHALLENGES THAT WE SAW DURING 671 00:27:50,920 --> 00:27:53,480 THE PANDEMIC WAS MAYBE NOT SO 672 00:27:53,480 --> 00:27:54,680 SURPRISING BECAUSE UNFORTUNATELY 673 00:27:54,680 --> 00:27:56,200 MANY HEALTH CARE WORKERS IN THE 674 00:27:56,200 --> 00:27:57,720 LONG-TERM CARE INDUSTRY WERE NOT 675 00:27:57,720 --> 00:28:00,120 ABLE TO STAY HEALTHY AND WELL 676 00:28:00,120 --> 00:28:02,320 AND SAFE IN THEIR JOB. 677 00:28:02,320 --> 00:28:04,080 AND SO AS A RESULT MANY PEOPLE 678 00:28:04,080 --> 00:28:04,840 STEPPED OUT OF THE WORKFORCE 679 00:28:04,840 --> 00:28:06,000 DURING THE PANDEMIC. 680 00:28:06,000 --> 00:28:07,480 WHAT THIS SLIDE IS SHOWING IS 681 00:28:07,480 --> 00:28:11,400 HOW THE EMPLOYMENT LEVEL OF THE 682 00:28:11,400 --> 00:28:12,720 VARIOUS INDUSTRIES IN HEALTH 683 00:28:12,720 --> 00:28:15,920 CARE RELATE TO THE BEGINNING OF 684 00:28:15,920 --> 00:28:17,520 THE PANDEMIC. 685 00:28:17,520 --> 00:28:19,760 THAT FLAT RED LINE INDICATES THE 686 00:28:19,760 --> 00:28:21,000 VARIOUS LEVELS AT THE INDUSTRY 687 00:28:21,000 --> 00:28:22,520 BEFORE THE PANDEMIC STARTED. 688 00:28:22,520 --> 00:28:27,480 AND THE LINE I WANT YOU TO DRAW 689 00:28:27,480 --> 00:28:30,560 YOUR EYES TO IS THE NURSING AND 690 00:28:30,560 --> 00:28:32,200 HOME FACILITIES LINE WHERE WE 691 00:28:32,200 --> 00:28:35,320 SEE SLOW RECOVERY IN THE 692 00:28:35,320 --> 00:28:35,840 EMPLOYMENT LEVELS IN THIS 693 00:28:35,840 --> 00:28:42,120 PARTICULAR SECTOR. 694 00:28:42,120 --> 00:28:44,360 THE RECOVERY IS SEEMINGLY DRIVEN 695 00:28:44,360 --> 00:28:46,120 BY THE ASSISTED LIVING 696 00:28:46,120 --> 00:28:47,880 FACILITIES WHICH HAVE FINALLY 697 00:28:47,880 --> 00:28:48,760 RECOVERED TO EMPLOYMENT LEVELS 698 00:28:48,760 --> 00:28:50,240 SEEN BEFORE THE PANDEMIC 699 00:28:50,240 --> 00:28:51,440 STARTED. 700 00:28:51,440 --> 00:28:52,680 HOWEVER, OUR NURSING CARE 701 00:28:52,680 --> 00:28:55,840 FACILITIES ARE REALLY STILL AT 702 00:28:55,840 --> 00:28:56,880 ABOUT 13% BELOW EMPLOYMENT 703 00:28:56,880 --> 00:29:01,840 LEVELS SINCE THE BEGINNING OF 704 00:29:01,840 --> 00:29:02,200 THE PANDEMIC. 705 00:29:02,200 --> 00:29:05,080 RELATED TO THIS IS WE SEE HIGH 706 00:29:05,080 --> 00:29:07,760 TURNOVER AMONG OUR AIDS AND 707 00:29:07,760 --> 00:29:08,040 ASSISTANTS. 708 00:29:08,040 --> 00:29:09,800 THIS IS NOT BROKEN DOWN BY 709 00:29:09,800 --> 00:29:12,040 LONG-TERM CARE BY LOOKING AT THE 710 00:29:12,040 --> 00:29:13,080 HEALTH CARE INDUSTRY AND THE 711 00:29:13,080 --> 00:29:15,560 LINE I'LL POINT YOU TO IS THE 712 00:29:15,560 --> 00:29:17,880 TOP LINE FOR AIDES AND 713 00:29:17,880 --> 00:29:20,720 ASSISTANTS WE SEE HIGHER LEVELS 714 00:29:20,720 --> 00:29:22,160 OF TURNOVER COMPARED TO ALL 715 00:29:22,160 --> 00:29:23,920 OTHER OCCUPATIONS. 716 00:29:23,920 --> 00:29:29,240 IT'S WORTH KNOWING OUR LVNs AND 717 00:29:29,240 --> 00:29:30,920 RPNs ARE SEEING SLOWER TURNOVER 718 00:29:30,920 --> 00:29:31,800 SINCE THE START OF THE PANDEMIC 719 00:29:31,800 --> 00:29:33,800 AND BEFORE THE PANDEMIC STARTED 720 00:29:33,800 --> 00:29:36,520 OUR AIDES AND ASSISTANTS HAVE 721 00:29:36,520 --> 00:29:37,840 SEEN HIGHER TURNOVER RATES THAN 722 00:29:37,840 --> 00:29:42,760 ANY OTHER OCCUPATION. 723 00:29:42,760 --> 00:29:45,160 THIS IS TAKING TURNOVER BY RURAL 724 00:29:45,160 --> 00:29:47,840 AND URBAN AREAS. 725 00:29:47,840 --> 00:29:50,560 IN URBAN AREAS WE SEE HIGHER 726 00:29:50,560 --> 00:29:51,760 LEVELS OF TURNOVER AMONG HEALTH 727 00:29:51,760 --> 00:29:54,520 CARE WORKERS IN GENERAL IN PART 728 00:29:54,520 --> 00:29:55,280 BECAUSE THERE'S OTHER JOB 729 00:29:55,280 --> 00:29:56,480 OPPORTUNITIES AVAILABLE AND THIS 730 00:29:56,480 --> 00:29:59,280 SHOWS RATES WHERE PEOPLE ARE 731 00:29:59,280 --> 00:30:02,360 LEAVING PLACES OF EMPLOYMENT TO 732 00:30:02,360 --> 00:30:03,400 UNEMPLOYMENT AND OUT OF THE 733 00:30:03,400 --> 00:30:04,800 LABOR FORCE AND NOT SHOWING 734 00:30:04,800 --> 00:30:06,520 PEOPLE TRANSITIONING BETWEEN 735 00:30:06,520 --> 00:30:07,240 EMPLOYERS. 736 00:30:07,240 --> 00:30:10,200 WHAT IS CONCERNING ARE THE TOP 737 00:30:10,200 --> 00:30:10,440 LINES. 738 00:30:10,440 --> 00:30:12,040 THE GRAY LINE YOUR PAYING 739 00:30:12,040 --> 00:30:14,040 ATTENTION TO POINTING OUT 740 00:30:14,040 --> 00:30:18,200 LONG-TERM CARE WE'RE SEEING 741 00:30:18,200 --> 00:30:21,960 HIGHER LEVELS OF TURNOVER AND 742 00:30:21,960 --> 00:30:25,640 YOU SEE THAT IN THE FLATNESS 743 00:30:25,640 --> 00:30:25,840 LINE. 744 00:30:25,840 --> 00:30:26,920 THERE'S RESEARCH GAPS WHEN IT 745 00:30:26,920 --> 00:30:30,240 COMES TO PUBLICLY AVAILABLE 746 00:30:30,240 --> 00:30:30,440 DATA. 747 00:30:30,440 --> 00:30:36,160 WE CANNOT IDENTIFY WORKERS 748 00:30:36,160 --> 00:30:37,400 CARING FOR SPECIFIC KINDS OF 749 00:30:37,400 --> 00:30:37,680 PATIENTS. 750 00:30:37,680 --> 00:30:38,920 WE IDENTIFY THE WORKERS 751 00:30:38,920 --> 00:30:40,600 THEMSELVES AND WHERE WE FIND THE 752 00:30:40,600 --> 00:30:42,800 PATIENTS AND THE CARE SETTINGS 753 00:30:42,800 --> 00:30:44,400 IN WHICH THEY MIGHT BE IN BUT 754 00:30:44,400 --> 00:30:46,640 CONNECTING THE WORKERS TO THEIR 755 00:30:46,640 --> 00:30:47,840 ROLES AND CARING FOR PATIENTS 756 00:30:47,840 --> 00:30:51,000 WITH DEMENTIA IS SPARSE AMONG 757 00:30:51,000 --> 00:30:52,440 PUBLICLY AVAILABLE DATA. 758 00:30:52,440 --> 00:30:56,080 WE HAVE LICENSURE DATA FOR THOSE 759 00:30:56,080 --> 00:30:58,400 LICENSED PROFESSIONALS PROVIDING 760 00:30:58,400 --> 00:30:59,720 MORE DEMOGRAPHIC CHARACTERISTICS 761 00:30:59,720 --> 00:31:00,920 ABOUT OUR HEALTH CARE WORKERS 762 00:31:00,920 --> 00:31:06,160 INCLUDING WHERE THEY MIGHT BE 763 00:31:06,160 --> 00:31:09,600 WORKING AND AGE AND THINGS LIKE 764 00:31:09,600 --> 00:31:12,440 THAT AND WE ARE NOT LICENSED AS 765 00:31:12,440 --> 00:31:14,400 JOANNE MENTIONED EARLIER SO 766 00:31:14,400 --> 00:31:17,400 WHERE WE DON'T HAVE LICENSURE 767 00:31:17,400 --> 00:31:27,880 DATA AVAILABLE WE RELY ON 768 00:31:28,280 --> 00:31:30,520 SURVEYS TO LOOK AT WHO IS CARING 769 00:31:30,520 --> 00:31:31,600 FOR PATIENTS WITH DEMENTIA AND 770 00:31:31,600 --> 00:31:34,040 WE HAVE NO INFORMATION ON THE 771 00:31:34,040 --> 00:31:34,720 WORKFORCE IN THE ASSISTED LIVING 772 00:31:34,720 --> 00:31:44,480 SETTINGS. 773 00:31:44,480 --> 00:31:46,400 WE'VE IDENTIFIED WHO WE MAY BE 774 00:31:46,400 --> 00:31:48,680 LOSING WORKERS TO AND IT'S BEEN 775 00:31:48,680 --> 00:31:50,040 A CHALLENGE IN TERMS OF 776 00:31:50,040 --> 00:31:51,440 MAINTAINING AND RETAINING 777 00:31:51,440 --> 00:31:53,320 WORKERS IN THEIR JOB AND AS 778 00:31:53,320 --> 00:31:54,240 INDICATED EARLY MANY HEALTH CARE 779 00:31:54,240 --> 00:31:55,920 WORKERS WHO ARE WORKING WITH 780 00:31:55,920 --> 00:31:57,040 THIS POPULATION OF PATIENTS 781 00:31:57,040 --> 00:31:59,560 LIVING WITH DEMENTIA MAY BE 782 00:31:59,560 --> 00:32:01,840 STRUGGLING WITH THEIR OWN 783 00:32:01,840 --> 00:32:02,920 FINANCIAL CHALLENGES INCLUDING 784 00:32:02,920 --> 00:32:04,000 NOT HAVING SURANCE. 785 00:32:04,000 --> 00:32:05,560 THEY'RE LOOKING TOWARDS OTHER 786 00:32:05,560 --> 00:32:07,840 INDUSTRIES TO HELP THEM BE MORE 787 00:32:07,840 --> 00:32:18,160 FINANCIALLY SECURE. 788 00:32:21,040 --> 00:32:22,040 AND WE BRING MORE ATTENTION TO 789 00:32:22,040 --> 00:32:24,520 THE DEMENTIA CARE WORKFORCE AND 790 00:32:24,520 --> 00:32:26,880 THIS RAISES OPPORTUNITIES TO 791 00:32:26,880 --> 00:32:28,920 THINK OF BETTER DATA COLLECTION 792 00:32:28,920 --> 00:32:31,600 AND EXPANDING THE SCOPE OF OUR 793 00:32:31,600 --> 00:32:33,680 HEALTH CARE WORKERS WHICH MAY 794 00:32:33,680 --> 00:32:34,800 INCREASE OUR SUPPLY OF HEALTH 795 00:32:34,800 --> 00:32:35,320 CARE WORKERS. 796 00:32:35,320 --> 00:32:36,200 I'LL END THERE. 797 00:32:36,200 --> 00:32:38,160 THANK YOU FOR THE OPPORTUNITY 798 00:32:38,160 --> 00:32:42,160 AND I'LL TURN IT TO THE NEXT 799 00:32:42,160 --> 00:32:48,480 SPEAKER. 800 00:32:48,480 --> 00:32:50,920 >>I'M JASMINE TRAVERS A 801 00:32:50,920 --> 00:32:52,440 RESEARCHER AND ASSISTANT 802 00:32:52,440 --> 00:32:54,720 PROFESSOR AT NYU COLLEGE OF 803 00:32:54,720 --> 00:32:56,440 NURSING AND I'LL PROVIDE MORE 804 00:32:56,440 --> 00:33:01,640 INFORMATION ON THE NURSING CARE 805 00:33:01,640 --> 00:33:02,040 DIRECT WORKFORCE. 806 00:33:02,040 --> 00:33:04,520 NEARLY 600 CERTIFIED NURSING 807 00:33:04,520 --> 00:33:05,360 ASSISTS, DIRECT WORKERS 808 00:33:05,360 --> 00:33:11,160 CONSISTENT MORE THAN 50% OF 809 00:33:11,160 --> 00:33:12,560 WORKFORCE AND PROVIDE THE 810 00:33:12,560 --> 00:33:14,200 MAJORITY OF DIRECT CARE TO 811 00:33:14,200 --> 00:33:17,320 RESIDENTS LIVING WITH DEMENTIA. 812 00:33:17,320 --> 00:33:20,760 SOME OF THE CHALLENGES PLAGUING 813 00:33:20,760 --> 00:33:22,200 THE WORKFORCE IS LOW PAY AND 814 00:33:22,200 --> 00:33:23,960 LIMITED EDUCATION AND TRAINING 815 00:33:23,960 --> 00:33:25,960 AND STAFFING SHORTAGES AND POOR 816 00:33:25,960 --> 00:33:28,000 TREATMENT TOP THE PAY IS 817 00:33:28,000 --> 00:33:28,640 CONSIDERABLY LOW. 818 00:33:28,640 --> 00:33:30,640 THE WORKERS ARE NOT BEING PAID A 819 00:33:30,640 --> 00:33:31,560 LIVING WAGE. 820 00:33:31,560 --> 00:33:33,840 HERE DIRECT CARE WORKERS SUMS IT 821 00:33:33,840 --> 00:33:36,720 UP BEST, YOU CAN'T MAKE $10, $11 822 00:33:36,720 --> 00:33:38,440 OR $12 AN HOUR AND THEN GO HOME 823 00:33:38,440 --> 00:33:40,400 AND PAY FOR A $900 APARTMENT. 824 00:33:40,400 --> 00:33:43,480 IT'S NOT GOING TO WORK. 825 00:33:43,480 --> 00:33:45,560 THE FIGURE ON THE LEFT WE SEE 826 00:33:45,560 --> 00:33:47,040 WHAT STATES PAY THE HIGHEST AND 827 00:33:47,040 --> 00:33:47,280 LOWEST. 828 00:33:47,280 --> 00:33:49,840 THERE'S LIMITED ACCESS TO 829 00:33:49,840 --> 00:33:51,480 EMPLOYEE BENEFITS INCLUDING 830 00:33:51,480 --> 00:33:52,920 HEALTH INSURANCE COVERAGE, SICK 831 00:33:52,920 --> 00:33:56,200 LEAVE AND RETIREMENT BENEFITS. 832 00:33:56,200 --> 00:33:59,280 ALSO PROBLEMATIC IS THE PAY A 833 00:33:59,280 --> 00:34:01,080 DIRECT CARE WORKER RECEIVES 834 00:34:01,080 --> 00:34:02,560 ACROSS SETTINGS AND ACROSS 835 00:34:02,560 --> 00:34:04,560 OCCUPATIONS WITH SIMILAR ENTRY 836 00:34:04,560 --> 00:34:06,200 LEVEL REQUIREMENTS WHICH MAKES 837 00:34:06,200 --> 00:34:07,440 EXTREMELY CHALLENGING THE 838 00:34:07,440 --> 00:34:08,440 LONG-TERM CARE EMPLOYERS TO 839 00:34:08,440 --> 00:34:09,240 RECRUIT AND RETAIN THE ESSENTIAL 840 00:34:09,240 --> 00:34:13,680 WORKERS. 841 00:34:13,680 --> 00:34:16,680 ANOTHER ISSUE IS THE EDUCATION 842 00:34:16,680 --> 00:34:18,160 AND TRAINING THE DIRECT CARE 843 00:34:18,160 --> 00:34:20,480 WORKFORCE RECEIVES. 844 00:34:20,480 --> 00:34:23,840 I HIGHLIGHT THE NEEDS SALIENT 845 00:34:23,840 --> 00:34:25,520 FOR THOSE LIVING WITH DEMENTIA. 846 00:34:25,520 --> 00:34:26,760 YOU SEE THE CURRENT EDUCATION 847 00:34:26,760 --> 00:34:29,560 REQUIREMENTS QUITE LIMITED. 848 00:34:29,560 --> 00:34:32,520 THEY HAVE RECOMMENDATIONS FOR AT 849 00:34:32,520 --> 00:34:34,680 LEAST 120 HOURS OF EDUCATION AND 850 00:34:34,680 --> 00:34:39,640 SEE HIGHER TEST SCORES ON 851 00:34:39,640 --> 00:34:45,680 WRITTEN EXAMS AND IT CAN LEAD TO 852 00:34:45,680 --> 00:34:47,400 NEGLECT AND MALTREATMENT. 853 00:34:47,400 --> 00:34:49,840 NURSING HOMES HAVE EXPERIENCED 854 00:34:49,840 --> 00:34:55,040 THE WORSE JOB LOSS OF ANY 855 00:34:55,040 --> 00:34:55,960 SECTOR. 856 00:34:55,960 --> 00:35:03,960 96% OF NURSING HOMES DESPITE 857 00:35:03,960 --> 00:35:06,800 HIGHER WAGES AND BONUSES AND THE 858 00:35:06,800 --> 00:35:09,000 POOR TREATMENT AND UNDER VALUING 859 00:35:09,000 --> 00:35:10,400 AND DISRESPECT OF WORKERS. 860 00:35:10,400 --> 00:35:12,600 THERE'S POTENTIAL FOR ON THE JOB 861 00:35:12,600 --> 00:35:15,840 INJURY AND PHYSICAL AND 862 00:35:15,840 --> 00:35:17,400 EMOTIONAL STRESS AND LACK OF 863 00:35:17,400 --> 00:35:19,600 RESPECT FROM OTHER HEALTH 864 00:35:19,600 --> 00:35:20,720 PROFESSIONALS AND OPPORTUNITIES 865 00:35:20,720 --> 00:35:22,840 FOR EXPERIENCES FOR DIRECT CARE 866 00:35:22,840 --> 00:35:23,080 WORKERS. 867 00:35:23,080 --> 00:35:25,480 THE FULL INTEGRATION INTO THE 868 00:35:25,480 --> 00:35:27,520 CARE TEAMS IS LIMITED WHERE THEY 869 00:35:27,520 --> 00:35:30,040 ARE NOT ADEQUATELY SOUGHT OUT 870 00:35:30,040 --> 00:35:32,680 FOR THEIR CARE PLANNING 871 00:35:32,680 --> 00:35:34,160 ACTIVITIES DESPITE BEING 872 00:35:34,160 --> 00:35:35,560 RESPONSIBLE FOR THE RESIDENT 873 00:35:35,560 --> 00:35:37,160 CARE HOURS. 874 00:35:37,160 --> 00:35:40,200 THE RECENTLY PUBLIC REPORT ON 875 00:35:40,200 --> 00:35:42,600 HOME CARE QUALITY ADDRESSED 876 00:35:42,600 --> 00:35:43,560 ISSUES I'VE PRESENTED. 877 00:35:43,560 --> 00:35:45,640 THE FIRST OF WHICH IS TO ENSURE 878 00:35:45,640 --> 00:35:50,160 COMPETITIVE WAGES AND BENEFITS. 879 00:35:50,160 --> 00:35:51,240 OPPORTUNITIES INCLUDE LEVERAGING 880 00:35:51,240 --> 00:35:53,280 WAGE PASS THROUGHS AN ADDITIONAL 881 00:35:53,280 --> 00:35:54,680 ALLOCATION OF FUND THROUGH 882 00:35:54,680 --> 00:35:56,440 MEDICAID REIMBURSEMENT FOR THE 883 00:35:56,440 --> 00:35:59,160 PURPOSE OF INCREASING 884 00:35:59,160 --> 00:36:03,360 COMPENSATION AND QUALITY 885 00:36:03,360 --> 00:36:05,760 INCENTIVE PROGRAMS PROVIDED. 886 00:36:05,760 --> 00:36:07,360 APPROPRIATING FUNDS TO STAFFING 887 00:36:07,360 --> 00:36:09,040 WHERE STATES HAVE REQUIRED A 888 00:36:09,040 --> 00:36:10,880 CERTAIN PERCENTAGE OF FUNDS 889 00:36:10,880 --> 00:36:12,040 TOWARDS STAFFING. 890 00:36:12,040 --> 00:36:14,800 LIVING WAGE INDICATOR TAKING 891 00:36:14,800 --> 00:36:16,680 INTO ACCOUNT HOUSING AND 892 00:36:16,680 --> 00:36:18,200 EDUCATION, FOOD. 893 00:36:18,200 --> 00:36:19,160 COMPETITIVE WAGE INDICATORS. 894 00:36:19,160 --> 00:36:22,200 THIS ALLOWS FOR THE RAISING OF 895 00:36:22,200 --> 00:36:25,160 PAY FOR DIRECT WORKERS THAT 896 00:36:25,160 --> 00:36:27,440 SIMILAR ENTRY LEVEL OCCUPATIONS 897 00:36:27,440 --> 00:36:30,080 AND STATE INITIATIVES AROUND 898 00:36:30,080 --> 00:36:34,160 WAGES WE CAN REPLICATE AND SCALE 899 00:36:34,160 --> 00:36:34,320 UP. 900 00:36:34,320 --> 00:36:36,560 SO RAISING THE LIVING WAGE WOULD 901 00:36:36,560 --> 00:36:40,080 GIVE 75% OF DIRECT CARE WORKERS 902 00:36:40,080 --> 00:36:43,600 AN AVERAGE RAISE OF 15.5%. 903 00:36:43,600 --> 00:36:45,800 WITH REGARDS TO A COMPETITIVE 904 00:36:45,800 --> 00:36:47,000 WAGE, HERE WE SEE STARK 905 00:36:47,000 --> 00:36:49,200 DIFFERENCES BETWEEN DIRECT CARE 906 00:36:49,200 --> 00:36:50,640 WORKERS AND OCCUPATIONS WITH 907 00:36:50,640 --> 00:36:52,560 SIMILAR OR LOW ENTRY LEVEL 908 00:36:52,560 --> 00:36:52,880 REQUIREMENTS. 909 00:36:52,880 --> 00:36:54,240 FOR EXAMPLE IN THE STATE OF 910 00:36:54,240 --> 00:36:56,760 ALABAMA, DIRECT CARE WORKERS 911 00:36:56,760 --> 00:36:59,120 MAKE $3.40 LESS THAN THOSE WITH 912 00:36:59,120 --> 00:37:01,840 SIMILAR ENTRY LEVEL 913 00:37:01,840 --> 00:37:03,880 REQUIREMENTS. 914 00:37:03,880 --> 00:37:07,760 THE NASCENT REPORT CALLED FOR 915 00:37:07,760 --> 00:37:10,320 STANDARDS WHERE CMS HAS BEEN 916 00:37:10,320 --> 00:37:12,640 CONDUCTING A STUDY ON STAFFING 917 00:37:12,640 --> 00:37:14,960 REQUIREMENTS AND ALSO IS THE 918 00:37:14,960 --> 00:37:17,000 MINIMUM LEVELS OF EDUCATION 919 00:37:17,000 --> 00:37:19,280 STAFF SHOULD HAVE AND AN 920 00:37:19,280 --> 00:37:20,080 REGISTERED NURSE PRESENT 24 921 00:37:20,080 --> 00:37:21,880 HOURS A DAY OPPOSED TO EIGHT 922 00:37:21,880 --> 00:37:22,640 HOURS A DAY. 923 00:37:22,640 --> 00:37:24,800 NEXT IS THE NEED FOR MORE 924 00:37:24,800 --> 00:37:27,000 EDUCATION. 925 00:37:27,000 --> 00:37:29,880 IT'S NOT JUST A DIDACTIC BUT WE 926 00:37:29,880 --> 00:37:33,600 SEE TESTING IS BETTER ON WRITTEN 927 00:37:33,600 --> 00:37:37,760 EXAMS THAN CLINICAL EXAMS AND 928 00:37:37,760 --> 00:37:41,920 MAKING SURE IT'S BI-DIRECTIONAL 929 00:37:41,920 --> 00:37:42,760 AND EMPHASIZE THE SOFT SKILLS 930 00:37:42,760 --> 00:37:48,760 AND COMPASSION FOR THE 931 00:37:48,760 --> 00:37:49,040 RESIDENTS. 932 00:37:49,040 --> 00:37:51,200 PAID TRAIN AND FACILITATE IN 933 00:37:51,200 --> 00:37:57,200 JOBS AND ADVANCEMENT PATHWAYS. 934 00:37:57,200 --> 00:37:59,080 AND EMPOWERMENT OF DIRECT CARE 935 00:37:59,080 --> 00:38:00,600 WORKERS TO PROVIDER SUPPORT TO 936 00:38:00,600 --> 00:38:03,760 RESIDENTS IN CREATIVE WAYS, 937 00:38:03,760 --> 00:38:05,040 PROTECT RESIDENTS' RIGHTS, BE 938 00:38:05,040 --> 00:38:06,600 INVOLVED IN TEAMS AND DECISION 939 00:38:06,600 --> 00:38:08,240 MAKING AND THE CONSIDERATION OF 940 00:38:08,240 --> 00:38:09,880 CROSS-TRAINING DIRECT CARE 941 00:38:09,880 --> 00:38:13,080 WORKERS IN OTHER POSITIONS AND 942 00:38:13,080 --> 00:38:19,000 PROVIDING BONUSES FOR EXTRA 943 00:38:19,000 --> 00:38:20,720 TRAINING AND THERE'S STATES HAVE 944 00:38:20,720 --> 00:38:23,200 MEMORY CARE SPECIALISTS AND 945 00:38:23,200 --> 00:38:24,680 THESE DIRECT CARE WORKERS 946 00:38:24,680 --> 00:38:30,000 RECEIVE AT LEAST $1.50 MORE PER 947 00:38:30,000 --> 00:38:30,200 HOUR. 948 00:38:30,200 --> 00:38:32,600 AND THESE THAT SCORED HIGH WERE 949 00:38:32,600 --> 00:38:35,960 LIKELY TO HAVE HIGHER CNA 950 00:38:35,960 --> 00:38:36,880 RETENTION THAN STATES THAT 951 00:38:36,880 --> 00:38:38,040 SCORED LOWER. 952 00:38:38,040 --> 00:38:39,480 ADDITIONALLY IMPORTANT FOR 953 00:38:39,480 --> 00:38:42,480 RECRUITMENT AND RESENSE 954 00:38:42,480 --> 00:38:43,080 AEMPHASIZED IN THE REPORT 955 00:38:43,080 --> 00:38:44,680 INCLUDES LONG-TERM INVESTMENTS 956 00:38:44,680 --> 00:38:46,760 IN PROGRAMS THAT WILL ATTRACT 957 00:38:46,760 --> 00:38:47,120 WORKERS. 958 00:38:47,120 --> 00:38:48,200 CHANGING THE ENVIRONMENT AND 959 00:38:48,200 --> 00:38:51,200 CULTURE IN NURSING HOMES, 960 00:38:51,200 --> 00:38:52,960 FOCUSSING ON RESPECT AND 961 00:38:52,960 --> 00:38:54,560 RECOGNITION, PROVIDING ADEQUATE 962 00:38:54,560 --> 00:38:55,960 TRAINING AND SUPPORT WITH CAREER 963 00:38:55,960 --> 00:38:57,160 ADVANCEMENT OPPORTUNITIES. 964 00:38:57,160 --> 00:38:58,960 REFRAMING NURSING HOMEWORK AND 965 00:38:58,960 --> 00:39:01,600 AGING AND REALLY DIGGING INTO 966 00:39:01,600 --> 00:39:03,440 THE RECRUITMENT POOL STARTING 967 00:39:03,440 --> 00:39:05,320 EARLIER THAN LATER SO THINKING 968 00:39:05,320 --> 00:39:06,320 ABOUT STUDENTS THAT MIGHT BE IN 969 00:39:06,320 --> 00:39:08,400 HIGH SCHOOL AS WELL. 970 00:39:08,400 --> 00:39:10,960 HERE IN THE BOX IN THE BOTTOM 971 00:39:10,960 --> 00:39:13,640 RIGHT ARE FINDINGS FROM 972 00:39:13,640 --> 00:39:16,000 INTERVIEWS FROM PROVIDERS ASKING 973 00:39:16,000 --> 00:39:18,000 THEM HOW THEY PROMOTE THE 974 00:39:18,000 --> 00:39:20,880 WORKFORCE AND THEMES THAT 975 00:39:20,880 --> 00:39:22,040 EMERGED WERE HIRING FOR 976 00:39:22,040 --> 00:39:23,640 COMPASSION ENSURING THE 977 00:39:23,640 --> 00:39:25,120 INDIVIDUAL INTERVIEWED IS 978 00:39:25,120 --> 00:39:27,120 PASSIONATE ABOUT THE POSITION. 979 00:39:27,120 --> 00:39:28,400 GOING BEYOND THE STATUS QUO. 980 00:39:28,400 --> 00:39:31,040 NOT JUST A REGULAR INTERVIEW BUT 981 00:39:31,040 --> 00:39:32,760 SEEING HOW THE INDIVIDUAL 982 00:39:32,760 --> 00:39:34,680 INTERACTS WITH RESIDENTS WITH 983 00:39:34,680 --> 00:39:37,840 DEMENTIA AND MAINTAINING 984 00:39:37,840 --> 00:39:38,400 SUFFICIENT AND CONSISTENT 985 00:39:38,400 --> 00:39:41,760 STAFFING. 986 00:39:41,760 --> 00:39:43,160 A FOCUS ON DATA COLLECTION IS 987 00:39:43,160 --> 00:39:44,480 HIGHLIGHTED IN THE REPORT. 988 00:39:44,480 --> 00:39:46,120 WE NEED TO UNDERSTAND THE 989 00:39:46,120 --> 00:39:48,240 SATISFACTION OF STAFF AND 990 00:39:48,240 --> 00:39:49,840 DEMOGRAPHICS TO BETTER LEARN WHO 991 00:39:49,840 --> 00:39:52,280 THE WORKERS ARE AND WHO THEY'RE 992 00:39:52,280 --> 00:39:53,560 EXPERIENCING BASED ON THEIR 993 00:39:53,560 --> 00:39:54,680 CHARACTERISTICS AND WE TALKED 994 00:39:54,680 --> 00:39:55,840 ABOUT THE DATA SOURCES AND 995 00:39:55,840 --> 00:39:59,960 NEEDS. 996 00:39:59,960 --> 00:40:01,640 AND THE REPORT BRINGS UP THE 997 00:40:01,640 --> 00:40:04,160 NEED TO SEE FAMILY CAREGIVERS AS 998 00:40:04,160 --> 00:40:05,240 PART OF THE WORKFORCE AND 999 00:40:05,240 --> 00:40:06,800 ALLOWING THEM TO REMAIN ENGAGED 1000 00:40:06,800 --> 00:40:07,640 WITH THE RESIDENT. 1001 00:40:07,640 --> 00:40:11,200 WE SAW THE CONSEQUENCES OF NOT 1002 00:40:11,200 --> 00:40:15,400 INCLUDING THE FAMILY CAREGIVERS 1003 00:40:15,400 --> 00:40:23,080 AS IMPORTANT CAREERS OF THOSE 1004 00:40:23,080 --> 00:40:24,920 WITH DEMENTIA. 1005 00:40:24,920 --> 00:40:26,960 WHAT ARE THE CONTINUED KNOWLEDGE 1006 00:40:26,960 --> 00:40:27,280 GAPS? 1007 00:40:27,280 --> 00:40:29,360 KNOWING THE STRATEGIES AND 1008 00:40:29,360 --> 00:40:32,720 PROGRAMS OUT THERE THAT CAN BE 1009 00:40:32,720 --> 00:40:33,160 LEVERAGED. 1010 00:40:33,160 --> 00:40:34,080 THERE'S A LOT OF PEOPLE DOING 1011 00:40:34,080 --> 00:40:36,000 GREAT THINGS BUT WE NEED TO KNOW 1012 00:40:36,000 --> 00:40:36,600 ABOUT THEM. 1013 00:40:36,600 --> 00:40:39,600 IN THE SAME VEIN, KNOWING WHAT 1014 00:40:39,600 --> 00:40:41,480 WORKS, MORE RESEARCH IS NEEDED 1015 00:40:41,480 --> 00:40:42,840 IN THE AREA ALONG WITH 1016 00:40:42,840 --> 00:40:43,520 UNDERSTANDING THE ASSOCIATION OF 1017 00:40:43,520 --> 00:40:44,960 TRAINING WITH OUTCOMES OF 1018 00:40:44,960 --> 00:40:47,720 RESIDENTS LIVING WITH DEMENTIA. 1019 00:40:47,720 --> 00:40:50,320 THERE'S ALSO A NEED TO 1020 00:40:50,320 --> 00:40:52,640 UNDERSTAND IN WHICH IMPROVING 1021 00:40:52,640 --> 00:40:54,400 WAGES IMPROVES RECRUITMENT AND 1022 00:40:54,400 --> 00:40:56,720 RETENTION AND NEEDS TO BE A 1023 00:40:56,720 --> 00:40:58,160 CENTRALIZED DATA SOURCE ON THE 1024 00:40:58,160 --> 00:41:00,640 WORKFORCE. 1025 00:41:00,640 --> 00:41:03,120 LOOKING FORWARD SOME OF THE 1026 00:41:03,120 --> 00:41:05,200 OPPORTUNITIES LIE IN MINIMUM 1027 00:41:05,200 --> 00:41:05,920 STAFFING STANDARDS. 1028 00:41:05,920 --> 00:41:09,760 LOTS OF WORK IS BEING DONE IN 1029 00:41:09,760 --> 00:41:11,120 THE AREA. 1030 00:41:11,120 --> 00:41:13,040 OPPORTUNITY FOR BETTER DATA 1031 00:41:13,040 --> 00:41:14,720 COLLECTION, IMPROVING PAY AND 1032 00:41:14,720 --> 00:41:17,160 TRAINING FOR THE DEMENTIA CARE 1033 00:41:17,160 --> 00:41:17,680 WORKFORCE. 1034 00:41:17,680 --> 00:41:19,280 PROVIDING TRAINING AND EDUCATION 1035 00:41:19,280 --> 00:41:21,400 AND CAREER ADVANCEMENT 1036 00:41:21,400 --> 00:41:22,920 OPPORTUNITIES AND MEASURING 1037 00:41:22,920 --> 00:41:23,160 EQUITY. 1038 00:41:23,160 --> 00:41:24,040 WITH THAT THANK YOU AND LOOK 1039 00:41:24,040 --> 00:41:26,280 FORWARD TO THE REMAINING REMARKS 1040 00:41:26,280 --> 00:41:33,360 AND THE Q&A SESSION. 1041 00:41:33,360 --> 00:41:35,120 >>THANK YOU, JASMINE. 1042 00:41:35,120 --> 00:41:36,320 THANK YOU ALL FOR THE 1043 00:41:36,320 --> 00:41:38,120 OPPORTUNITY TO PRESENT ABOUT THE 1044 00:41:38,120 --> 00:41:39,960 DIRECT CARE WORKFORCE IN 1045 00:41:39,960 --> 00:41:40,640 HOME-BASED DEMENTIA CARE. 1046 00:41:40,640 --> 00:41:42,920 OPPORTUNITIES TO IMPROVE CARE. 1047 00:41:42,920 --> 00:41:45,000 MY NAME IS JENNY RECKREY. 1048 00:41:45,000 --> 00:41:47,080 I'M A GERIATRICIAN WORKING IN 1049 00:41:47,080 --> 00:41:48,800 HOME-BASED PRIMARY CARE AND 1050 00:41:48,800 --> 00:41:51,600 RESEARCHER AT THE ICAHN SCHOOL 1051 00:41:51,600 --> 00:41:53,480 OF MEDICINE MOUNT SINAI IN NEW 1052 00:41:53,480 --> 00:41:53,800 YORK. 1053 00:41:53,800 --> 00:41:54,640 I RECEIVED CAREER DEVELOPMENT 1054 00:41:54,640 --> 00:41:58,840 AND PILOT FUND FROM THE NIA. 1055 00:41:58,840 --> 00:42:01,280 MY PRESENTATION IS GOING TO 1056 00:42:01,280 --> 00:42:03,240 FOCUS ON DEMENTIA CARE IN THE 1057 00:42:03,240 --> 00:42:04,240 HOME SETTING. 1058 00:42:04,240 --> 00:42:05,720 THERE'S GROWING INTEREST IN HOME 1059 00:42:05,720 --> 00:42:07,520 BASED CLINICAL AND LONG-TERM 1060 00:42:07,520 --> 00:42:08,520 CARE. 1061 00:42:08,520 --> 00:42:10,280 THIS FIGURE COMES FROM A 2014 1062 00:42:10,280 --> 00:42:12,320 INSTITUTE OF MEDICINE AND 1063 00:42:12,320 --> 00:42:13,320 NATIONAL RESEARCH COUNCIL 1064 00:42:13,320 --> 00:42:16,120 WORKSHOP CALLED THE FUTURE OF 1065 00:42:16,120 --> 00:42:17,720 HOME HEALTH CARE AND HIGHLIGHTS 1066 00:42:17,720 --> 00:42:19,600 THE WIDE RANGE OF SUPPORT THAT 1067 00:42:19,600 --> 00:42:22,320 PEOPLE RECEIVE IN THE HOME 1068 00:42:22,320 --> 00:42:24,440 SETTING WHICH INCLUDES CLINICAL 1069 00:42:24,440 --> 00:42:27,080 CARE, HOME BASED PRIMARY CARE 1070 00:42:27,080 --> 00:42:29,640 AND HOME HOSPICE AND LONG-TERM 1071 00:42:29,640 --> 00:42:30,840 CARE WHICH INCLUDES MEDICAID 1072 00:42:30,840 --> 00:42:32,720 FUNDED HOME AND COMMUNITY-BASED 1073 00:42:32,720 --> 00:42:34,240 SERVICES INCREASINGLY SHIFTING 1074 00:42:34,240 --> 00:42:35,080 FROM THE INSTITUTIONAL SETTING 1075 00:42:35,080 --> 00:42:39,720 TO THE HOME SETTING. 1076 00:42:39,720 --> 00:42:41,000 HOME-BASED MODELS OF CARE AND 1077 00:42:41,000 --> 00:42:42,520 SUPPORT ARE PARTICULARLY 1078 00:42:42,520 --> 00:42:43,880 IMPORTANT FOR PEOPLE WITH 1079 00:42:43,880 --> 00:42:44,920 DEMENTIA BECAUSE MUCH OF THIS 1080 00:42:44,920 --> 00:42:47,400 HOME BASED CARE NOW IS ACTUALLY 1081 00:42:47,400 --> 00:42:48,880 BEING DELIVERED TO PEOPLE WITH 1082 00:42:48,880 --> 00:42:49,280 DEMENTIA. 1083 00:42:49,280 --> 00:42:52,760 AROUND 44% OF OLDER ADULTS WITH 1084 00:42:52,760 --> 00:42:54,000 DEMENTIA LIVING IN THE COMMUNITY 1085 00:42:54,000 --> 00:42:56,400 USE SOME FORM OF HOME BASED 1086 00:42:56,400 --> 00:42:58,280 CLINICAL CARE, SKILLED HOME 1087 00:42:58,280 --> 00:43:00,080 HEALTH AND HOPE BASED MEDICAL 1088 00:43:00,080 --> 00:43:03,040 CARE VERSUS 14% OF OTHERS. 1089 00:43:03,040 --> 00:43:06,920 WHEN THEY RECEIVED HOME BASED 1090 00:43:06,920 --> 00:43:09,360 HEALTH THEY RECEIVE MORE 1091 00:43:09,360 --> 00:43:12,320 INTENSIVE ATTENTION. 1092 00:43:12,320 --> 00:43:13,880 AND ABOUT 64% THOSE PEOPLE HAVE 1093 00:43:13,880 --> 00:43:24,040 DEMENTIA. 1094 00:43:26,440 --> 00:43:28,280 EVIDENCE SUGGESTS THE GROWTH OF 1095 00:43:28,280 --> 00:43:30,320 THE HOME BASED MEDICAL WORKFORCE 1096 00:43:30,320 --> 00:43:34,560 HAS BEEN ONLY MODEST AND THE 1097 00:43:34,560 --> 00:43:36,760 NUMBER OF NURSES REPORTING HOME 1098 00:43:36,760 --> 00:43:38,560 HEALTH AS THEIR PRIMARY PRACTICE 1099 00:43:38,560 --> 00:43:40,080 SETTING HAS DECLINED BETWEEN 1100 00:43:40,080 --> 00:43:45,360 2013 AND 2020. 1101 00:43:45,360 --> 00:43:46,560 FREQUENTLY WHAT IT IS THAT HELPS 1102 00:43:46,560 --> 00:43:49,040 THAT PERSON WITH DEMENTIA LIVING 1103 00:43:49,040 --> 00:43:54,280 AT HOME STAY AT HOME SO THEY CAN 1104 00:43:54,280 --> 00:43:57,120 CONTINUE IS DIRECT CARE. 1105 00:43:57,120 --> 00:43:58,840 EVIDENCE FROM A NATIONAL 1106 00:43:58,840 --> 00:44:00,200 REPRESENTATIVE SAMPLE SUGGESTS 1107 00:44:00,200 --> 00:44:02,400 25%, A QUARTER OF PEOPLE WITH 1108 00:44:02,400 --> 00:44:04,200 DEMENTIA AND LIVING AT HOME OR 1109 00:44:04,200 --> 00:44:05,120 IN THE COMMUNITY RECEIVE PAID 1110 00:44:05,120 --> 00:44:05,680 DIRECT CARE. 1111 00:44:05,680 --> 00:44:08,880 WHEN YOU LOOK AT JUST THE GROUP 1112 00:44:08,880 --> 00:44:11,680 WHO ALSO HAS IMPAIRMENT AND 1113 00:44:11,680 --> 00:44:13,120 ABILITY TO PERFORM FUNCTIONAL 1114 00:44:13,120 --> 00:44:15,040 TASKS IT COMES TO 50%. 1115 00:44:15,040 --> 00:44:16,880 THE GRAPH DEMONSTRATE THE 1116 00:44:16,880 --> 00:44:18,880 MAGNITUDE OF THAT CARE. 1117 00:44:18,880 --> 00:44:21,080 PEOPLE WITH DEMENTIA WHO ALSO 1118 00:44:21,080 --> 00:44:25,880 HAVE FUNCTIONAL IMPAIRMENT WHO 1119 00:44:25,880 --> 00:44:31,160 PAID CARE ON AVERAGE RECEIVE 70 1120 00:44:31,160 --> 00:44:32,800 HOURS OF FAMILY CARE PER WEEK 1121 00:44:32,800 --> 00:44:34,880 AND DESPITE THE HIGH LEVELS OF 1122 00:44:34,880 --> 00:44:36,120 CARE THERE'S LITTLE EXISTING 1123 00:44:36,120 --> 00:44:37,760 RESEARCH ABOUT DIRECT CARE 1124 00:44:37,760 --> 00:44:40,200 WORKFORCE AT HOME IN GENERAL BUT 1125 00:44:40,200 --> 00:44:41,560 FOR PEOPLE WITH DEMENTIA IN 1126 00:44:41,560 --> 00:44:42,560 PARTICULAR AND THAT'S THE REASON 1127 00:44:42,560 --> 00:44:44,720 WHY I WANT TO FOCUS THE REST OF 1128 00:44:44,720 --> 00:44:49,440 MY PRESENTATION ON THE DIRECT 1129 00:44:49,440 --> 00:44:50,280 CARE WORKFORCE FOR PEOPLE LIVING 1130 00:44:50,280 --> 00:44:51,760 WITH DEMENTIA AT HOME. 1131 00:44:51,760 --> 00:44:54,120 SO I THINK THERE'S REALLY FOUR 1132 00:44:54,120 --> 00:44:54,880 KEY QUESTIONS THAT ARE ESSENTIAL 1133 00:44:54,880 --> 00:45:00,520 TO ADDRESS AS WE WORK TO BUILD 1134 00:45:00,520 --> 00:45:02,160 THIS EVIDENCE BASE. 1135 00:45:02,160 --> 00:45:04,040 WHAT DO DIRECT CARE WORKERS DO 1136 00:45:04,040 --> 00:45:05,600 AS THEY PROVIDER CARE FOR PEOPLE 1137 00:45:05,600 --> 00:45:08,560 WITH DEMENTIA AT HOME. 1138 00:45:08,560 --> 00:45:10,840 SECOND, WHAT CONSTITUTES HIGH 1139 00:45:10,840 --> 00:45:17,960 QUALITY DIRECT CARE WITH PEOPLE 1140 00:45:17,960 --> 00:45:18,800 WITH DEMENTIA AND HOW DO THEY 1141 00:45:18,800 --> 00:45:20,080 COLLABORATE WITH FAMILIES AND 1142 00:45:20,080 --> 00:45:22,680 HOW DO WORKERS COLLABORATE WITH 1143 00:45:22,680 --> 00:45:24,680 THE LARGER DEMENTIA CARE TEAM? 1144 00:45:24,680 --> 00:45:26,760 FOR EACH I'LL HIGHLIGHT WHAT THE 1145 00:45:26,760 --> 00:45:28,280 EXISTING RESEARCH TELLS US THEN 1146 00:45:28,280 --> 00:45:28,840 OUTLINE CONSIDERATIONS FOR 1147 00:45:28,840 --> 00:45:33,480 FUTURE WORK. 1148 00:45:33,480 --> 00:45:36,320 WHAT DO DIRECT CARE WORKERS DO? 1149 00:45:36,320 --> 00:45:39,320 WE KNOW THE FUNCTIONAL SUPPORT 1150 00:45:39,320 --> 00:45:45,200 IS THE BEGINNING. 1151 00:45:45,200 --> 00:45:45,800 DIRECT CARE WORKERS HELP 1152 00:45:45,800 --> 00:45:49,240 IDENTIFY MEDICAL ISSUES AND 1153 00:45:49,240 --> 00:45:51,000 ASSIST WITH CHRONIC DISEASE 1154 00:45:51,000 --> 00:45:52,880 MANAGEMENT AND SUPPORT THOSE 1155 00:45:52,880 --> 00:45:54,840 THEY CARE FOR. 1156 00:45:54,840 --> 00:45:57,960 WE ALSO KNOW AND WE KNOW DIRECT 1157 00:45:57,960 --> 00:46:00,360 CARE WORKER TRAINING IS LIMITED 1158 00:46:00,360 --> 00:46:01,040 AND DEMENTIA SPECIFIC TRAINING 1159 00:46:01,040 --> 00:46:02,160 IS EVEN MER LIMITED. 1160 00:46:02,160 --> 00:46:06,840 AS WE CONDUCT RESEARCH TO BETTER 1161 00:46:06,840 --> 00:46:08,320 UNDERSTAND WHAT DIRECT CARE 1162 00:46:08,320 --> 00:46:10,520 WORKER S ARE DOING IN THE HOME. 1163 00:46:10,520 --> 00:46:12,680 FIRST IT'S NOT ENOUGH TO KNOW 1164 00:46:12,680 --> 00:46:14,440 SOMEONE HAS DIRECT CARE, YES OR 1165 00:46:14,440 --> 00:46:14,600 NO. 1166 00:46:14,600 --> 00:46:20,360 BUT WE NEED TO THINK ABOUT HOW 1167 00:46:20,360 --> 00:46:23,160 MUCH DIRECT CARE AND DOES IT 1168 00:46:23,160 --> 00:46:25,160 MEET THE CARE NEEDS THEY HAVE. 1169 00:46:25,160 --> 00:46:27,200 SIMILARLY IT'S IMPORTANT TO 1170 00:46:27,200 --> 00:46:28,760 THINK OF DEMENTIA SPECIFIC CARE 1171 00:46:28,760 --> 00:46:30,560 IN A MORE NUANCED WAY AND HOW 1172 00:46:30,560 --> 00:46:32,480 THE NEEDS OF INDIVIDUALS WITH 1173 00:46:32,480 --> 00:46:33,920 DEMENTIA LIVING AT HOME MAY 1174 00:46:33,920 --> 00:46:35,680 CHANGE OVER TIME PARTICULARLY AS 1175 00:46:35,680 --> 00:46:41,760 DEMENTIA ADVANCES. 1176 00:46:41,760 --> 00:46:43,280 SECOND, WHAT IS QUALITY DIRECT 1177 00:46:43,280 --> 00:46:44,040 CARE IN THE HOME? 1178 00:46:44,040 --> 00:46:45,920 MEASURES FOR HOME AND 1179 00:46:45,920 --> 00:46:47,760 COMMUNITY-BASED SERVICES FOLK ON 1180 00:46:47,760 --> 00:46:50,840 STATE LEVEL QUALITY MARKERS BUT 1181 00:46:50,840 --> 00:46:53,800 DON'T GET AT WHAT QUALITY DAY TO 1182 00:46:53,800 --> 00:46:55,200 DAY DEMENTIA CARE LOOKS LIKE FOR 1183 00:46:55,200 --> 00:46:56,440 SOMEONE IN THE HOME. 1184 00:46:56,440 --> 00:46:58,800 IT'S IMPORTANT TO NOTE SOME OF 1185 00:46:58,800 --> 00:47:01,280 THE CHALLENGE IS CURRENT 1186 00:47:01,280 --> 00:47:01,920 OPPORTUNITIES FOR SUPERVISION IN 1187 00:47:01,920 --> 00:47:04,080 THE HOME SETTING ARE LIMITED AND 1188 00:47:04,080 --> 00:47:06,000 IN SOME WAYS DEMENTIA HOME CARE 1189 00:47:06,000 --> 00:47:09,000 IS A LITTLE BIT OF A BLACK BOX 1190 00:47:09,000 --> 00:47:10,120 MAKING MEASURING QUALITY 1191 00:47:10,120 --> 00:47:10,400 CHALLENGING. 1192 00:47:10,400 --> 00:47:11,640 A FEW THINGS TO CONSIDER AS WE 1193 00:47:11,640 --> 00:47:13,800 THINK OF QUALITY AND HOME-BASED 1194 00:47:13,800 --> 00:47:15,760 DEMENTIA CARE AND THE FIRST IS 1195 00:47:15,760 --> 00:47:17,480 WHO DEFINES DEMENTIA CARE AND 1196 00:47:17,480 --> 00:47:20,600 WHO DEFINES QUALITY? 1197 00:47:20,600 --> 00:47:23,760 PAYERS? 1198 00:47:23,760 --> 00:47:27,240 THE HOME CARE AGENCY SUPERVISING 1199 00:47:27,240 --> 00:47:28,320 WORKERS AND FAMILY CAREGIVERS 1200 00:47:28,320 --> 00:47:30,160 COLLABORATING ON THE CARE AND 1201 00:47:30,160 --> 00:47:32,680 RELATED ARE THERE SPECIFIC 1202 00:47:32,680 --> 00:47:34,000 ASPECTS OF THE DIRECT CARE 1203 00:47:34,000 --> 00:47:36,560 EXPERIENCE THAT MAY IMPACT CARE 1204 00:47:36,560 --> 00:47:37,880 RECIPIENT OUTCOME? 1205 00:47:37,880 --> 00:47:41,520 FACTORS LIKE THE CONTINUITY OF 1206 00:47:41,520 --> 00:47:42,920 AN INDIVIDUAL DIRECT CARE WORKER 1207 00:47:42,920 --> 00:47:44,520 PROVIDING CARE OR CONCORDANCE 1208 00:47:44,520 --> 00:47:46,720 BETWEEN WORKER AND RECIPIENT. 1209 00:47:46,720 --> 00:47:50,800 THESE GET AT NOT JUST IS THERE 1210 00:47:50,800 --> 00:47:51,880 DIRECT CARE BUT WHAT IS THE 1211 00:47:51,880 --> 00:47:53,680 DIRECT CARE LIKE AND SHOULD BE 1212 00:47:53,680 --> 00:47:55,320 CONSIDERED AS WE THINK OF WHAT 1213 00:47:55,320 --> 00:47:58,520 MAKES QUALITY DIRECT CARE. 1214 00:47:58,520 --> 00:48:00,680 THIRD IS COLLABORATION WITH 1215 00:48:00,680 --> 00:48:00,960 FAMILIES. 1216 00:48:00,960 --> 00:48:03,440 IT'S REALLY CLEAR FAMILY 1217 00:48:03,440 --> 00:48:04,920 CAREGIVERS NEED A STRONG DIRECT 1218 00:48:04,920 --> 00:48:05,840 CARE WORKFORCE. 1219 00:48:05,840 --> 00:48:07,880 THIS IS ONE OF THE FIRST 1220 00:48:07,880 --> 00:48:09,280 PRINCIPLES OF THE 2022 NATIONAL 1221 00:48:09,280 --> 00:48:10,680 STRATEGY TO SUPPORT FAMILY 1222 00:48:10,680 --> 00:48:11,000 CAREGIVERS. 1223 00:48:11,000 --> 00:48:13,720 AND WHILE IT'S NOT SIMPLE 1224 00:48:13,720 --> 00:48:15,080 SUBSTITUTION SO A DIRECT CARE 1225 00:48:15,080 --> 00:48:16,200 WORKER DOES NOT TAKE THE PLACE 1226 00:48:16,200 --> 00:48:18,320 OF A FAMILY CARE GIVING, WORKERS 1227 00:48:18,320 --> 00:48:21,880 CAN IMPACT THE FAMILY CAREGIVER 1228 00:48:21,880 --> 00:48:24,160 EXPERIENCE AND EVIDENCE SUGGESTS 1229 00:48:24,160 --> 00:48:27,840 IMPACTING CAREGIVER BURDEN AND 1230 00:48:27,840 --> 00:48:30,400 THE CAREGIVER'S ABILITY TO 1231 00:48:30,400 --> 00:48:32,680 WORKOUT SIDE THE HOME. 1232 00:48:32,680 --> 00:48:34,000 AS WE EXAMINE THE COLLABORATION, 1233 00:48:34,000 --> 00:48:36,640 I THINK IT'S IMPORTANT TO 1234 00:48:36,640 --> 00:48:37,440 CONSIDER THE SPECIFIC 1235 00:48:37,440 --> 00:48:38,240 CIRCUMSTANCES WHERE THAT 1236 00:48:38,240 --> 00:48:40,800 COLLABORATION MAY BE THE MOST 1237 00:48:40,800 --> 00:48:41,280 IMPORTANT. 1238 00:48:41,280 --> 00:48:43,920 I WANT TO HIGHLIGHT TWO QUICKLY. 1239 00:48:43,920 --> 00:48:45,280 ONE IS CONSUMER DIRECTED CARE. 1240 00:48:45,280 --> 00:48:47,640 THIS IS WHERE INDIVIDUALS WHO 1241 00:48:47,640 --> 00:48:49,640 RECEIVE MEDICAID FUNDED DIRECT 1242 00:48:49,640 --> 00:48:52,600 CARE CAN BASICALLY CHOOSE THEIR 1243 00:48:52,600 --> 00:48:53,960 CAREGIVERS AND HIGHER AND 1244 00:48:53,960 --> 00:48:55,040 SUPERVISE THE DIRECT CARE 1245 00:48:55,040 --> 00:48:55,960 PROVIDER RATHER THAN GOING 1246 00:48:55,960 --> 00:48:57,960 THROUGH A HOME CARE AGENCY. 1247 00:48:57,960 --> 00:48:59,680 THE SECOND SITUATION IS 1248 00:48:59,680 --> 00:48:59,960 SELF-PAY. 1249 00:48:59,960 --> 00:49:01,520 DIRECT CARE IS PAID FOR DIRECTLY 1250 00:49:01,520 --> 00:49:04,000 BY A PERSON WITH DEMENTIA OR 1251 00:49:04,000 --> 00:49:06,920 THEIR FAMILY EITHER THROUGH A 1252 00:49:06,920 --> 00:49:09,080 PRIVATE AGENCY OR MORE COMMONLY 1253 00:49:09,080 --> 00:49:10,200 THROUGH THE MARKET. 1254 00:49:10,200 --> 00:49:19,600 AND FAMILIES ENGAGE WITH DIRECT 1255 00:49:19,600 --> 00:49:24,160 CARE WORKERS AND THOSE NEED TO 1256 00:49:24,160 --> 00:49:25,080 BE EXPLORED. 1257 00:49:25,080 --> 00:49:27,560 AND COLLABORATION WITH THE TEAM. 1258 00:49:27,560 --> 00:49:29,640 EVIDENCE IS CLEAR DIRECT CARE 1259 00:49:29,640 --> 00:49:32,480 WORKERS ARE NOT WELL 1260 00:49:32,480 --> 00:49:34,200 COLLABORATED IN THE HOME CARE 1261 00:49:34,200 --> 00:49:35,720 SCENE AND FOR HEART FAILURE 1262 00:49:35,720 --> 00:49:37,200 CARE, FOR EXAMPLE BUT ALSO TRUE 1263 00:49:37,200 --> 00:49:41,080 FOR HOME BASED CLINICAL CARE 1264 00:49:41,080 --> 00:49:42,840 LIKE HOSPICE OR PRIMARY CARE. 1265 00:49:42,840 --> 00:49:44,280 WORK THAT WORKS TO EVALUATE OR 1266 00:49:44,280 --> 00:49:46,040 PROMOTE THE DIRECT CARE WORKER 1267 00:49:46,040 --> 00:49:47,160 ROLE WITHIN THE TEAM IS 1268 00:49:47,160 --> 00:49:47,760 ESSENTIAL. 1269 00:49:47,760 --> 00:49:49,480 AND A FEW THINGS TO CONSIDER. 1270 00:49:49,480 --> 00:49:51,120 FIRST IS THE NEED FOR ROLE 1271 00:49:51,120 --> 00:49:51,560 CLARITY. 1272 00:49:51,560 --> 00:49:52,800 I THINK WE THINK ABOUT DIRECT 1273 00:49:52,800 --> 00:49:54,640 CARE WORKERS IN THE HOME IN A 1274 00:49:54,640 --> 00:49:55,760 LOT OF WAYS. 1275 00:49:55,760 --> 00:49:57,040 SOMETIMES IT'S LIKE FAMILY. 1276 00:49:57,040 --> 00:49:58,520 BUT OTHER TIMES WE THINK OF 1277 00:49:58,520 --> 00:50:00,760 DIRECT CARE WORKERS AS THE EYES 1278 00:50:00,760 --> 00:50:02,840 AND EARS OF THE HEALTH CARE TEAM 1279 00:50:02,840 --> 00:50:04,680 AND SOMETIMES THE ROLES COULD BE 1280 00:50:04,680 --> 00:50:06,640 AT ODDS AND WE NEED TO BE CLEAR 1281 00:50:06,640 --> 00:50:09,080 HOW WE EXPECT AND WOULD LIKE 1282 00:50:09,080 --> 00:50:10,440 DIRECT CARE WORKERS TO 1283 00:50:10,440 --> 00:50:13,400 CONTRIBUTE TO THE LARGER TEAM. 1284 00:50:13,400 --> 00:50:15,080 AND SECOND ARE SPECIFIC SETTINGS 1285 00:50:15,080 --> 00:50:17,360 WHERE IT MAKES SENSE TO TARGET 1286 00:50:17,360 --> 00:50:18,240 WORKER AND TEAM COLLABORATION. 1287 00:50:18,240 --> 00:50:19,640 I WANT TO HIGHLIGHT IN 1288 00:50:19,640 --> 00:50:22,400 PARTICULAR THE DIRECT CARE 1289 00:50:22,400 --> 00:50:23,520 WORKERS ROLE IN SERIOUS ILLNESS 1290 00:50:23,520 --> 00:50:25,400 AND END OF LIFE AT CARE AT HOME. 1291 00:50:25,400 --> 00:50:26,720 THE PLACE OF DEATH FOR PEOPLE 1292 00:50:26,720 --> 00:50:29,800 WITH DEMENTIA IS MOVING FROM 1293 00:50:29,800 --> 00:50:31,360 INSTITUTIONS INTO THE HOME 1294 00:50:31,360 --> 00:50:31,600 SETTING. 1295 00:50:31,600 --> 00:50:32,720 BUT GOOD CARE FOR PEOPLE LIVING 1296 00:50:32,720 --> 00:50:34,640 WITH DEMENTIA AT THE END OF LIFE 1297 00:50:34,640 --> 00:50:36,440 TAKES A VILLAGE AND WE NEED TO 1298 00:50:36,440 --> 00:50:37,840 UNDERSTAND HOW DIRECT CARE 1299 00:50:37,840 --> 00:50:39,840 WORKERS FIT INTO THAT AND HOW 1300 00:50:39,840 --> 00:50:41,960 THEY CAN BEST CONTRIBUTE TO OVER 1301 00:50:41,960 --> 00:50:43,680 ALL CARE AT A TIME WHEN THE CARE 1302 00:50:43,680 --> 00:50:46,560 NEEDS ARE SO INTENSE. 1303 00:50:46,560 --> 00:50:49,360 SO IN CLOSING, DIRECT CARE 1304 00:50:49,360 --> 00:50:51,240 WORKERS REALLY ARE AN ESSENTIAL 1305 00:50:51,240 --> 00:50:53,320 PART OF HOME BASED DEMENTIA CARE 1306 00:50:53,320 --> 00:50:54,680 WORKFORCE AND I THINK THIS MEANS 1307 00:50:54,680 --> 00:50:56,560 WE NEED TO CONSIDER DIRECT CARE 1308 00:50:56,560 --> 00:50:59,800 WORKERS NOT JUST AS AN ABSTRACT 1309 00:50:59,800 --> 00:51:00,720 WORKFORCE THOUGH ISSUES RELATED 1310 00:51:00,720 --> 00:51:03,280 TO PAYMENT AND RECRUITMENT AND 1311 00:51:03,280 --> 00:51:06,120 RETENTION ARE IMPORTANT BUT WE 1312 00:51:06,120 --> 00:51:08,600 NEED TO THINK OF WORKERS IN 1313 00:51:08,600 --> 00:51:10,160 RELATION TO THE PEOPLE THEY CARE 1314 00:51:10,160 --> 00:51:11,480 FOR AND FAMILIES WHERE THEY 1315 00:51:11,480 --> 00:51:14,240 SHARE CARE AND CARE TEAMS PART 1316 00:51:14,240 --> 00:51:15,440 OF CARE AS WELL. 1317 00:51:15,440 --> 00:51:23,960 I THINK THIS APPROACH WILL HELP 1318 00:51:23,960 --> 00:51:28,360 DIRECT CARE WORKERS MEANINGFULLY 1319 00:51:28,360 --> 00:51:28,920 CONTRIBUTE TO THOSE NEEDING 1320 00:51:28,920 --> 00:51:29,760 SERVICES. 1321 00:51:29,760 --> 00:51:35,320 >>THANK YOU TO ALL OF OUR 1322 00:51:35,320 --> 00:51:35,560 SPEAKERS. 1323 00:51:35,560 --> 00:51:37,120 THOSE WERE GREAT PRESENTATIONS 1324 00:51:37,120 --> 00:51:39,000 AND COVERED THE RANGE OF 1325 00:51:39,000 --> 00:51:39,880 CONCERNS THAT EXIST AROUND THE 1326 00:51:39,880 --> 00:51:41,200 WORKFORCE AS WELL AS THE 1327 00:51:41,200 --> 00:51:42,160 RESEARCH GAP AND OPPORTUNITIES 1328 00:51:42,160 --> 00:51:43,920 WE HAVE TO DO BETTER WORK AND 1329 00:51:43,920 --> 00:51:47,200 UNDERSTAND MORE IN THE FUTURE. 1330 00:51:47,200 --> 00:51:49,400 SO THERE ARE THREE RESEARCH GAPS 1331 00:51:49,400 --> 00:51:51,800 AND OPPORTUNITIES THAT WE PRE 1332 00:51:51,800 --> 00:51:52,920 OPPOSED HERE. 1333 00:51:52,920 --> 00:51:54,800 FIRST TO DEVELOP DATA SYSTEMS 1334 00:51:54,800 --> 00:51:56,880 THAT WILL SUPPORT THE TRACK OF 1335 00:51:56,880 --> 00:52:00,680 WORKFORCE EDUCATION, TRAINING, 1336 00:52:00,680 --> 00:52:02,480 DIVERSITY, EXPERIENCE SKILLS AND 1337 00:52:02,480 --> 00:52:04,160 SATISFACTION AND SUPPORT DATA 1338 00:52:04,160 --> 00:52:05,760 LINKAGES SO THERE COULD BE 1339 00:52:05,760 --> 00:52:07,080 RESEARCH ON THE RELATIONSHIP 1340 00:52:07,080 --> 00:52:09,560 BETWEEN THE WORKFORCE AND 1341 00:52:09,560 --> 00:52:10,280 PERSON-CENTERED OUTCOMES FOR 1342 00:52:10,280 --> 00:52:11,440 PERSONS LIVING WITH DEMENTIA AND 1343 00:52:11,440 --> 00:52:12,920 THEIR CARE PARTNERS. 1344 00:52:12,920 --> 00:52:14,320 THE DIRECT CARE WORKFORCE SHOULD 1345 00:52:14,320 --> 00:52:16,960 BE INCLUDED IN ALL THE DATA SET 1346 00:52:16,960 --> 00:52:18,600 DEVELOPMENT BECAUSE THEY PLAY 1347 00:52:18,600 --> 00:52:20,400 SUCH IMPORTANT ROLES IN THE CARE 1348 00:52:20,400 --> 00:52:22,360 PROVIDED TO PEOPLE LIVING WITH 1349 00:52:22,360 --> 00:52:23,880 DEMENTIA SO THEY NEED TO BE 1350 00:52:23,880 --> 00:52:26,200 INCLUDED IN ALL THE DEVELOPMENT 1351 00:52:26,200 --> 00:52:28,040 RELATED TO THE WORKFORCE IN THIS 1352 00:52:28,040 --> 00:52:30,560 CARE AND THE RESEARCH SHOULD 1353 00:52:30,560 --> 00:52:31,840 FOCUS AND INCLUDE THEIR ROLES 1354 00:52:31,840 --> 00:52:35,840 AND CONTRIBUTIONS. 1355 00:52:35,840 --> 00:52:38,560 SECOND WE IDENTIFIED AS A 1356 00:52:38,560 --> 00:52:39,880 RESEARCH GAP AND AOPPORTUNITY 1357 00:52:39,880 --> 00:52:41,920 THE NEED TO IDENTIFY AND 1358 00:52:41,920 --> 00:52:43,720 EVALUATE NEW AND EXPANDING 1359 00:52:43,720 --> 00:52:45,040 INTERVENTIONS AND STRATEGIES TO 1360 00:52:45,040 --> 00:52:46,600 ADVANCE AND SUPPORT ALL MEMBERS 1361 00:52:46,600 --> 00:52:49,480 OF THE DEMENTIA CARE WORKFORCE 1362 00:52:49,480 --> 00:52:52,160 AT ALL PROFESSIONAL LEVELS 1363 00:52:52,160 --> 00:52:54,200 THROUGH PHYSICIANS AND 1364 00:52:54,200 --> 00:52:55,000 SPECIALIST PHYSICIANS TO SUPPORT 1365 00:52:55,000 --> 00:52:56,320 THE REPLICATION AND 1366 00:52:56,320 --> 00:52:57,360 DISSEMINATION OF THE APPROACHES 1367 00:52:57,360 --> 00:52:59,920 THAT ARE THE MOST SUCCESSFUL. 1368 00:52:59,920 --> 00:53:00,840 WE SEE A LOT OF PROMISING MODELS 1369 00:53:00,840 --> 00:53:04,000 OUT THERE. 1370 00:53:04,000 --> 00:53:05,600 OUR SPEAKERS HAVE TALKED ABOUT 1371 00:53:05,600 --> 00:53:06,200 PROMISING IMPROVEMENTS THAT 1372 00:53:06,200 --> 00:53:08,840 COULD BE MADE AND WE NEED TO 1373 00:53:08,840 --> 00:53:10,280 UNDERSTAND AND EVALUATE THOSE 1374 00:53:10,280 --> 00:53:12,280 USING RIGOROUS IMPLEMENTATION 1375 00:53:12,280 --> 00:53:13,080 SCIENCE AND EVALUATION 1376 00:53:13,080 --> 00:53:15,720 STRATEGIES SO WE CAN DO A GREAT 1377 00:53:15,720 --> 00:53:17,840 JOB OF PUTTING THE BEST 1378 00:53:17,840 --> 00:53:19,280 APPROACHES OUT TO SERVE MORE 1379 00:53:19,280 --> 00:53:22,600 PEOPLE LIVING WITH DEMENTIA. 1380 00:53:22,600 --> 00:53:25,080 AND THIRD WE IDENTIFIED AN 1381 00:53:25,080 --> 00:53:26,520 OPPORTUNITY AS DEVELOPING 1382 00:53:26,520 --> 00:53:28,600 MEASURES AND RESEARCH METHODS 1383 00:53:28,600 --> 00:53:29,760 THAT EXPLORE COLLABORATION AND 1384 00:53:29,760 --> 00:53:32,640 CARE PROVIDED BY TEAMS OF CARE 1385 00:53:32,640 --> 00:53:33,680 PROVIDERS THAT INCLUDE DIRECT 1386 00:53:33,680 --> 00:53:36,240 CARE WORKERS, CARE PARTNERS AND 1387 00:53:36,240 --> 00:53:37,960 PEOPLE LIVING WITH DEMENTIA TO 1388 00:53:37,960 --> 00:53:38,880 UNDERSTAND THE INTERACTIONS 1389 00:53:38,880 --> 00:53:40,480 BETWEEN THE GROUPS AND THE BEST 1390 00:53:40,480 --> 00:53:42,120 APPROACH TO ADVANCING THE 1391 00:53:42,120 --> 00:53:45,680 QUALITY OF PERSON-CENTERED CARE. 1392 00:53:45,680 --> 00:53:47,760 MANY OF THESE THEMES IN OUR 1393 00:53:47,760 --> 00:53:49,320 IDENTIFIED RESEARCH GAPS AND 1394 00:53:49,320 --> 00:53:49,880 OPPORTUNITIES AROUND THE 1395 00:53:49,880 --> 00:53:51,480 WORKFORCE INTERSECT WITH THE 1396 00:53:51,480 --> 00:53:53,040 OTHER GAPS AND OPPORTUNITIES 1397 00:53:53,040 --> 00:53:54,440 THAT WERE IDENTIFIED YESTERDAY 1398 00:53:54,440 --> 00:53:57,760 AND THE DAY BEFORE RELATED TO 1399 00:53:57,760 --> 00:53:59,800 DIFFERENT MODELS OF CARE 1400 00:53:59,800 --> 00:54:01,440 DIFFERENT WAYS OF DISSEMINATING 1401 00:54:01,440 --> 00:54:02,480 THE SUCCESSFUL MODELS OF CARE 1402 00:54:02,480 --> 00:54:03,840 AND DIFFERENT WAYS OF ENSURING 1403 00:54:03,840 --> 00:54:05,560 PEOPLE ARE BEST SUPPORTED 1404 00:54:05,560 --> 00:54:08,040 THROUGH A WORKFORCE THAT IS ALSO 1405 00:54:08,040 --> 00:54:10,200 WELL SUPPORTED IN ITS SKILLS, 1406 00:54:10,200 --> 00:54:11,480 KNOWLEDGE AND WORKING CONDITIONS 1407 00:54:11,480 --> 00:54:12,040 SO THEY CAN DO THEIR JOBS 1408 00:54:12,040 --> 00:54:17,480 BETTER. 1409 00:54:17,480 --> 00:54:19,320 I BELIEVE NOW WE CAN TURN TO OUR 1410 00:54:19,320 --> 00:54:22,080 TWO PANELIST. 1411 00:54:22,080 --> 00:54:23,920 WE'LL BEGIN WITH DAVID GRABOWSKI 1412 00:54:23,920 --> 00:54:25,800 FROM HARVARD UNIVERSITY FOR 1413 00:54:25,800 --> 00:54:28,760 COMMENTS AND TO MELISSA 1414 00:54:28,760 --> 00:54:29,680 MYERS-BRISTOL. 1415 00:54:29,680 --> 00:54:31,960 >>THANK YOU, DR. SPETZ AND 1416 00:54:31,960 --> 00:54:32,600 HELLO EVERYONE. 1417 00:54:32,600 --> 00:54:35,960 IT'S A GREAT HONOR TO BE HERE 1418 00:54:35,960 --> 00:54:38,040 AND REACT TO THIS ALL-STAR 1419 00:54:38,040 --> 00:54:38,520 PANEL. 1420 00:54:38,520 --> 00:54:40,280 I'M DAVID GRABOWSKI A PROFESSOR 1421 00:54:40,280 --> 00:54:42,440 AT HEALTH CARE POLICY AT HARVARD 1422 00:54:42,440 --> 00:54:43,160 MEDICAL SCHOOL. 1423 00:54:43,160 --> 00:54:50,840 I WANTED TO REFLECT ON SEVERAL 1424 00:54:50,840 --> 00:54:53,280 POINTS THE SPEAKERS RAISED. 1425 00:54:53,280 --> 00:54:55,120 A THOUGHT ALL THREE 1426 00:54:55,120 --> 00:54:55,840 PRESENTATIONS WERE EXCELLENT. 1427 00:54:55,840 --> 00:54:58,160 FIRST AND FOREMOST THE WORKFORCE 1428 00:54:58,160 --> 00:54:59,760 AS DR. FROGNER SAID IT'S NOT 1429 00:54:59,760 --> 00:55:01,000 EVEN A WORKFORCE. 1430 00:55:01,000 --> 00:55:02,360 IT'S SPREAD OUT AND QUITE 1431 00:55:02,360 --> 00:55:03,600 DIVERSE AND SPREAD OVER 1432 00:55:03,600 --> 00:55:05,480 DIFFERENT SETTINGS AND IN 1433 00:55:05,480 --> 00:55:08,200 PARTICULAR WE NEED TO SUPPORT 1434 00:55:08,200 --> 00:55:09,560 THE DEMENTIA WORKFORCE IN 1435 00:55:09,560 --> 00:55:10,600 NURSING HOMES AND OTHER 1436 00:55:10,600 --> 00:55:11,840 INSTITUTIONAL SETTINGS. 1437 00:55:11,840 --> 00:55:13,000 WE NEED TO SUPPORT THEM IN THE 1438 00:55:13,000 --> 00:55:16,040 HOME AND THEN WE NEED TO SUPPORT 1439 00:55:16,040 --> 00:55:16,880 THEM AS DR. RECKREY SAID 1440 00:55:16,880 --> 00:55:19,520 ALONGSIDE FAMILY. 1441 00:55:19,520 --> 00:55:21,840 AND I DON'T VIEW THOSE AS 1442 00:55:21,840 --> 00:55:23,920 COMPETING OBJECTIVES BUT RATHER 1443 00:55:23,920 --> 00:55:26,120 COMPLIMENTARY ONES. 1444 00:55:26,120 --> 00:55:29,640 WE NEED TO SUPPORT THE WORKFORCE 1445 00:55:29,640 --> 00:55:31,400 AS INDIVIDUALS NEED SERVICES 1446 00:55:31,400 --> 00:55:34,560 ACROSS THESE DIFFERENT SETTINGS. 1447 00:55:34,560 --> 00:55:36,320 AND LET'S INVEST ACROSS THE 1448 00:55:36,320 --> 00:55:36,560 SPECTRUM. 1449 00:55:36,560 --> 00:55:39,720 THE FIRST BIG POINT WE HEARD IN 1450 00:55:39,720 --> 00:55:42,200 THE PRESENTATIONS WAS ABOUT PAY 1451 00:55:42,200 --> 00:55:44,440 AND BENEFITS AND I BELIEVE THIS 1452 00:55:44,440 --> 00:55:47,840 IS NECESSARY BUT NOT SUFFICIENT 1453 00:55:47,840 --> 00:55:48,440 TO REALLY BUILDING A STRONG 1454 00:55:48,440 --> 00:55:50,800 WORKFORCE. 1455 00:55:50,800 --> 00:55:54,480 WE UNDER PAY AS WAS NOTED DURING 1456 00:55:54,480 --> 00:55:58,040 THE PRESENTATIONS ESPECIALLY 1457 00:55:58,040 --> 00:55:58,360 DR. TRAVERS. 1458 00:55:58,360 --> 00:56:01,160 WE UNDER PAY A LOT OF THE 1459 00:56:01,160 --> 00:56:02,320 WORKERS IN THE SECTOR. 1460 00:56:02,320 --> 00:56:03,560 BETTER PAY WILL BRING MORE 1461 00:56:03,560 --> 00:56:05,040 INDIVIDUALS INTO THE WORKFORCE 1462 00:56:05,040 --> 00:56:06,720 BUT IT'S NOT NECESSARILY ENOUGH. 1463 00:56:06,720 --> 00:56:08,680 AND THAT GOES TO THE SECOND 1464 00:56:08,680 --> 00:56:10,280 POINT DR. TRAVERS AND OTHERS 1465 00:56:10,280 --> 00:56:11,280 TALKED ABOUT. 1466 00:56:11,280 --> 00:56:13,240 THAT'S REALLY EMPOWERING THE 1467 00:56:13,240 --> 00:56:15,000 WORKFORCE MAKE BEING BETTER 1468 00:56:15,000 --> 00:56:17,360 JOBS. 1469 00:56:17,360 --> 00:56:19,680 IT'S MORE THAN PAY. 1470 00:56:19,680 --> 00:56:21,200 EMPOWERED WILL STAY IN THE 1471 00:56:21,200 --> 00:56:22,240 POSITIONS LONGER AND BE MORE 1472 00:56:22,240 --> 00:56:24,320 WILLING TO WORK IN THESE 1473 00:56:24,320 --> 00:56:24,600 SETTINGS. 1474 00:56:24,600 --> 00:56:28,280 WE'VE SEEN THIS IN THE BEST 1475 00:56:28,280 --> 00:56:29,400 MODELS FOR EXAMPLE IN THE 1476 00:56:29,400 --> 00:56:31,760 NURSING HOME SETTING. 1477 00:56:31,760 --> 00:56:34,720 THE GREENHOUSE MODEL WHERE THE 1478 00:56:34,720 --> 00:56:39,720 WORKING SITUATION'S MUCH LESS 1479 00:56:39,720 --> 00:56:41,680 HIERARCHICAL AND INVEST IN 1480 00:56:41,680 --> 00:56:43,400 CAREGIVERS AND GET BETTER 1481 00:56:43,400 --> 00:56:45,960 QUALITY FOR INDIVIDUALS WITH 1482 00:56:45,960 --> 00:56:47,040 DEMENTIA BUT GET A WORKFORCE 1483 00:56:47,040 --> 00:56:49,120 THAT'S HAPPIER. 1484 00:56:49,120 --> 00:56:51,320 THEY PAY THEIR WORKERS BETTER 1485 00:56:51,320 --> 00:56:52,280 TOO BUT ONCE AGAIN IT'S NOT JUST 1486 00:56:52,280 --> 00:56:55,040 THE PAY BUT THE WORKING 1487 00:56:55,040 --> 00:56:56,600 CONDITIONS AS WELL. 1488 00:56:56,600 --> 00:56:58,240 FINAL POINT I'LL MAKE AND IT 1489 00:56:58,240 --> 00:57:00,320 CAME OUT IN THE FIRST GOAL 1490 00:57:00,320 --> 00:57:03,280 DR. SPETZ MENTIONED, WE NEED 1491 00:57:03,280 --> 00:57:04,080 BETTER DATA. 1492 00:57:04,080 --> 00:57:06,280 WE'VE INVESTED IN RICH PAYROLL 1493 00:57:06,280 --> 00:57:08,600 BASED DATA IN THE NURSING HOME 1494 00:57:08,600 --> 00:57:10,160 SETTING BUT FLYING BLIND IN A 1495 00:57:10,160 --> 00:57:11,640 LOT OF THE OTHER PARTS OF THE 1496 00:57:11,640 --> 00:57:11,880 SYSTEM. 1497 00:57:11,880 --> 00:57:13,680 HOW DO WE GET A BETTER SENSE OF 1498 00:57:13,680 --> 00:57:16,960 NOT JUST WHO WORKS HERE BUT AS 1499 00:57:16,960 --> 00:57:19,560 DR. TRAVERS SAID MORE ABOUT 1500 00:57:19,560 --> 00:57:19,760 THEM. 1501 00:57:19,760 --> 00:57:20,880 THEY'RE DEMOGRAPHICS. 1502 00:57:20,880 --> 00:57:22,800 MORE BACKGROUND ON THIS 1503 00:57:22,800 --> 00:57:24,680 WORKFORCE ESPECIALLY THE 1504 00:57:24,680 --> 00:57:25,840 NON-NURSING HOME WORKFORCE. 1505 00:57:25,840 --> 00:57:27,440 WE HAVE A LOT OF LEFT TO LEARN. 1506 00:57:27,440 --> 00:57:28,360 WE TALKED ABOUT THIS. 1507 00:57:28,360 --> 00:57:31,240 I WAS ON THE NATIONAL ACADEMIES 1508 00:57:31,240 --> 00:57:33,160 COMMISSION WITH DR. TRAVERS AND 1509 00:57:33,160 --> 00:57:34,360 WE MADE THE RECOMMENDATIONS. 1510 00:57:34,360 --> 00:57:35,520 WE NEED TO FOLLOW THROUGH. 1511 00:57:35,520 --> 00:57:36,400 I'LL STOP THERE AND LOOK FORWARD 1512 00:57:36,400 --> 00:57:43,400 TO THE DISCUSSION. 1513 00:57:43,400 --> 00:57:48,360 >>THANK YOU, DAVID. 1514 00:57:48,360 --> 00:57:51,480 >>HI, EVERYONE. 1515 00:57:51,480 --> 00:57:52,000 GOOD MORNING. 1516 00:57:52,000 --> 00:57:55,440 I'M HONOR AND DELIGHTED TO BE 1517 00:57:55,440 --> 00:57:56,120 PART OF THIS EXTRAORDINARY 1518 00:57:56,120 --> 00:57:57,360 EVENT. 1519 00:57:57,360 --> 00:57:59,000 I'D LIKE TO CONGRATULATE THE 1520 00:57:59,000 --> 00:58:00,160 PRESENTER ON THE JOB WELL DONE 1521 00:58:00,160 --> 00:58:03,840 AND THE TOPIC AND CONVERSATION 1522 00:58:03,840 --> 00:58:04,600 DISCUSSED IN THE SESSION ARE 1523 00:58:04,600 --> 00:58:05,440 ESSENTIAL IN TODAY'S 1524 00:58:05,440 --> 00:58:05,960 ENVIRONMENT. 1525 00:58:05,960 --> 00:58:09,680 IN RESPONSE TO THE GROWING NEED 1526 00:58:09,680 --> 00:58:10,840 FOR A DEMENTIA SKILLED WORKFORCE 1527 00:58:10,840 --> 00:58:13,080 IT'S CRUCIAL MORE THAN EVER FOR 1528 00:58:13,080 --> 00:58:15,120 INVESTMENT AND COMMITMENT TO 1529 00:58:15,120 --> 00:58:17,120 PUBLIC HEALTH AND SOCIAL CARE 1530 00:58:17,120 --> 00:58:19,120 FOR PEOPLE LIVING WITH DEMENTIA 1531 00:58:19,120 --> 00:58:21,440 AND THEIR FAMILY CAREGIVERS. 1532 00:58:21,440 --> 00:58:23,720 TODAY'S PRESENTATION REMINDS US 1533 00:58:23,720 --> 00:58:28,080 THAT WE MUST DEVELOP A NATIONAL 1534 00:58:28,080 --> 00:58:29,600 PUBLIC HEALTH INITIATIVE TO 1535 00:58:29,600 --> 00:58:31,000 PROVIDE A DEMENTIA WORKFORCE 1536 00:58:31,000 --> 00:58:34,240 WITH THE CAPABILITY AND SKILL 1537 00:58:34,240 --> 00:58:37,120 SET TO DELIVER HIGH QUALITY 1538 00:58:37,120 --> 00:58:40,640 SERVICES TO SUPPORT THE GROWING 1539 00:58:40,640 --> 00:58:41,400 DEMENTIA POPULATION WHILE 1540 00:58:41,400 --> 00:58:43,760 EFFECTIVELY CONTENDING WITH THE 1541 00:58:43,760 --> 00:58:46,480 COMPLEX AND PROGRESSIVE IMPACT 1542 00:58:46,480 --> 00:58:48,520 OF DEMENTIA AT ALL LEVELS OF 1543 00:58:48,520 --> 00:58:48,920 SOCIETY. 1544 00:58:48,920 --> 00:58:51,280 WE ARE CONSTANTLY REMINDED THAT 1545 00:58:51,280 --> 00:58:53,920 PUBLIC POLICIES MUST BE 1546 00:58:53,920 --> 00:58:54,960 STRENGTHENED FOR HIRING, 1547 00:58:54,960 --> 00:58:57,800 TRAINING AND RETAINING THE 1548 00:58:57,800 --> 00:59:01,800 WORKFORCE IN HOME-BASED DEMENTIA 1549 00:59:01,800 --> 00:59:06,080 CARE TO PLAN THE SUPPLY OF 1550 00:59:06,080 --> 00:59:09,160 HEALTH AND PROFESSIONALS AND 1551 00:59:09,160 --> 00:59:11,720 WORKERS IS VIT FOR PUBLIC 1552 00:59:11,720 --> 00:59:13,840 FINANCING TO BE REORGANIZED TO 1553 00:59:13,840 --> 00:59:15,080 SUPPORT THE PROVISION AND 1554 00:59:15,080 --> 00:59:17,320 EXPANSION OF COMMUNITY-BASED 1555 00:59:17,320 --> 00:59:18,520 SERVICES FOR THE PERSONS LIVING 1556 00:59:18,520 --> 00:59:22,240 WITH DEMENTIA AND THOSE WHO ARE 1557 00:59:22,240 --> 00:59:24,280 HIRED TO SERVE THEM FOR WHOM 1558 00:59:24,280 --> 00:59:26,920 COVERAGE IS HARDLY OPTIONAL AND 1559 00:59:26,920 --> 00:59:31,760 VARIES IN FUNDING BY THE STATES. 1560 00:59:31,760 --> 00:59:35,000 IT IS ESSENTIAL FOR QUALITY 1561 00:59:35,000 --> 00:59:35,920 IMPROVEMENT, INSURANCE SYSTEM 1562 00:59:35,920 --> 00:59:37,640 AND METRICS FOR DEMENTIA CARE 1563 00:59:37,640 --> 00:59:41,960 AND SERVICES TO BE MATCHED TO 1564 00:59:41,960 --> 00:59:42,680 PRIORITIZE NEEDS OF THE 1565 00:59:42,680 --> 00:59:43,480 POPULATION. 1566 00:59:43,480 --> 00:59:44,800 AS STATED IN THE PRESENTATION 1567 00:59:44,800 --> 00:59:48,840 AND TO REASSURE OUR COMMITMENT 1568 00:59:48,840 --> 00:59:52,280 ACTIONS IN SEVERAL AREAS MUST BE 1569 00:59:52,280 --> 00:59:53,520 ADDRESSED INCLUDING RESEARCH 1570 00:59:53,520 --> 00:59:55,680 GAPS, OPPORTUNITIES THAT ARE 1571 00:59:55,680 --> 00:59:57,400 CONSTANTLY GROWING AND LAST BUT 1572 00:59:57,400 --> 01:00:01,680 NOT LEAST COMPETITIVE WAGES AND 1573 01:00:01,680 --> 01:00:02,880 BENEFIT OPTIONS. 1574 01:00:02,880 --> 01:00:04,600 EVERYONE MADE SOME VALID POINTS 1575 01:00:04,600 --> 01:00:08,000 AND I THINK MORE THAN EVER WE'RE 1576 01:00:08,000 --> 01:00:11,880 LEARNING NOW IN 2025 DATA HAS 1577 01:00:11,880 --> 01:00:13,440 SHOWN THE DEMENTIA CARE 1578 01:00:13,440 --> 01:00:16,720 POPULATION IS GOING TO GROW 1579 01:00:16,720 --> 01:00:17,800 SUBSTANTIALLY. 1580 01:00:17,800 --> 01:00:18,680 SO OBVIOUSLY THERE'S A GREAT 1581 01:00:18,680 --> 01:00:21,760 NEED FOR US TO PRIORITIZE AND 1582 01:00:21,760 --> 01:00:22,680 UNDERSTAND WHAT'S NEEDED TO BE 1583 01:00:22,680 --> 01:00:27,360 DONE TO ENSURE WE CAN CARE FOR 1584 01:00:27,360 --> 01:00:29,200 OUR CAREGIVERS AND OUR DEMENTIA 1585 01:00:29,200 --> 01:00:32,200 POPULATION AND THOSE WHO ARE 1586 01:00:32,200 --> 01:00:33,280 CONSTANTLY SUFFERING AND NEEDING 1587 01:00:33,280 --> 01:00:33,520 OUR HELP. 1588 01:00:33,520 --> 01:00:41,400 THANK YOU. 1589 01:00:41,400 --> 01:00:43,040 >>THANK YOU, MELISSA AND DAVID 1590 01:00:43,040 --> 01:00:45,440 FOR YOUR COMMENTS. 1591 01:00:45,440 --> 01:00:48,160 I BELIEVE NOW WE ARE MOVING TO 1592 01:00:48,160 --> 01:00:49,440 THE QUESTION AND ANSWER PART. 1593 01:00:49,440 --> 01:00:51,680 ALL OF OUR SPEAKERS AND 1594 01:00:51,680 --> 01:00:54,640 PANELISTS CAN COME BACK ON VIDEO 1595 01:00:54,640 --> 01:00:56,880 AND THEN WE CAN LOOK AT THE 1596 01:00:56,880 --> 01:00:59,000 VARIETY OF QUESTIONS THAT WE 1597 01:00:59,000 --> 01:01:00,840 HAVE COMING INTO THE Q&A BOX. 1598 01:01:00,840 --> 01:01:03,320 PLEASE USE THE Q&A BOX TO 1599 01:01:03,320 --> 01:01:07,000 PROVIDE YOUR QUESTIONS AND THEN 1600 01:01:07,000 --> 01:01:10,200 ALSO THERE IS A PATHWAY TO ASK 1601 01:01:10,200 --> 01:01:12,160 QUESTIONS FROM THE NIA WEB PAGE. 1602 01:01:12,160 --> 01:01:15,600 THE LINKS HAVE BEEN PROVIDED IN 1603 01:01:15,600 --> 01:01:16,840 THE CHAT BY NATIONAL INSTITUTE 1604 01:01:16,840 --> 01:01:18,400 ON AGING PEOPLE INVOLVED IN 1605 01:01:18,400 --> 01:01:21,920 COORDINATING THE EVENT. 1606 01:01:21,920 --> 01:01:24,400 I WILL TAKE THE SESSION 1607 01:01:24,400 --> 01:01:25,440 CO-MODERATOR'S PREROGATIVE AND 1608 01:01:25,440 --> 01:01:26,840 PUT A QUESTION OUT THERE ALSO 1609 01:01:26,840 --> 01:01:27,880 REFLECTIVE OF AT LEAST ONE 1610 01:01:27,880 --> 01:01:31,320 QUESTION THAT'S COMING FROM THE 1611 01:01:31,320 --> 01:01:31,680 Q&A. 1612 01:01:31,680 --> 01:01:34,480 AND THAT IS AROUND WHAT POLICIES 1613 01:01:34,480 --> 01:01:36,440 OR PROGRAMS THAT AFFECT THE 1614 01:01:36,440 --> 01:01:38,320 WORKFORCE MIGHT BE THE MOST 1615 01:01:38,320 --> 01:01:41,080 IMPORTANT TO PRIORITIZE FOR 1616 01:01:41,080 --> 01:01:41,760 RESEARCH? 1617 01:01:41,760 --> 01:01:43,760 I'LL START WITH BIANCA BECAUSE 1618 01:01:43,760 --> 01:01:45,040 SHE WAS OUR FIRST PRESENTER SO 1619 01:01:45,040 --> 01:01:46,840 WE'LL GET HER VOICE IN THE ROOM. 1620 01:01:46,840 --> 01:01:48,200 AND THIS IS A QUESTION I THINK 1621 01:01:48,200 --> 01:01:50,800 ALL OF OUR SPEAKERS AND 1622 01:01:50,800 --> 01:01:51,800 PANELISTS MIGHT HAVE THOUGHTS 1623 01:01:51,800 --> 01:01:52,920 AROUND AROUND POLICIES AND 1624 01:01:52,920 --> 01:01:54,280 PROGRAMS THE MOST IMPORTANT TO 1625 01:01:54,280 --> 01:01:57,640 STUDY FIRST. 1626 01:01:57,640 --> 01:01:59,440 >>THANK YOU FOR THE QUESTION 1627 01:01:59,440 --> 01:02:00,840 AND WHAT EXCELLENT 1628 01:02:00,840 --> 01:02:01,200 PRESENTATIONS. 1629 01:02:01,200 --> 01:02:02,840 THAT IS SUCH AN IMPORTANT 1630 01:02:02,840 --> 01:02:04,040 QUESTION AND SUCH A DIFFICULT 1631 01:02:04,040 --> 01:02:07,560 ONE BECAUSE I THINK A LOT OF IT 1632 01:02:07,560 --> 01:02:09,680 IS ASKING WHO'S PRIORITIES ARE 1633 01:02:09,680 --> 01:02:11,680 WE PRIORITIZING IN SOME WAYS. 1634 01:02:11,680 --> 01:02:13,520 I THINK THE HARD PART I CAN SEE 1635 01:02:13,520 --> 01:02:15,440 AS A RESEARCHER IN THE FIELD IS 1636 01:02:15,440 --> 01:02:17,160 THERE'S SO MANY WONDERFUL PILOTS 1637 01:02:17,160 --> 01:02:19,960 TAKING PLACE ACROSS THE COUNTRY. 1638 01:02:19,960 --> 01:02:21,840 IN SOME WAYS WE COULD FIRST 1639 01:02:21,840 --> 01:02:24,680 START WITH SOME BETTER BRINGING 1640 01:02:24,680 --> 01:02:27,240 TOGETHER OF WHAT THOSE PILOTS 1641 01:02:27,240 --> 01:02:27,400 ARE. 1642 01:02:27,400 --> 01:02:30,080 AND THEN THE RESULTS FROM THE 1643 01:02:30,080 --> 01:02:30,640 PILOTS. 1644 01:02:30,640 --> 01:02:33,200 I THINK OTHER GROUPS HAVE 1645 01:02:33,200 --> 01:02:35,480 CERTAINLY TRIED TO COMB THE 1646 01:02:35,480 --> 01:02:38,440 LITERATURE TO TRY TO TELL US 1647 01:02:38,440 --> 01:02:39,680 WHAT THE PUBLISHED LITERATURE 1648 01:02:39,680 --> 01:02:40,880 SAYS AND THERE'S PROGRAMS THAT 1649 01:02:40,880 --> 01:02:43,160 EXIST IN SETTINGS THAT HAVEN'T 1650 01:02:43,160 --> 01:02:44,360 BEEN EVALUATED BECAUSE WE DON'T 1651 01:02:44,360 --> 01:02:45,760 HAVE FUNDING TO DO THAT 1652 01:02:45,760 --> 01:02:46,080 EVALUATION. 1653 01:02:46,080 --> 01:02:48,360 IN SOME WAYS I WOULD LOVE TO SEE 1654 01:02:48,360 --> 01:02:50,200 A BETTER MORE COMPREHENSIVE 1655 01:02:50,200 --> 01:02:51,400 APPROACH TO IDENTIFY WHAT 1656 01:02:51,400 --> 01:02:53,360 PROGRAMS ARE WORKING ON THE 1657 01:02:53,360 --> 01:02:55,560 GROUND AND DO SOME BETTER 1658 01:02:55,560 --> 01:02:57,240 PULLING TOGETHER OF THAT WORK 1659 01:02:57,240 --> 01:02:57,600 FIRST. 1660 01:02:57,600 --> 01:03:00,240 THE OTHER PART IS DURING THE 1661 01:03:00,240 --> 01:03:02,120 PANDEMIC IN PARTICULAR THERE'S 1662 01:03:02,120 --> 01:03:03,280 BEEN EXPERIMENTATION AT THE 1663 01:03:03,280 --> 01:03:05,720 STATE LEVEL WITH MEDICAID AND 1664 01:03:05,720 --> 01:03:08,000 AWHAT STATES ARE DOING TO MAKE 1665 01:03:08,000 --> 01:03:09,360 MEDICAID MORE FLEXIBLE TO PAY 1666 01:03:09,360 --> 01:03:10,720 FOR LONG-TERM CARE. 1667 01:03:10,720 --> 01:03:12,200 I THINK WE CAN DO MORE TO 1668 01:03:12,200 --> 01:03:13,800 UNDERSTAND WHAT'S HAPPENING 1669 01:03:13,800 --> 01:03:14,520 THERE. 1670 01:03:14,520 --> 01:03:18,200 I'LL LET THE OTHER PANELISTS 1671 01:03:18,200 --> 01:03:20,960 CHIME IN. 1672 01:03:20,960 --> 01:03:22,720 >>I'LL HOP IN. 1673 01:03:22,720 --> 01:03:24,360 I AGREE WITH DR. FROGNER AND TO 1674 01:03:24,360 --> 01:03:28,200 ADD TO THAT IN THINKING WHAT 1675 01:03:28,200 --> 01:03:28,840 ORGANIZATIONS ARE DOING 1676 01:03:28,840 --> 01:03:31,280 SPECIFICALLY RELATED TO NURSING 1677 01:03:31,280 --> 01:03:33,920 HOMES, HOW DO WE INCREASE 1678 01:03:33,920 --> 01:03:35,440 PARTNERSHIPS WITH NURSING HOMES 1679 01:03:35,440 --> 01:03:36,360 ESPECIALLY WITH ACADEMIA. 1680 01:03:36,360 --> 01:03:38,560 WE HAVE THE ABILITY TO CONDUCT 1681 01:03:38,560 --> 01:03:39,840 THIS RESEARCH. 1682 01:03:39,840 --> 01:03:42,080 WE'RE ABLE TO IDENTIFY RESOURCES 1683 01:03:42,080 --> 01:03:43,040 TO BE ABLE TO CONDUCT THIS 1684 01:03:43,040 --> 01:03:43,280 RESEARCH. 1685 01:03:43,280 --> 01:03:46,080 HOW DO WE PARTNER WITH NURSING 1686 01:03:46,080 --> 01:03:49,320 HOMES THAT MAY NOT HAVE THE 1687 01:03:49,320 --> 01:03:52,320 RESOURCES OR THE INFORMATION OR 1688 01:03:52,320 --> 01:03:53,520 HOW-TO TO UNDERSTAND HOW WE 1689 01:03:53,520 --> 01:03:54,640 EVALUATE WHAT THEY'RE DOCK AND 1690 01:03:54,640 --> 01:03:56,480 WHAT THEY'RE DOING WELL 1691 01:03:56,480 --> 01:03:58,720 ESPECIALLY TO REALLY SUPPORT 1692 01:03:58,720 --> 01:03:59,720 THAT DISSEMINATION OF 1693 01:03:59,720 --> 01:04:00,000 INFORMATION. 1694 01:04:00,000 --> 01:04:03,640 SO ESPECIALLY FOR NURSING HOMES 1695 01:04:03,640 --> 01:04:05,880 WHO ARE LIKE AND STATES THAT ARE 1696 01:04:05,880 --> 01:04:07,200 DOING SOMETHING GREAT AND SEEING 1697 01:04:07,200 --> 01:04:08,840 GREAT RESULTS, THERE'S A LOT OF 1698 01:04:08,840 --> 01:04:11,240 SUCCESS BUT WE DON'T KNOW HOW TO 1699 01:04:11,240 --> 01:04:12,240 EVALUATE THIS AND COMMUNICATE 1700 01:04:12,240 --> 01:04:12,440 THIS. 1701 01:04:12,440 --> 01:04:14,800 HOW DO WE PARTNER WITH OTHERS 1702 01:04:14,800 --> 01:04:17,040 EQUIPPED TO DO SO TO GET THAT 1703 01:04:17,040 --> 01:04:20,200 INFORMATION OUT IS REALLY 1704 01:04:20,200 --> 01:04:21,520 IMPORTANT. 1705 01:04:21,520 --> 01:04:22,560 AND THEN SOME THOUGHTS AROUND 1706 01:04:22,560 --> 01:04:25,320 WHERE DO WE PUT PROGRAMS AND 1707 01:04:25,320 --> 01:04:27,400 STUDY FIRST AND WITH DR. FROGNER 1708 01:04:27,400 --> 01:04:28,760 THERE'S SO MUCH THAT NEEDS TO 1709 01:04:28,760 --> 01:04:30,520 HAPPEN AND DOESN'T NEED TO 1710 01:04:30,520 --> 01:04:33,960 HAPPEN IN ISOLATION PER SE BUT 1711 01:04:33,960 --> 01:04:35,680 DEFINITELY PROVIDING AND 1712 01:04:35,680 --> 01:04:36,520 SUPPORTING THE DIRECT CARE 1713 01:04:36,520 --> 01:04:39,680 WORKFORCE AND WHAT THAT LOOKS 1714 01:04:39,680 --> 01:04:41,720 LIKE IN THIS COMPREHENSIVE 1715 01:04:41,720 --> 01:04:42,600 SENSE. 1716 01:04:42,600 --> 01:04:44,640 SO IN MAKING SURE THEY ARE ABLE 1717 01:04:44,640 --> 01:04:47,440 TO LIVE ADEQUATELY WITH WHAT 1718 01:04:47,440 --> 01:04:49,080 THAT MEANS, THINKING ABOUT PAY 1719 01:04:49,080 --> 01:04:56,280 AND BENEFITS FOR EXAMPLE, THERE 1720 01:04:56,280 --> 01:04:59,200 ARE EMPOWERED AND SEEING WHAT IS 1721 01:04:59,200 --> 01:05:02,600 HELPING THIS DIRECT CARE 1722 01:05:02,600 --> 01:05:03,960 WORKFORCE LIVE IN THIS WAY THEY 1723 01:05:03,960 --> 01:05:09,600 HAD THE RESOURCES TO DO WHAT 1724 01:05:09,600 --> 01:05:15,840 THEY'RE DOING AND LOOK AT THE 1725 01:05:15,840 --> 01:05:17,160 PROGRAMS AND INITIATIVES. 1726 01:05:17,160 --> 01:05:20,680 >>DR. SPETZ, WE'VE HAD GOOD 1727 01:05:20,680 --> 01:05:23,640 NATURAL EXPERIMENTS I THINK TO 1728 01:05:23,640 --> 01:05:27,280 DR. FROGNER'S LAST POINT AND 1729 01:05:27,280 --> 01:05:29,240 MEDICAID AND HOW DO WE LEARN 1730 01:05:29,240 --> 01:05:32,440 FROM THOSE HOME BASED SERVICES 1731 01:05:32,440 --> 01:05:34,400 AND OPPORTUNITIES WITH IN FLEX 1732 01:05:34,400 --> 01:05:38,200 DOLLARS AND POINT STATES TO THE 1733 01:05:38,200 --> 01:05:40,440 RIGHT DIRECTION OF POLICY. 1734 01:05:40,440 --> 01:05:42,480 I'D BE EXCITED TO SEE ADDITIONAL 1735 01:05:42,480 --> 01:05:43,480 WORK THERE BECAUSE I THINK 1736 01:05:43,480 --> 01:05:44,000 THERE'S REAL OPPORTUNITY. 1737 01:05:44,000 --> 01:05:54,160 THANKS. 1738 01:06:01,680 --> 01:06:03,840 >>PAYING FOR A DIRECT CARE 1739 01:06:03,840 --> 01:06:06,640 WORKER AT HOME IS DIFFERENT THAN 1740 01:06:06,640 --> 01:06:06,920 MEDICAID. 1741 01:06:06,920 --> 01:06:08,160 THERE'S A LOT OF OPPORTUNITIES 1742 01:06:08,160 --> 01:06:09,400 TO THINK THROUGH HOW TO TALK 1743 01:06:09,400 --> 01:06:11,160 ABOUT THIS AND HOW TO ALLOW FOR 1744 01:06:11,160 --> 01:06:13,120 THAT COMPLEXITY AND TO DIVE IN 1745 01:06:13,120 --> 01:06:14,360 BECAUSE I THINK THAT COMPLEXITY 1746 01:06:14,360 --> 01:06:16,560 MAKES PEOPLE AVOID IT AND IT 1747 01:06:16,560 --> 01:06:18,240 TURNS INTO THIS THING NOBODY'S 1748 01:06:18,240 --> 01:06:20,120 REALLY TAKING ON. 1749 01:06:20,120 --> 01:06:21,840 I THINK HAVING A LARGER 1750 01:06:21,840 --> 01:06:23,680 CONVERSATION THAT DESPITE ALL 1751 01:06:23,680 --> 01:06:24,840 THE VARIABILITY AND HOW PROGRAMS 1752 01:06:24,840 --> 01:06:27,040 LOOK LIKE AND HOW HEALTH CARE IS 1753 01:06:27,040 --> 01:06:29,480 DELIVERED, UNDERSTANDING THE KEY 1754 01:06:29,480 --> 01:06:31,280 PIECES THAT TRANSCEND SETTING 1755 01:06:31,280 --> 01:06:32,480 AND INDIVIDUAL POLICIES OF THE 1756 01:06:32,480 --> 01:06:34,120 STATE I THINK IS IMPORTANT AND I 1757 01:06:34,120 --> 01:06:39,400 THINK THAT'S SOMETHING AS A 1758 01:06:39,400 --> 01:06:42,640 COLLECTIVE GROUP WE CAN DO AND 1759 01:06:42,640 --> 01:06:45,760 MORE OF A COLLECTIVE EFFORTS 1760 01:06:45,760 --> 01:06:46,520 RATHER THAN INDIVIDUAL PEOPLE 1761 01:06:46,520 --> 01:06:47,080 WORKING IN THEIR INDIVIDUAL 1762 01:06:47,080 --> 01:06:57,200 AREA. 1763 01:06:58,080 --> 01:06:59,080 AND THERE'S INFORMATION IN THE 1764 01:06:59,080 --> 01:07:00,240 CHAT FOR PEOPLE WHO HAVE THE 1765 01:07:00,240 --> 01:07:03,720 LIVED EXPERIENCE OF WORKING IN 1766 01:07:03,720 --> 01:07:06,600 DIFFERENT DIRECT CARE 1767 01:07:06,600 --> 01:07:07,480 ENVIRONMENTS. 1768 01:07:07,480 --> 01:07:09,520 ONE PERSON IN COMMON WAS 1769 01:07:09,520 --> 01:07:12,080 THINKING ABOUT THE DISTRIBUTION 1770 01:07:12,080 --> 01:07:15,400 OF FOLKS LIVING IN SETTINGS OF 1771 01:07:15,400 --> 01:07:16,960 ASSISTED LIVING FACILITIES AND 1772 01:07:16,960 --> 01:07:18,520 PRACTICAL NURSES TEND TO DO A 1773 01:07:18,520 --> 01:07:19,680 LOT OF THAT LIFTING. 1774 01:07:19,680 --> 01:07:21,960 I WANT TO ACKNOWLEDGE THAT AND 1775 01:07:21,960 --> 01:07:23,160 ANOTHER COMMENT THAT TALKS ABOUT 1776 01:07:23,160 --> 01:07:24,360 A LOT OF THE CHALLENGES AND 1777 01:07:24,360 --> 01:07:26,000 BARRIERS WE SEE AND HOW THEY MAY 1778 01:07:26,000 --> 01:07:29,040 BE SIMILAR IN CONTEXT AND OTHER 1779 01:07:29,040 --> 01:07:31,160 COUNTRIES AND IN COMPARISON TO 1780 01:07:31,160 --> 01:07:33,880 SIMILAR BARRIERS IN EUROPE. 1781 01:07:33,880 --> 01:07:35,960 ACKNOWLEDGING THE POINTS. 1782 01:07:35,960 --> 01:07:37,280 THERE'S A QUESTION ABOUT 1783 01:07:37,280 --> 01:07:39,880 SOLUTIONS RELATED TO MEDICAID 1784 01:07:39,880 --> 01:07:41,360 FUNDING YOU ALL KIND OF TOUCHED 1785 01:07:41,360 --> 01:07:43,240 ON AND IF WE HAVE TIME MAYBE 1786 01:07:43,240 --> 01:07:45,800 WE'LL COME BACK TO THAT. 1787 01:07:45,800 --> 01:07:46,720 I'LL ASK A SPECIFIC QUESTION 1788 01:07:46,720 --> 01:07:48,960 THAT HAS TO DO WITH DIRECT CARE 1789 01:07:48,960 --> 01:07:50,120 WORKERS AND FINANCIAL ABILITY 1790 01:07:50,120 --> 01:07:51,760 AND THE QUESTION IN THE CHAT 1791 01:07:51,760 --> 01:07:54,560 THAT HAS TO DO WITH INDIVIDUAL 1792 01:07:54,560 --> 01:07:56,200 REQUIREMENT SAVINGS PLANS. 1793 01:07:56,200 --> 01:07:58,280 I'M NOT SURE IF DR. GRABOWSKI OR 1794 01:07:58,280 --> 01:08:08,840 OTHERS WANT TO TALK ABOUT POLICY 1795 01:08:08,840 --> 01:08:11,480 OPTION TO SUPPLEMENT SOCIAL 1796 01:08:11,480 --> 01:08:12,320 SECURITY BENEFITS. 1797 01:08:12,320 --> 01:08:17,560 >>THERE'S OPPORTUNITIES TO MAKE 1798 01:08:17,560 --> 01:08:22,840 THIS A BETTER JOB THROUGH 1799 01:08:22,840 --> 01:08:24,960 THROUGH BENEFITS LIKE RETIREMENT 1800 01:08:24,960 --> 01:08:27,320 AND SAVINGS. 1801 01:08:27,320 --> 01:08:28,080 A PACKAGE. 1802 01:08:28,080 --> 01:08:30,680 I'D LIKE TO SEE REFORMS THAT 1803 01:08:30,680 --> 01:08:33,040 MAKE THIS A COMPETITIVE JOB 1804 01:08:33,040 --> 01:08:36,680 WHERE YOU'RE TREATED EQUALLY. 1805 01:08:36,680 --> 01:08:38,760 WHEN CANDIDATES LOOK AT THESE 1806 01:08:38,760 --> 01:08:41,320 POSITIONS IT'S APPLES TO APPLES 1807 01:08:41,320 --> 01:08:42,880 IN TERMS OF THE ACTUAL 1808 01:08:42,880 --> 01:08:43,800 COMPENSATION. 1809 01:08:43,800 --> 01:08:46,400 I'M SURE DR. FROGNER YOU 1810 01:08:46,400 --> 01:08:47,120 PROBABLY HAVE THOUGHTS ON THIS 1811 01:08:47,120 --> 01:08:47,880 AS WELL. 1812 01:08:47,880 --> 01:08:49,320 >>THE COMPETITION ASPECT IS 1813 01:08:49,320 --> 01:08:49,960 SOMETHING NOT TO BE UNDER 1814 01:08:49,960 --> 01:09:00,120 STATED. 1815 01:09:00,880 --> 01:09:01,440 THE COMPETITION FOR LONG-TERM 1816 01:09:01,440 --> 01:09:04,200 CARE WORKERS IS NOT JUST WITHIN 1817 01:09:04,200 --> 01:09:04,880 THE HEALTH CARE INDUSTRY. 1818 01:09:04,880 --> 01:09:06,720 THE HOSPITALS ARE A BIG 1819 01:09:06,720 --> 01:09:07,840 COMPETITOR AND THE OTHER 1820 01:09:07,840 --> 01:09:10,440 COMPETITORS ARE IN THE RETAIL 1821 01:09:10,440 --> 01:09:13,440 AND FOOD SERVICES BASE. 1822 01:09:13,440 --> 01:09:16,840 YOU'RE LOCAL WAL-MART, AMAZON, 1823 01:09:16,840 --> 01:09:18,080 BURGER KING, THEY COMPETE FOR 1824 01:09:18,080 --> 01:09:21,120 THE SAME POOL OF WORKERS BECAUSE 1825 01:09:21,120 --> 01:09:23,600 THERE'S LOW BARRIERS TO ENTRY. 1826 01:09:23,600 --> 01:09:25,240 THERE ISN'T YEARS OF INVESTMENT 1827 01:09:25,240 --> 01:09:26,800 IN YOUR EDUCATION AND SO 1828 01:09:26,800 --> 01:09:28,160 THEREFORE ONE CAN POTENTIALLY 1829 01:09:28,160 --> 01:09:29,960 SHIFT GEARS AND TAKE A JOB IN 1830 01:09:29,960 --> 01:09:31,040 ANOTHER SETTING. 1831 01:09:31,040 --> 01:09:33,160 NOT TO SAY PEOPLE IN THIS FIELD 1832 01:09:33,160 --> 01:09:35,280 AREN'T VERY DEDICATED PEOPLE AND 1833 01:09:35,280 --> 01:09:36,240 HAVE INCREDIBLE AMOUNT OF SKILLS 1834 01:09:36,240 --> 01:09:37,800 THEY'VE LEARNED ON THE JOB. 1835 01:09:37,800 --> 01:09:40,080 WE DON'T REWARD IT VERY WELL. 1836 01:09:40,080 --> 01:09:42,200 SO PEOPLE HAVE TO LOOK ELSEWHERE 1837 01:09:42,200 --> 01:09:44,200 SOMETIMES TO FIND THEIR REWARDS 1838 01:09:44,200 --> 01:09:45,960 SUCH AS HAVING PROMOTION 1839 01:09:45,960 --> 01:09:46,880 OPPORTUNITIES, CAREER PATHWAY 1840 01:09:46,880 --> 01:09:48,680 OPPORTUNITIES AND I THINK WE CAN 1841 01:09:48,680 --> 01:09:50,280 DO MORE TO SUPPORT CAREER 1842 01:09:50,280 --> 01:09:52,560 DEVELOPMENT FOR MANY OF OUR 1843 01:09:52,560 --> 01:09:53,680 HEALTH CARE WORKERS. 1844 01:09:53,680 --> 01:09:55,920 TAKING CARE OF PATIENTS WITH 1845 01:09:55,920 --> 01:09:56,520 DEMENTIA. 1846 01:09:56,520 --> 01:09:58,000 FOR EXAMPLE, HELPING TO TAKE 1847 01:09:58,000 --> 01:10:01,080 CARE OF TUITION IF THEY WANT TO 1848 01:10:01,080 --> 01:10:02,320 PURSUE TUITION. 1849 01:10:02,320 --> 01:10:06,200 IN WASHINGTON WE'RE TRYING OUT 1850 01:10:06,200 --> 01:10:07,240 AN APPRENTICESHIP PROGRAMS TO 1851 01:10:07,240 --> 01:10:10,080 HELP THEM BECOME A LICENSED 1852 01:10:10,080 --> 01:10:10,400 NURSING. 1853 01:10:10,400 --> 01:10:12,960 IT DOES TAKE SOME POLITICAL WILL 1854 01:10:12,960 --> 01:10:15,760 AND PARTNERSHIPS WITHIN A STATE 1855 01:10:15,760 --> 01:10:16,440 HAVING LEADERS IN THE STATE AND 1856 01:10:16,440 --> 01:10:18,840 HAVING PARTNERSHIPS WITH THE 1857 01:10:18,840 --> 01:10:19,760 WORKFORCE EDUCATION AND TRAINING 1858 01:10:19,760 --> 01:10:21,480 BOARDS THAT MAY BE EXISTING IN 1859 01:10:21,480 --> 01:10:22,920 EVERY STATE TO THINK ABOUT HOW 1860 01:10:22,920 --> 01:10:25,960 DO WE CREATE MORE CAREER 1861 01:10:25,960 --> 01:10:27,520 DEVELOPMENT. 1862 01:10:27,520 --> 01:10:30,200 I'M SURE DR. RECKREY AND TRAVERS 1863 01:10:30,200 --> 01:10:32,360 HAVE OTHER THOUGHTS IN THEIR 1864 01:10:32,360 --> 01:10:32,840 SPACES. 1865 01:10:32,840 --> 01:10:35,000 >>I'D LIKE TO CHIME IN A LITTLE 1866 01:10:35,000 --> 01:10:36,520 BIT BECAUSE I DO KNOW BECAUSE I 1867 01:10:36,520 --> 01:10:38,840 WORK IN NEW YORK AND CURRENTLY 1868 01:10:38,840 --> 01:10:42,200 LIVE IN GEORGIA AND THERE'S A 1869 01:10:42,200 --> 01:10:46,720 VAST DIFFERENCE BASED ON WHERE 1870 01:10:46,720 --> 01:10:47,760 YOU LIVE. 1871 01:10:47,760 --> 01:10:50,840 ONE IS MEDICAID ACCESS AND IN 1872 01:10:50,840 --> 01:10:53,560 DIFFERENT STATES CAN CAUSE THE 1873 01:10:53,560 --> 01:10:54,440 TRAINING AND PAYMENT TO BE 1874 01:10:54,440 --> 01:10:56,280 DIFFERENT AND WAGES AND BENEFITS 1875 01:10:56,280 --> 01:10:57,600 AND THAT'S SOMETHING THAT WE 1876 01:10:57,600 --> 01:10:59,520 NEED TO CONSIDER AND WE NEED TO 1877 01:10:59,520 --> 01:11:02,520 KIND OF LOOK AT IT ON A NATIONAL 1878 01:11:02,520 --> 01:11:04,560 LEVEL BECAUSE I DO AGREE WITH 1879 01:11:04,560 --> 01:11:05,560 EVERYONE BUT THIS NEEDS TO BE 1880 01:11:05,560 --> 01:11:08,640 DONE ON A NATIONAL LEVEL SO THEY 1881 01:11:08,640 --> 01:11:13,040 CAN UNDERSTAND THAT MEDICAID 1882 01:11:13,040 --> 01:11:16,200 ACCESS DOES DRIVE THE BENEFIT OF 1883 01:11:16,200 --> 01:11:19,280 WAGE PER STATE WHICH IS 1884 01:11:19,280 --> 01:11:19,560 IMPACTING. 1885 01:11:19,560 --> 01:11:25,640 SOME CNA OR SOME DIRECTOR WOKKER 1886 01:11:25,640 --> 01:11:27,160 WILL GO TO ONE STATE TO ANOTHER 1887 01:11:27,160 --> 01:11:29,640 BECAUSE THE PAY IS BETTER. 1888 01:11:29,640 --> 01:11:33,280 IT'S IMPACTING EVERYWHERE. 1889 01:11:33,280 --> 01:11:34,360 IT'S SOMETHING THEY NEED TO 1890 01:11:34,360 --> 01:11:37,920 ADDRESS ON THE STATE AND 1891 01:11:37,920 --> 01:11:41,160 NATIONAL LEVEL. 1892 01:11:41,160 --> 01:11:42,160 >>THANK YOU VERY MUCH EVERYBODY 1893 01:11:42,160 --> 01:11:48,000 FOR ANSWERING THE QUESTION. 1894 01:11:48,000 --> 01:11:51,800 WE NOW HAVE MICHAEL ELLENBOGGEN 1895 01:11:51,800 --> 01:11:55,280 HAS A QUESTION HE WOULD LIKE TO 1896 01:11:55,280 --> 01:11:55,520 ASK. 1897 01:11:55,520 --> 01:11:58,200 YOU CAN UNMUTE HIM TO ASK HIS 1898 01:11:58,200 --> 01:11:59,440 QUESTION. 1899 01:11:59,440 --> 01:12:01,760 >>MY NAME IS MICHAEL 1900 01:12:01,760 --> 01:12:06,840 ELLENBOGGEN AND I APPRECIATE YOU 1901 01:12:06,840 --> 01:12:07,960 TALKING ABOUT THE WORKFORCE 1902 01:12:07,960 --> 01:12:11,160 HAVING SALARY PROBLEMS WHICH IS 1903 01:12:11,160 --> 01:12:12,120 DEFINITELY A REAL CONCERN. 1904 01:12:12,120 --> 01:12:14,520 HOW CAN YOU GET PEOPLE TO WORK 1905 01:12:14,520 --> 01:12:17,080 AT SUCH LOW SALARIES AND EXPECT 1906 01:12:17,080 --> 01:12:21,600 THEM TO BE GOOD. 1907 01:12:21,600 --> 01:12:23,520 THEN AGAIN YOU ALSO HAVE AN 1908 01:12:23,520 --> 01:12:25,000 ISSUE MORE IMPORTANT WE HAVE TO 1909 01:12:25,000 --> 01:12:26,680 THINK ABOUT IS BESIDES THE 1910 01:12:26,680 --> 01:12:28,440 WORKFORCE NOT HAVING ENOUGH 1911 01:12:28,440 --> 01:12:31,440 PEOPLE THERE BUT WE ASSUME 1912 01:12:31,440 --> 01:12:33,800 PEOPLE WHO ARE CARING FOR THESE 1913 01:12:33,800 --> 01:12:37,280 PEOPLE ARE EDUCATED TO WORK WITH 1914 01:12:37,280 --> 01:12:39,280 PEOPLE WHO ARE LIVING WITH 1915 01:12:39,280 --> 01:12:39,520 DEMENTIA. 1916 01:12:39,520 --> 01:12:42,280 I HAVE TO TELL YOU IT MIGHT WORK 1917 01:12:42,280 --> 01:12:47,920 FOR ALL THE OTHER DISEASES OUT 1918 01:12:47,920 --> 01:12:49,960 THERE TO HAVE STAFF BUT WHEN IT 1919 01:12:49,960 --> 01:12:53,960 COMES TO DEMENTIA WE NEED 1920 01:12:53,960 --> 01:12:54,560 SPECIAL TRAINING. 1921 01:12:54,560 --> 01:12:55,960 I SEE THAT ACROSS THE BOARD AND 1922 01:12:55,960 --> 01:13:00,600 NOT ONLY ME BUT THE FOLKS COMING 1923 01:13:00,600 --> 01:13:03,520 TO WORK IN THE WORKFORCES DO NOT 1924 01:13:03,520 --> 01:13:04,880 HAVE THE REQUIRED EDUCATION 1925 01:13:04,880 --> 01:13:07,280 NEEDED TO WORK WITH PEOPLE WITH 1926 01:13:07,280 --> 01:13:07,560 DEMENTIA. 1927 01:13:07,560 --> 01:13:11,880 IT TAKES A SPECIAL SKILL SET AND 1928 01:13:11,880 --> 01:13:13,240 IT'S NOT ONLY THAT YOU HAVE THE 1929 01:13:13,240 --> 01:13:16,520 PEOPLE OUT THERE WHO ARE TRYING 1930 01:13:16,520 --> 01:13:19,400 TO EDUCATE PEOPLE BUT EVEN IN 1931 01:13:19,400 --> 01:13:22,120 THE TRAINING PROCESS COMING OUT 1932 01:13:22,120 --> 01:13:24,360 OF SCHOOLS. 1933 01:13:24,360 --> 01:13:26,560 THEY ARE NOT TRAINED WELL TO BE 1934 01:13:26,560 --> 01:13:28,240 ABLE TO HANDLE THESE PEOPLE. 1935 01:13:28,240 --> 01:13:29,920 I THINK WE HAVE TO LOOK AT OTHER 1936 01:13:29,920 --> 01:13:31,960 ASPECTS HOW WE FILL THE GAPS 1937 01:13:31,960 --> 01:13:38,800 BECAUSE THEY'RE REALLY IMPORTANT 1938 01:13:38,800 --> 01:13:41,320 GAPS. 1939 01:13:41,320 --> 01:13:44,960 >>THANK YOU, MICHAEL FOR YOUR 1940 01:13:44,960 --> 01:13:46,920 IMPORTANT COMMENT. 1941 01:13:46,920 --> 01:13:48,960 AND ABOUT TRAINING SPECIFICALLY 1942 01:13:48,960 --> 01:13:53,160 RELATED TO TO WORKING WITH THOSE 1943 01:13:53,160 --> 01:13:54,920 LIVING WITH DEMENTIA AND OTHER 1944 01:13:54,920 --> 01:13:55,760 COGNITIVE CHALLENGES. 1945 01:13:55,760 --> 01:13:57,560 THANK YOU SO MUCH. 1946 01:13:57,560 --> 01:13:59,960 WE HAVE A QUESTION/COMMENT IN 1947 01:13:59,960 --> 01:14:02,000 THE CHAT I'LL READ ALOUD TALKING 1948 01:14:02,000 --> 01:14:02,840 ABOUT ANOTHER IMPORTANT ASPECT 1949 01:14:02,840 --> 01:14:04,520 OF THE WORKFORCE IS THE NUMBER 1950 01:14:04,520 --> 01:14:06,800 OF WOMEN AND PEOPLE OF COLOR 1951 01:14:06,800 --> 01:14:08,200 INCLUDING IMMIGRANTS IN THE 1952 01:14:08,200 --> 01:14:08,680 WORKFORCE. 1953 01:14:08,680 --> 01:14:11,400 IT SEEMS THERE'S 1954 01:14:11,400 --> 01:14:13,440 INTERSECTIONALITY IN DISPARATE 1955 01:14:13,440 --> 01:14:16,600 PAY AND COULD THE PANEL MEMBERS 1956 01:14:16,600 --> 01:14:17,680 COMMENT ON ANY WORK ADDRESSING 1957 01:14:17,680 --> 01:14:19,280 THE DISPARITIES THE GROUP MAY 1958 01:14:19,280 --> 01:14:21,920 FACE IN TERMS OF EMPLOYMENT, 1959 01:14:21,920 --> 01:14:22,800 FUTURE OPPORTUNITIES AND 1960 01:14:22,800 --> 01:14:23,960 FINANCIAL STATUS? 1961 01:14:23,960 --> 01:14:25,160 ANYBODY CAN GO AHEAD AND ANSWER 1962 01:14:25,160 --> 01:14:25,360 FIRST. 1963 01:14:25,360 --> 01:14:31,800 THANKS. 1964 01:14:31,800 --> 01:14:36,120 >>WE JUST RELEASED A PAPER ON 1965 01:14:36,120 --> 01:14:37,320 THE NURSING HOME WORKFORCE AND 1966 01:14:37,320 --> 01:14:41,720 AT A HIGH LEVEL WE FOUND 1967 01:14:41,720 --> 01:14:42,840 IMMIGRANT INCREASE THE NUMBER OF 1968 01:14:42,840 --> 01:14:47,040 NURSING HOMEWORKERS AND LEAD TO 1969 01:14:47,040 --> 01:14:51,680 IMPROVED QUALITY OF CARE. 1970 01:14:51,680 --> 01:14:53,440 THAT'S ENCOURAGING. 1971 01:14:53,440 --> 01:14:55,200 I THINK IMMIGRANTS ARE AN 1972 01:14:55,200 --> 01:14:56,040 IMPORTANT PART OF THE WORKFORCE 1973 01:14:56,040 --> 01:14:58,680 BUT THE CONCERN IS THEY CREATE 1974 01:14:58,680 --> 01:15:02,120 THE TWO-TIERED SYSTEM. 1975 01:15:02,120 --> 01:15:04,360 THAT'S UNACCEPTABLE. 1976 01:15:04,360 --> 01:15:06,480 NOBODY IS ARGUING IMMIGRANTS 1977 01:15:06,480 --> 01:15:08,720 SHOULD BE A LOWER-COST 1978 01:15:08,720 --> 01:15:09,080 SUBSTITUTE. 1979 01:15:09,080 --> 01:15:10,560 WE NEED TO RAISE WAGES AND 1980 01:15:10,560 --> 01:15:11,280 BENEFITS FOR EVERYONE. 1981 01:15:11,280 --> 01:15:21,800 WE JUST NEED MORE BODIES AND 1982 01:15:25,920 --> 01:15:27,120 ENFORCING ON THE GROUND ALL THE 1983 01:15:27,120 --> 01:15:28,360 POLICIES THAT HAVE COME UP 1984 01:15:28,360 --> 01:15:30,560 DURING THE SESSION NEED TO BE IN 1985 01:15:30,560 --> 01:15:32,800 PLACE BECAUSE WITHOUT THAT YOU 1986 01:15:32,800 --> 01:15:35,000 DO HAVE THIS TWO-TIERED SYSTEM 1987 01:15:35,000 --> 01:15:36,680 AND ONCE AGAIN THAT'S NOT WHAT 1988 01:15:36,680 --> 01:15:39,960 ANY OF US WANT. 1989 01:15:39,960 --> 01:15:42,640 WE WANT IMMIGRANT ARE SOME OF 1990 01:15:42,640 --> 01:15:45,440 OUR BEST WORKERS. 1991 01:15:45,440 --> 01:15:47,520 PLEASE DO NOT -- THE TAKEAWAY IS 1992 01:15:47,520 --> 01:15:48,360 NOT THEY'RE LOWER COST 1993 01:15:48,360 --> 01:15:55,240 SUBSTITUTE BY ANY STRETCH. 1994 01:15:55,240 --> 01:15:57,200 >>I THINK IT'S IMPORTANT TO 1995 01:15:57,200 --> 01:15:58,400 RECOGNIZE AND ACKNOWLEDGE THE 1996 01:15:58,400 --> 01:16:03,440 ROLE OF IMMIGRANTS IN OUR HEALTH 1997 01:16:03,440 --> 01:16:05,280 CARE WORKFORCE. 1998 01:16:05,280 --> 01:16:08,120 WE HAVE TO LOOK AT OUR POLICIES 1999 01:16:08,120 --> 01:16:12,360 AND SUPPORT WHAT'S HAPPENING TO 2000 01:16:12,360 --> 01:16:13,720 THIS WORKFORCE. 2001 01:16:13,720 --> 01:16:15,200 WE LEVERS WITHIN HEALTH CARE 2002 01:16:15,200 --> 01:16:17,320 WORKING WITH THE MEDICAID 2003 01:16:17,320 --> 01:16:20,720 REIMBURSEMENT SYSTEM AND MAKING 2004 01:16:20,720 --> 01:16:22,080 SURE THOSE ARE COMPREHENSIVE AND 2005 01:16:22,080 --> 01:16:23,640 SUPPORTIVE OF FAMILIES AND HAVE 2006 01:16:23,640 --> 01:16:26,240 TO LOOK AT OTHER SOCIAL POLICIES 2007 01:16:26,240 --> 01:16:27,400 BEING DISCUSSED SUCH AS 2008 01:16:27,400 --> 01:16:28,480 CHILDCARE POLICIES. 2009 01:16:28,480 --> 01:16:32,880 SOMETHING THAT HAS BEEN 2010 01:16:32,880 --> 01:16:38,520 MENTIONED A COUPLE TIMES IS THAT 2011 01:16:38,520 --> 01:16:41,360 THIS WORKFORCE TENDS TO BE 2012 01:16:41,360 --> 01:16:43,040 PREDOMINANTLY WOMEN AND MANY OF 2013 01:16:43,040 --> 01:16:45,560 THE PEOPLE CARING FOR PATIENTS 2014 01:16:45,560 --> 01:16:47,560 LIVING WITH DEMENTIA CARE FOR 2015 01:16:47,560 --> 01:16:50,800 CHURCH AT HOME. 2016 01:16:50,800 --> 01:16:53,360 WE HAVE TO MAKE SURE WE PROVIDE 2017 01:16:53,360 --> 01:16:54,520 GOOD SUPPORTIVE CHILDCARE 2018 01:16:54,520 --> 01:16:56,040 BENEFITS AND THAT GAP EXISTS IN 2019 01:16:56,040 --> 01:16:59,240 TERMS OF ACCESS TO AFFORDABLE 2020 01:16:59,240 --> 01:17:00,800 CHILDCARE ACROSS THE SOCIO 2021 01:17:00,800 --> 01:17:02,600 ECONOMIC SPECTRUM. 2022 01:17:02,600 --> 01:17:04,760 WE HAVE TO THINK OF THE 2023 01:17:04,760 --> 01:17:05,120 INSURANCE PIECE. 2024 01:17:05,120 --> 01:17:11,920 WE HAVE HAD POLICIES TO ENSURE 2025 01:17:11,920 --> 01:17:14,800 HAVE COVERAGE AND LOOK AT THE 2026 01:17:14,800 --> 01:17:16,560 DISPARITIES THAT ALREADY EXIST 2027 01:17:16,560 --> 01:17:18,360 AND APPLY THEM TO THE SAME 2028 01:17:18,360 --> 01:17:20,240 WORKFORCE RECOGNIZING MANY OF 2029 01:17:20,240 --> 01:17:24,400 OUR WEEKWORKERS LIVING WITH 2030 01:17:24,400 --> 01:17:25,080 DEMENTIA STRUGGLE WITH THE SAME 2031 01:17:25,080 --> 01:17:33,120 ISSUES OTHERS DO IN OUR COUNTRY. 2032 01:17:33,120 --> 01:17:35,640 >>I'LL ADD IN MORE THOUGH WE 2033 01:17:35,640 --> 01:17:37,160 SEE LOW PAY AMONG THE DIRECT 2034 01:17:37,160 --> 01:17:42,520 CARE WORKFORCE WE SEE LOW PAY 2035 01:17:42,520 --> 01:17:46,640 AMONG PEOPLE OF COLOR AND 2036 01:17:46,640 --> 01:17:49,320 DIFFERENCES IN SHIFT FOR EXAMPLE 2037 01:17:49,320 --> 01:17:53,880 A PAPER MYSELF AND DR. GRABOWSKI 2038 01:17:53,880 --> 01:17:56,720 WERE ON FOUND FEWER VACCINATIONS 2039 01:17:56,720 --> 01:17:59,440 AND TESTING AMONG STAFF THAT 2040 01:17:59,440 --> 01:18:00,720 WORKED THE NIGHT SHIFT COMPARED 2041 01:18:00,720 --> 01:18:03,280 TO OTHER SHIFT. 2042 01:18:03,280 --> 01:18:04,840 WHEN THINKING ABOUT REQUIREMENT 2043 01:18:04,840 --> 01:18:06,040 FOR VACCINATION OR TESTING 2044 01:18:06,040 --> 01:18:08,240 WITHIN NURSING HOME SETTINGS AND 2045 01:18:08,240 --> 01:18:11,360 WHERE THE GAPS MIGHT BE THERE 2046 01:18:11,360 --> 01:18:15,080 MAY NOT BE ENOUGH EDUCATION 2047 01:18:15,080 --> 01:18:16,240 OPPORTUNITIES WITHIN THE NIGHT 2048 01:18:16,240 --> 01:18:17,480 SHIFT COMPARED TO THE DAY SHIFT 2049 01:18:17,480 --> 01:18:20,720 AND SEE THE CONSEQUENCES OF NOT 2050 01:18:20,720 --> 01:18:22,960 HAVING ADEQUATE SUPPORT STAFF 2051 01:18:22,960 --> 01:18:24,680 AMONG THE NIGHT SHIFT AND WHO IS 2052 01:18:24,680 --> 01:18:26,040 LIKELY TO BE ON THE NIGHT SHIFT 2053 01:18:26,040 --> 01:18:28,440 AND PEOPLE OF COLOR AND SEE THE 2054 01:18:28,440 --> 01:18:31,400 UNINTENDED CONSEQUENCES OF THAT. 2055 01:18:31,400 --> 01:18:32,920 WE'VE SEEP WORK WHERE DIRECT 2056 01:18:32,920 --> 01:18:34,200 CARE STAFF SAY IF IT'S MAJORITY 2057 01:18:34,200 --> 01:18:39,600 OF PEOPLE OF COLOR WORKING YOU 2058 01:18:39,600 --> 01:18:42,200 SEE SHORTER STAFF AND THE STAFF 2059 01:18:42,200 --> 01:18:43,680 IS SHORTER THAN IF IT WERE 2060 01:18:43,680 --> 01:18:47,960 PRIMARILY NON PEOPLE OF COLOR 2061 01:18:47,960 --> 01:18:50,080 AND SEE SYSTEMIC RACISM WHERE WE 2062 01:18:50,080 --> 01:18:52,520 SEE THE DISPARITIES. 2063 01:18:52,520 --> 01:18:53,560 SOME THINGS WE'RE SEEING COMING 2064 01:18:53,560 --> 01:18:58,840 OUT THE RECOMMENDATIONS FROM THE 2065 01:18:58,840 --> 01:19:07,080 NASEM REPORT CALLED FOR 2066 01:19:07,080 --> 01:19:11,120 DIVERSITY, EQUITY AND INCLUSIVE 2067 01:19:11,120 --> 01:19:12,440 TRAINING AND HOW IT AFFECTS 2068 01:19:12,440 --> 01:19:15,720 WORKERS OF ALL RACES AND 2069 01:19:15,720 --> 01:19:19,600 ETHNICITIES AND CALL FOR A 2070 01:19:19,600 --> 01:19:21,240 MEASURE TO UNDERSTAND HOW 2071 01:19:21,240 --> 01:19:22,200 WHATEVER EFFORTS THEY'RE 2072 01:19:22,200 --> 01:19:24,080 IMPLEMENTING HOW THEY'RE 2073 01:19:24,080 --> 01:19:24,720 CHANGING THE INEQUITIES WE ARE 2074 01:19:24,720 --> 01:19:33,960 SEEING. 2075 01:19:33,960 --> 01:19:35,880 WE TALKED ABOUT DATA AND IF WE 2076 01:19:35,880 --> 01:19:37,360 DON'T HAVE DEMOGRAPHICS BY 2077 01:19:37,360 --> 01:19:38,960 GENDER AND RACE ETHNICITY AND 2078 01:19:38,960 --> 01:19:41,240 HOW DO WE ARE ABLE TO UNDERSTAND 2079 01:19:41,240 --> 01:19:43,320 ON A NATIONAL LEVEL WHAT'S GOING 2080 01:19:43,320 --> 01:19:44,560 ON AND WHAT CHANGES ARE 2081 01:19:44,560 --> 01:19:47,440 HAPPENING AND LAST THING I'LL 2082 01:19:47,440 --> 01:19:49,480 BRING UP ARP AND THINKING OF 2083 01:19:49,480 --> 01:19:50,640 HOME AND COMMUNITY SETTING AND 2084 01:19:50,640 --> 01:19:52,080 THE NURSING HOME SETTING THEY 2085 01:19:52,080 --> 01:19:57,400 HAVE A LONG-TERM SERVICES AND 2086 01:19:57,400 --> 01:19:58,400 SUPPORT SCORECARD THAT LOOKS AT 2087 01:19:58,400 --> 01:20:01,160 INDICATE WITHIN THE HOME AND 2088 01:20:01,160 --> 01:20:02,200 COMMUNITY-BASED AND NURSING HOME 2089 01:20:02,200 --> 01:20:04,800 SETTING THAT REFLECTS QUALITY OF 2090 01:20:04,800 --> 01:20:07,280 CARE FOR OLDER ADULTS AND 2091 01:20:07,280 --> 01:20:09,000 INCLUDES EQUITY AND FOCUS ON THE 2092 01:20:09,000 --> 01:20:11,520 WORKFORCE TOO. 2093 01:20:11,520 --> 01:20:13,480 THERE WILL BE A MEASURE RELATED 2094 01:20:13,480 --> 01:20:14,800 TO WORKFORCE AND EQUITY SO 2095 01:20:14,800 --> 01:20:16,320 STATES CAN SEE HOW THEY'RE 2096 01:20:16,320 --> 01:20:18,240 FARING AND CHANGING ACROSS YEARS 2097 01:20:18,240 --> 01:20:20,000 WITH REGARDS TO EQUITY AND THEIR 2098 01:20:20,000 --> 01:20:23,680 WORKFORCE. 2099 01:20:23,680 --> 01:20:28,120 I WANTED TO ECHO ONE THING THAT 2100 01:20:28,120 --> 01:20:29,240 WAS AN IMPORTANT PART DURING THE 2101 01:20:29,240 --> 01:20:30,720 PRESENTATION AND CAME UP IN THE 2102 01:20:30,720 --> 01:20:31,000 QUESTION. 2103 01:20:31,000 --> 01:20:36,200 THE QUESTION OF VALUE AND 2104 01:20:36,200 --> 01:20:46,040 RESPECT HOW DO WE VALUE IT AND 2105 01:20:46,040 --> 01:20:52,240 SEE IT AS ESSENTIAL? 2106 01:20:52,240 --> 01:20:57,280 IT'S EASY TO REPLICATE THIS AND 2107 01:20:57,280 --> 01:20:58,880 IN ADDITION TO POLICIES AND 2108 01:20:58,880 --> 01:20:59,920 DIRECT THINGS TO SUPPORT I THINK 2109 01:20:59,920 --> 01:21:04,560 WE NEED TO STEP BACK AND HOW DO 2110 01:21:04,560 --> 01:21:07,640 WE THINK ABOUT CARE WHETHER IT'S 2111 01:21:07,640 --> 01:21:13,360 FAMILY CAREGIVERS OR DIRECT CARE 2112 01:21:13,360 --> 01:21:13,560 WORKERS? 2113 01:21:13,560 --> 01:21:17,360 HOW DO WE FRAME THE IMPORTANCE 2114 01:21:17,360 --> 01:21:18,800 OF THE CARE FOR PEOPLE WITH 2115 01:21:18,800 --> 01:21:21,320 DEMENTIA AND ELEVATE THIS AS A 2116 01:21:21,320 --> 01:21:22,680 ROLE THAT'S ESSENTIAL RATHER 2117 01:21:22,680 --> 01:21:24,440 THAN AN AFTER THOUGHT AFTER 2118 01:21:24,440 --> 01:21:35,000 MEDICAL NEEDS ARE TAKEN CARE OF. 2119 01:21:35,720 --> 01:21:38,320 >>I HAVE A QUESTION I'D LOVE TO 2120 01:21:38,320 --> 01:21:42,240 HEAR THE PANEL'S THOUGHTS OF ON 2121 01:21:42,240 --> 01:21:44,680 SOCIAL WORK IN SERVING NEEDS OF 2122 01:21:44,680 --> 01:21:46,160 PEOPLE LIVING WITH DEMENTIA AND 2123 01:21:46,160 --> 01:21:48,800 THEIR CARE PARTNERS. 2124 01:21:48,800 --> 01:21:49,720 MANY SOCIAL WORKERS AND 2125 01:21:49,720 --> 01:21:52,200 COMMUNITY HEALTH WORKERS ARE NOT 2126 01:21:52,200 --> 01:21:54,200 FORMALLY EMBEDDED WITHIN HEALTH 2127 01:21:54,200 --> 01:21:54,560 SYSTEMS. 2128 01:21:54,560 --> 01:21:55,880 SOME MIGHT BE IN PRIVATE 2129 01:21:55,880 --> 01:21:57,840 PRACTICE AND IN COMMUNITY-BASED 2130 01:21:57,840 --> 01:22:01,960 ORGANIZATIONS SOMEWHAT DISTINCT 2131 01:22:01,960 --> 01:22:04,000 FROM THE HEALTH CARE SYSTEM. 2132 01:22:04,000 --> 01:22:09,480 I WONDER YOUR THOUGHTS HOW TO 2133 01:22:09,480 --> 01:22:20,000 BRIDGE THAT WORKFORCE INTO THE 2134 01:22:21,440 --> 01:22:27,400 OVER ALL SUPPORT OF SUPPORTING 2135 01:22:27,400 --> 01:22:28,000 PEOPLE WITH DEMENTIA. 2136 01:22:28,000 --> 01:22:34,000 >>AS MICHAEL STATED EARLIER I 2137 01:22:34,000 --> 01:22:36,040 CAN HEAR HIS PASSION IN HIS 2138 01:22:36,040 --> 01:22:41,560 VOICE AND THAT'S A CONCERN FOR 2139 01:22:41,560 --> 01:22:43,920 ALL OF US THAT MOST PEOPLE 2140 01:22:43,920 --> 01:22:46,800 SERVING DEMENTIA PATIENTS ARE 2141 01:22:46,800 --> 01:22:49,560 NOT PROPERLY TRAINED AND AS MUCH 2142 01:22:49,560 --> 01:22:50,760 AS WE ADVOCATE FOR PEOPLE 2143 01:22:50,760 --> 01:22:51,560 SOMETIMES THEY HIRE PEOPLE NOT 2144 01:22:51,560 --> 01:22:52,880 TRAINED BECAUSE THEY NEED A BODY 2145 01:22:52,880 --> 01:22:57,720 IN THE BUILDING. 2146 01:22:57,720 --> 01:23:05,760 I DO UNDERSTAND I SEE THE ISSUE 2147 01:23:05,760 --> 01:23:08,120 WHERE IT NEEDS TO BE ADDRESSED 2148 01:23:08,120 --> 01:23:09,120 FOR THE CARE FOR DEMENTIA 2149 01:23:09,120 --> 01:23:10,760 PATIENT AS WE STATED EARLIER 2150 01:23:10,760 --> 01:23:12,520 BEING A SOCIAL WORKER YOU'RE 2151 01:23:12,520 --> 01:23:20,120 TRAINED ON A HIGH LEVEL. 2152 01:23:20,120 --> 01:23:21,520 AND THEREFORE SERVING ON A HIGH 2153 01:23:21,520 --> 01:23:24,880 LEVEL MAY NOT BE THE SAME UNIQUE 2154 01:23:24,880 --> 01:23:27,160 SERVICE THAT SOM SOMEONE WHO HAS 2155 01:23:27,160 --> 01:23:28,520 DEMENTIA NEEDS. 2156 01:23:28,520 --> 01:23:31,560 THERE'S A GAP IN THAT AND I KNOW 2157 01:23:31,560 --> 01:23:36,600 THEY'RE DOING AS BEST THEY CAN 2158 01:23:36,600 --> 01:23:42,720 TO SERVE THAT POPULATION BUT 2159 01:23:42,720 --> 01:23:44,680 FAMILY STRUGGLES WITH HOW DO WE 2160 01:23:44,680 --> 01:23:46,680 BRIDGE THE GAP BETWEEN CARE FOR 2161 01:23:46,680 --> 01:23:47,760 LOVED ONES AND CONTINUING TO 2162 01:23:47,760 --> 01:23:50,600 LIVE A HEALTHY LIFE AND A SOCIAL 2163 01:23:50,600 --> 01:23:55,920 WORKER CAN HELP WITH TIMES BUT 2164 01:23:55,920 --> 01:24:00,240 THEY STRUGGLE BECAUSE OF THE 2165 01:24:00,240 --> 01:24:02,240 SKILL SET IS NOT UNIQUE. 2166 01:24:02,240 --> 01:24:02,920 WE KNOW THERE'S SPECIFIC 2167 01:24:02,920 --> 01:24:07,800 PROGRAMS AVAILABLE JUST FOR 2168 01:24:07,800 --> 01:24:10,440 PEOPLE WHO WANT TO SERVE 2169 01:24:10,440 --> 01:24:11,760 DEMENTIA PATIENTS BUT IT CAN 2170 01:24:11,760 --> 01:24:16,960 CAUSE AN ISSUE WITH THAT. 2171 01:24:16,960 --> 01:24:19,840 >>THANK YOU, MELISSA. 2172 01:24:19,840 --> 01:24:21,080 I'LL ADD ONE COMMENT AND GIVE 2173 01:24:21,080 --> 01:24:22,240 THE FINAL QUESTION AND 2174 01:24:22,240 --> 01:24:23,800 ACKNOWLEDGE THE KNOWLEDGE IN 2175 01:24:23,800 --> 01:24:25,400 CHAT ABOUT APPROPRIATE TRAINING. 2176 01:24:25,400 --> 01:24:28,000 THAT DISCUSSION HAS BEEN HAD AND 2177 01:24:28,000 --> 01:24:29,000 ACKNOWLEDGING THE ADDITIONAL 2178 01:24:29,000 --> 01:24:31,440 POINT OF NOT MAKING ANOTHER TIME 2179 01:24:31,440 --> 01:24:33,240 PRESSURE FOR STRESSED WORKERS. 2180 01:24:33,240 --> 01:24:33,960 THAT CHALLENGE REMAINS AND 2181 01:24:33,960 --> 01:24:35,000 CONTINUES BOTH THE NEED FOR 2182 01:24:35,000 --> 01:24:36,600 TRAINING AND BALANCING THAT WITH 2183 01:24:36,600 --> 01:24:40,400 NOT OVER LOADING THOSE WHO MIGHT 2184 01:24:40,400 --> 01:24:41,760 RECEIVE TRAINING. 2185 01:24:41,760 --> 01:24:42,760 FOR OUR FINAL QUESTION IN THE 2186 01:24:42,760 --> 01:24:45,560 CHAT ONE SAYS IN SOME AREAS THE 2187 01:24:45,560 --> 01:24:47,560 PRICE OF CAREGIVERS THROUGH 2188 01:24:47,560 --> 01:24:49,040 AGENCIES EXCEEDS $30 PER HOUR. 2189 01:24:49,040 --> 01:24:50,080 WITH A THIRD OF THAT GOING TO 2190 01:24:50,080 --> 01:24:50,520 THE AGENCY. 2191 01:24:50,520 --> 01:24:53,640 THIS IS FAR OUT OF RANGE FOR ALL 2192 01:24:53,640 --> 01:24:56,440 EXCEPT EXTREMELY WEALTHY. 2193 01:24:56,440 --> 01:24:57,480 WHAT CAN BE DONE IN THE SHORT 2194 01:24:57,480 --> 01:24:59,320 TERM TO MAKE THE NEEDED CARE 2195 01:24:59,320 --> 01:24:59,640 AFFORDABLE? 2196 01:24:59,640 --> 01:25:08,360 ANYBODY CAN RESPOND. 2197 01:25:08,360 --> 01:25:11,200 >>THAT'S A DIFFICULT QUESTION. 2198 01:25:11,200 --> 01:25:13,200 THERE'S ATTENTION TO AGENCIES IN 2199 01:25:13,200 --> 01:25:15,400 LIGHT OF THE TRAVEL NURSING 2200 01:25:15,400 --> 01:25:16,120 CONVERSATIONS MANY PROBABLY READ 2201 01:25:16,120 --> 01:25:21,320 ABOUT. 2202 01:25:21,320 --> 01:25:24,560 IT'S HARD TO KNOW IF IT'S A 2203 01:25:24,560 --> 01:25:27,080 LONG-TERM GAME OR NOT. 2204 01:25:27,080 --> 01:25:28,680 PROBABLY SOMETHING WE NEED MORE 2205 01:25:28,680 --> 01:25:32,320 REGULATORS TO PROVIDE OVERSIGHT. 2206 01:25:32,320 --> 01:25:35,840 I BELIEVE THE GAO HAS A STUDY OR 2207 01:25:35,840 --> 01:25:38,200 I THINK BILL TO CALL GAO TO 2208 01:25:38,200 --> 01:25:39,520 POTENTIALLY STUDY THE ROLE OF 2209 01:25:39,520 --> 01:25:41,400 AGENCIES ESPECIALLY DURING THE 2210 01:25:41,400 --> 01:25:41,680 PANDEMIC. 2211 01:25:41,680 --> 01:25:43,320 I THINK THERE'S AN OPPORTUNITY 2212 01:25:43,320 --> 01:25:44,520 TO BETTER UNDERSTAND THAT. 2213 01:25:44,520 --> 01:25:48,040 THIS GOES BACK TO DATA. 2214 01:25:48,040 --> 01:25:50,720 A LOT OF WE AS RESEARCHERS ARE 2215 01:25:50,720 --> 01:25:51,880 BLIND TO THE FINANCIAL 2216 01:25:51,880 --> 01:25:52,760 TRANSACTIONS TAKING PLACE BEHIND 2217 01:25:52,760 --> 01:25:55,440 THE PAYMENT OF WORKERS. 2218 01:25:55,440 --> 01:25:58,200 I THINK DR. GRABOWSKI AND 2219 01:25:58,200 --> 01:25:59,600 DR. TRAVERS HAVE DONE A LOT OF 2220 01:25:59,600 --> 01:26:02,080 GREAT WORK WITH AVAILABLE DATA 2221 01:26:02,080 --> 01:26:04,200 MEDICARE PUT OUT THAT'S PUBLICLY 2222 01:26:04,200 --> 01:26:05,760 AVAILABLE TO TRACK WHAT WE KNOW 2223 01:26:05,760 --> 01:26:06,920 ABOUT THE WORKFORCE. 2224 01:26:06,920 --> 01:26:08,400 WE'RE FLYING BLIND WHEN IT COMES 2225 01:26:08,400 --> 01:26:08,760 TO THE DATA. 2226 01:26:08,760 --> 01:26:10,960 IT MAKES IT HARD TO MAKE SOLID 2227 01:26:10,960 --> 01:26:12,400 STATEMENTS HOW BIG OF A PROBLEM 2228 01:26:12,400 --> 01:26:19,400 THIS IS AND MAKE THIS AN 2229 01:26:19,400 --> 01:26:19,680 ARGUMENT. 2230 01:26:19,680 --> 01:26:20,400 WE NEED BETTER TRANSPARENCY AT 2231 01:26:20,400 --> 01:26:20,800 THAT LEVEL. 2232 01:26:20,800 --> 01:26:24,680 >>THANK YOU FOR ENDING US ON 2233 01:26:24,680 --> 01:26:26,040 THE COMMENT ABOUT MORE AND 2234 01:26:26,040 --> 01:26:27,120 BETTER DATA TO ENHANCE THE 2235 01:26:27,120 --> 01:26:27,840 RESEARCH ENTERPRISE. 2236 01:26:27,840 --> 01:26:29,720 THANK YOU FOR YOUR TIME AND 2237 01:26:29,720 --> 01:26:31,480 WONDERFUL DISCUSSION AND I'LL 2238 01:26:31,480 --> 01:26:33,520 TURN THINGS BACK TO ANDREA. 2239 01:26:33,520 --> 01:26:34,080 THANK YOU. 2240 01:26:34,080 --> 01:26:34,920 >>WONDERFUL. 2241 01:26:34,920 --> 01:26:45,000 THANK YOU ALL SO MUCH FOR A 2242 01:26:45,000 --> 01:26:45,920 REBUST DISCUSSION STIMULATED 2243 01:26:45,920 --> 01:26:47,560 FROM QUESTIONS FROM THE 2244 01:26:47,560 --> 01:26:47,800 AUDIENCE. 2245 01:26:47,800 --> 01:26:49,360 WE'LL TRANSITION TO A 35-MINUTE 2246 01:26:49,360 --> 01:26:51,880 BREAK AND RESUME AT 1:00 P.M. 2247 01:26:51,880 --> 01:26:53,280 EASTERN STANDARD TIME FOR OUR 2248 01:26:53,280 --> 01:26:56,080 NEXT SESSION THAT'S GOING TO 2249 01:26:56,080 --> 01:26:59,040 DIVE INTO MORE DETAILED ECONOMIC 2250 01:26:59,040 --> 01:27:00,240 IMPACTS AND APPROACHES. 2251 01:27:00,240 --> 01:27:04,080 ADDITIONALLY I WOULD LIKE TO 2252 01:27:04,080 --> 01:27:05,080 REMIND EVERYONE PARTICIPATING IF 2253 01:27:05,080 --> 01:27:06,360 YOU HAVE QUESTIONS YOU WERE 2254 01:27:06,360 --> 01:27:08,040 UNABLE TO ASK OVER THE COURSE OF 2255 01:27:08,040 --> 01:27:09,600 THE THREE DAYS OF THE SUMMIT OR 2256 01:27:09,600 --> 01:27:13,640 IF YOU HAVE INPUT TO SHARE WITH 2257 01:27:13,640 --> 01:27:14,320 SUMMIT PLANNERS AND THE NIA 2258 01:27:14,320 --> 01:27:16,560 YOU'RE INVITED TO JOIN US AT 2259 01:27:16,560 --> 01:27:18,240 4:00 P.M. EASTERN STANDARD TIME 2260 01:27:18,240 --> 01:27:21,040 TODAY FOR A POST-SUMMIT 2261 01:27:21,040 --> 01:27:22,920 LISTENING SESSION AND WE 2262 01:27:22,920 --> 01:27:24,760 ESPECIALLY ENCOURAGE THOSE 2263 01:27:24,760 --> 01:27:27,280 LIVING WITH COGNITIVE SYMPTOMS 2264 01:27:27,280 --> 01:27:28,120 AND/OR CARE PARTNERS AND 2265 01:27:28,120 --> 01:27:29,120 CAREGIVERS TO JOIN US. 2266 01:27:29,120 --> 01:27:30,600 WE LOOK FORWARD TO HEARING YOUR 2267 01:27:30,600 --> 01:27:32,440 QUESTIONS AND FEEDBACK AT THAT 2268 01:27:32,440 --> 01:27:34,240 TIME IF YOU DO JOIN. 2269 01:27:34,240 --> 01:27:37,960 SEE YOU ALL IN 35 MINUTES. 2270 01:27:37,960 --> 01:27:47,120 >>WELCOME BACK. 2271 01:27:47,120 --> 01:27:50,680 I'M JULIE ZISSIMOPOULOS WITH 2272 01:27:50,680 --> 01:27:54,160 ANDREA GILMORE-BYKOVSKYI AND 2273 01:27:54,160 --> 01:27:59,040 I'LL INVITE CO-CHAIRS OF SESSION 2274 01:27:59,040 --> 01:28:06,520 7 PEI-JUNG LIN AND PRISCILLA 2275 01:28:06,520 --> 01:28:06,720 NOVAK. 2276 01:28:06,720 --> 01:28:07,960 >>I'M A PROGRAM OFFICIAL WITH 2277 01:28:07,960 --> 01:28:10,600 THE NATIONAL INSTITUTE ON AGING. 2278 01:28:10,600 --> 01:28:13,320 15 YEARS AGO I WAS A HOME HEALTH 2279 01:28:13,320 --> 01:28:17,120 AID WITH MULTIPLE JOBS. 2280 01:28:17,120 --> 01:28:19,280 EVERY DAY WITH MY ALZHEIMER'S 2281 01:28:19,280 --> 01:28:20,640 PATIENTS START THE STATEMENT. 2282 01:28:20,640 --> 01:28:24,080 I KNOCK ON THE DOOR AND SAY 2283 01:28:24,080 --> 01:28:27,760 HELLO, I'M PRISCILLA AND HERE TO 2284 01:28:27,760 --> 01:28:33,640 HELP MY PATIENT HAS HER NAME 2285 01:28:33,640 --> 01:28:34,280 CHANGED BUT HAS SIMILAR ISSUES 2286 01:28:34,280 --> 01:28:39,600 OF ALZHEIMER'S DISEASE AND 2287 01:28:39,600 --> 01:28:45,200 RELATED DEMENTIAS. 2288 01:28:45,200 --> 01:28:50,880 MISS THOMAS LIVED ALONE ON A 2289 01:28:50,880 --> 01:28:51,640 BEAUTIFUL DOUBLE LOT. 2290 01:28:51,640 --> 01:28:54,480 SHE LIVED IN THE SAME HOUSE OVER 2291 01:28:54,480 --> 01:28:56,960 50 YEARS AND HAD ALWAYS BEEN 2292 01:28:56,960 --> 01:28:58,600 KNOWN FOR HER HONEST WAYS AND 2293 01:28:58,600 --> 01:28:59,520 KIND HEART. 2294 01:28:59,520 --> 01:29:03,680 LIKE MANY PEOPLE HER PATH TO 2295 01:29:03,680 --> 01:29:04,280 DEMENTIA DIAGNOSIS HAD BEEN 2296 01:29:04,280 --> 01:29:07,400 THROUGH FINANCIAL FRAUD. 2297 01:29:07,400 --> 01:29:13,440 ONE DAY MISS THOMAS RECEIVED A 2298 01:29:13,440 --> 01:29:18,160 LETTER THAT ONE OF HER OAK TREES 2299 01:29:18,160 --> 01:29:21,480 WAS DISEASED AND NEEDED TO BE 2300 01:29:21,480 --> 01:29:23,320 REMOVED AND SENT A CHECK FOR 2301 01:29:23,320 --> 01:29:23,920 $50,000. 2302 01:29:23,920 --> 01:29:27,080 THE DAY THE COMPANY CAME TO TAKE 2303 01:29:27,080 --> 01:29:28,640 DOWN THE TREE MISS THOMAS NOT 2304 01:29:28,640 --> 01:29:31,440 HER REAL NAME, CALLED HER 2305 01:29:31,440 --> 01:29:35,360 NEAREST RELATIVE, NIECE IN 2306 01:29:35,360 --> 01:29:37,040 DISTRESS. 2307 01:29:37,040 --> 01:29:38,960 SHE HAD NO RECOLLECTION OF 2308 01:29:38,960 --> 01:29:40,120 REMOVAL OF ANY TREES. 2309 01:29:40,120 --> 01:29:42,920 HER NIECE ASKED HER TO EXPLAIN 2310 01:29:42,920 --> 01:29:45,320 BUT TRY AS SHE MIGHT, SHE COULD 2311 01:29:45,320 --> 01:29:46,600 NOT EXPLAIN. 2312 01:29:46,600 --> 01:29:49,080 THE NEXT DAY THE NIECE WAS ON 2313 01:29:49,080 --> 01:29:53,320 THE PHONE WITH THE BANK AND 2314 01:29:53,320 --> 01:30:00,920 LEARNED THE EXORBITANT PRICE SHE 2315 01:30:00,920 --> 01:30:01,120 PAID. 2316 01:30:01,120 --> 01:30:02,800 MANY FAMILIES ON THE SESSION OF 2317 01:30:02,800 --> 01:30:04,200 ECONOMIC IMPACT OF ALZHEIMER'S 2318 01:30:04,200 --> 01:30:06,160 DISEASE HAVE SIMILAR STORIES TO 2319 01:30:06,160 --> 01:30:06,600 HEL. 2320 01:30:06,600 --> 01:30:08,800 THE ECONOMIC IMPACT OF 2321 01:30:08,800 --> 01:30:10,840 ALZHEIMER'S DISEASE RANKS FROM 2322 01:30:10,840 --> 01:30:16,440 FRAUD TO INABILITY TO AFFORD 2323 01:30:16,440 --> 01:30:17,240 NEEDED CARE. 2324 01:30:17,240 --> 01:30:20,360 TODAY WE HAVE AN ESTEEMED PANEL 2325 01:30:20,360 --> 01:30:22,080 WHO WILL BE DISCUSSING THE 2326 01:30:22,080 --> 01:30:24,680 IMPACT OF DEMENTIA ON FAMILIES 2327 01:30:24,680 --> 01:30:27,360 AND THE HEALTH CARE SYSTEM AND 2328 01:30:27,360 --> 01:30:29,840 OPPORTUNITIES TO ALLEVIATE 2329 01:30:29,840 --> 01:30:32,480 ECONOMIC BURDEN AND WE'LL 2330 01:30:32,480 --> 01:30:34,560 CONSIDER THE SYSTEM TO IMPROVE 2331 01:30:34,560 --> 01:30:37,480 COORDINATION AND OUTCOMES AND 2332 01:30:37,480 --> 01:30:38,280 REDUCE COST. 2333 01:30:38,280 --> 01:30:40,160 WE'LL ALSO ADDRESS NOVEL 2334 01:30:40,160 --> 01:30:42,400 APPROACHES TO THE INNOVATIONS IN 2335 01:30:42,400 --> 01:30:43,960 DEMENTIA CARE AND TREATMENT AND 2336 01:30:43,960 --> 01:30:46,280 THE IMPACT OF DEMENTIA ON HEALTH 2337 01:30:46,280 --> 01:30:47,600 CARE AND ECONOMIC DECISION 2338 01:30:47,600 --> 01:30:47,800 MAKING. 2339 01:30:47,800 --> 01:30:50,200 JOIN ME IN WELCOMING OUR FIRST 2340 01:30:50,200 --> 01:30:54,880 SPEAKER, DR. DUKE HAN. 2341 01:30:54,880 --> 01:30:57,840 THANK YOU FOR THAT INTRODUCTION 2342 01:30:57,840 --> 01:30:59,600 DR. NOVAK. 2343 01:30:59,600 --> 01:31:01,160 I'M A CLINICAL NURSE 2344 01:31:01,160 --> 01:31:03,200 PSYCHOLOGIST AND A PROFESSOR AT 2345 01:31:03,200 --> 01:31:04,800 THE UNIVERSITY OF SOUTHERN 2346 01:31:04,800 --> 01:31:05,240 CALIFORNIA. 2347 01:31:05,240 --> 01:31:07,480 I HAVE THE PRIVILEGE OF SHARING 2348 01:31:07,480 --> 01:31:08,440 THOUGHTS ABOUT FINANCIAL 2349 01:31:08,440 --> 01:31:09,800 DECISION MAKING AND COGNITIVE 2350 01:31:09,800 --> 01:31:10,600 DECLINE AND ALZHEIMER'S DISEASE. 2351 01:31:10,600 --> 01:31:13,520 I WANTED TO START WITH A BRIEF 2352 01:31:13,520 --> 01:31:14,000 ANECDOTE. 2353 01:31:14,000 --> 01:31:15,800 ONE OF THE REASONS I BECAME 2354 01:31:15,800 --> 01:31:18,440 INTERESTED IN THIS TOPIC WAS 2355 01:31:18,440 --> 01:31:19,960 EXPERIENCES IN CLINIC. 2356 01:31:19,960 --> 01:31:23,640 I OFTEN SEE OLDER ADULTS WHERE 2357 01:31:23,640 --> 01:31:25,440 THERE WAS A PRESUMPTION OF EARLY 2358 01:31:25,440 --> 01:31:27,800 DEMENTIA FOR ASSESSMENT IN MY 2359 01:31:27,800 --> 01:31:30,320 ROLE AS A CLINICAL NEURAL 2360 01:31:30,320 --> 01:31:31,280 PSYCHOLOGIST AND REMEMBER A 2361 01:31:31,280 --> 01:31:33,000 STRING OF PATIENTS I SAW ONE 2362 01:31:33,000 --> 01:31:35,800 AFTER THE OTHER WHERE IT WAS 2363 01:31:35,800 --> 01:31:37,520 PRESUMED THE PATIENT ACTUALLY 2364 01:31:37,520 --> 01:31:41,520 HAD EARLY DEMENTIA BECAUSE IT 2365 01:31:41,520 --> 01:31:43,960 WAS DISCOVERED THAT THAT PATIENT 2366 01:31:43,960 --> 01:31:46,120 WAS MAKING POOR FINANCIAL 2367 01:31:46,120 --> 01:31:46,680 DECISIONS. 2368 01:31:46,680 --> 01:31:48,640 I REMEMBER THIS VIVIDLY PATIENT 2369 01:31:48,640 --> 01:31:50,600 AFTER PATIENT DOCK HOURS OF 2370 01:31:50,600 --> 01:31:51,760 TESTING SOMETIMES FOUR, SIX 2371 01:31:51,760 --> 01:31:54,000 HOURS OF COGNITIVE TESTING AND 2372 01:31:54,000 --> 01:31:56,640 FINDING THAT PATIENT TO BE 2373 01:31:56,640 --> 01:31:57,920 COMPLETELY COGNITIVELY IN FACT 2374 01:31:57,920 --> 01:31:58,200 ACTUALLY. 2375 01:31:58,200 --> 01:32:02,760 CLEARLY THERE WAS A CHANGE IN 2376 01:32:02,760 --> 01:32:03,080 BEHAVIOR. 2377 01:32:03,080 --> 01:32:04,680 A CHANGE IN FINANCIAL DECISION 2378 01:32:04,680 --> 01:32:05,680 MAKING BEHAVIOR BUT OUR 2379 01:32:05,680 --> 01:32:07,560 COGNITIVE TESTS WERE NOT PICK UP 2380 01:32:07,560 --> 01:32:10,080 ON THIS. 2381 01:32:10,080 --> 01:32:12,320 AS A NEURO PSYCHOLOGIST I WAS 2382 01:32:12,320 --> 01:32:13,280 INTERESTED IN THE MISMATCH AND 2383 01:32:13,280 --> 01:32:16,960 WHAT WE WERE ASSESSING AND WHAT 2384 01:32:16,960 --> 01:32:17,560 WE WERE SEEING. 2385 01:32:17,560 --> 01:32:19,520 SO IN TERMS OF BACKGROUND WHAT 2386 01:32:19,520 --> 01:32:22,040 YOU MAY OR MAY NOT KNOW IS OLDER 2387 01:32:22,040 --> 01:32:24,360 ADULTS OVER THE AGE OF 65 HOLD A 2388 01:32:24,360 --> 01:32:26,280 THIRD OF THE NATION'S WEALTH. 2389 01:32:26,280 --> 01:32:28,600 THIS IS ALL OLDER ADULTS IN THE 2390 01:32:28,600 --> 01:32:29,000 UNITED STATES. 2391 01:32:29,000 --> 01:32:30,840 A PORTION OF OLDER ADULTS BECOME 2392 01:32:30,840 --> 01:32:33,320 THE VICTIM OF SCAM OR FRAUD AS 2393 01:32:33,320 --> 01:32:36,920 WE HEARD DURING THE 2394 01:32:36,920 --> 01:32:37,280 INTRODUCTION. 2395 01:32:37,280 --> 01:32:39,440 AND FINANCIAL EXPLOITATION IS 2396 01:32:39,440 --> 01:32:41,120 SUCH AN ISSUE THE FBI MAINTAINS 2397 01:32:41,120 --> 01:32:43,840 A WEBSITE DEVOTED JUST TO THAT 2398 01:32:43,840 --> 01:32:44,720 TOPIC. 2399 01:32:44,720 --> 01:32:46,280 AND SO THIS MAY BE 2400 01:32:46,280 --> 01:32:46,920 UNDERSTANDABLE TO A CERTAIN 2401 01:32:46,920 --> 01:32:49,080 EXTENT BECAUSE WE KNOW AS WE 2402 01:32:49,080 --> 01:32:50,560 GROW OLDER OUR BRAINS WILL 2403 01:32:50,560 --> 01:32:53,600 CHANGE AND SO WE WILL LOSE SOME 2404 01:32:53,600 --> 01:32:54,680 ASPECT OF OUR BRAIN. 2405 01:32:54,680 --> 01:32:56,400 THESE ARE THE BRAIN REGIONS IN 2406 01:32:56,400 --> 01:32:58,280 YELLOW IN THE UPPER LEFT AND 2407 01:32:58,280 --> 01:32:59,880 WHAT THAT CORRESPONDING LOSS OF 2408 01:32:59,880 --> 01:33:02,680 BRAIN SO DO WE LOSE SOME 2409 01:33:02,680 --> 01:33:03,960 COGNITIVE ABILITY AND AGAIN THIS 2410 01:33:03,960 --> 01:33:06,040 IS NORMAL AGING. 2411 01:33:06,040 --> 01:33:09,280 IN THE CONTEXT OF DEMENTIA YOU 2412 01:33:09,280 --> 01:33:11,920 CAN IMAGINE IT'S QUITE 2413 01:33:11,920 --> 01:33:12,240 PRONOUNCED. 2414 01:33:12,240 --> 01:33:14,280 ONE TAKEAWAY FROM THIS BODY OF 2415 01:33:14,280 --> 01:33:18,680 WORK YOU CAN TAKE IS THAT AS WE 2416 01:33:18,680 --> 01:33:20,480 DEVELOP COGNITIVE IMPAIRMENT AS 2417 01:33:20,480 --> 01:33:22,320 WE GROW OLDER IT COULD BE WE 2418 01:33:22,320 --> 01:33:26,280 MAKE POORER FINANCIAL AND HEALTH 2419 01:33:26,280 --> 01:33:26,560 DECISIONS. 2420 01:33:26,560 --> 01:33:30,480 SO WE ACTUALLY TESTED THIS. 2421 01:33:30,480 --> 01:33:36,720 I WAS A PART OF OF THE RUSH 2422 01:33:36,720 --> 01:33:47,280 ALZHEIMER'S DISEASE CENTER AND 2423 01:33:47,680 --> 01:33:48,800 THEY DID MAKE POORER FINANCIAL 2424 01:33:48,800 --> 01:33:51,800 AND HEALTH DECISIONS ON THE 2425 01:33:51,800 --> 01:33:53,160 DECISION MAKING MEASURE. 2426 01:33:53,160 --> 01:33:54,720 SO I THINK IT'S SAFE TO SAY THAT 2427 01:33:54,720 --> 01:33:58,720 AS WE GROW OLDER AND WE MIGHT 2428 01:33:58,720 --> 01:34:00,280 HAVE SOME COGNITIVE IMPAIRMENT 2429 01:34:00,280 --> 01:34:02,360 WE MIGHT MAKE NOT AS GOOD 2430 01:34:02,360 --> 01:34:04,920 FINANCIAL AND HEALTH DECISIONS. 2431 01:34:04,920 --> 01:34:06,720 HOWEVER, I WANTED TO ALSO MAKE 2432 01:34:06,720 --> 01:34:08,000 THE POINT IT'S NOT JUST ABOUT 2433 01:34:08,000 --> 01:34:10,520 WHAT WE TYPICALLY CALL COGNITIVE 2434 01:34:10,520 --> 01:34:10,760 ABILITY. 2435 01:34:10,760 --> 01:34:13,240 I OPEN MY TALK WITH THIS EXAMPLE 2436 01:34:13,240 --> 01:34:16,000 OF PATIENTS WE'RE SEEING WHERE 2437 01:34:16,000 --> 01:34:17,080 WE COULDN'T REALLY SEE COGNITIVE 2438 01:34:17,080 --> 01:34:19,440 IMPAIRMENT BUT THERE WAS A CLEAR 2439 01:34:19,440 --> 01:34:20,800 CHANGE IN DECISION-MAKING 2440 01:34:20,800 --> 01:34:21,080 BEHAVIOR. 2441 01:34:21,080 --> 01:34:22,920 WE WANTED TO LOOK AT THIS AND WE 2442 01:34:22,920 --> 01:34:26,720 DID AND A GROUP OF OLDER ADULTS 2443 01:34:26,720 --> 01:34:29,120 OUTDEMENTIA OVER 600 OLDER 2444 01:34:29,120 --> 01:34:30,960 ADULTS WITH THE HYPOTHESIS A 2445 01:34:30,960 --> 01:34:32,320 PORTION WOULD SHOW A DIFFERENCE 2446 01:34:32,320 --> 01:34:33,800 BETWEEN DECISION MAKING AND 2447 01:34:33,800 --> 01:34:36,800 COGNITIVE ABILITY. 2448 01:34:36,800 --> 01:34:38,120 SO WHAT YOU SEE HERE ARE THE 2449 01:34:38,120 --> 01:34:38,360 RESULTS. 2450 01:34:38,360 --> 01:34:42,720 THESE ARE INDIVIDUALS HERE. 2451 01:34:42,720 --> 01:34:44,280 YOU SEE A LOT OF BLUE WHERE AN 2452 01:34:44,280 --> 01:34:46,160 OLDER ADULT IS SHOWING DECISION 2453 01:34:46,160 --> 01:34:47,080 MAKING ABILITY WITHIN THEIR 2454 01:34:47,080 --> 01:34:49,080 COGNITIVE ABILITY RANGE. 2455 01:34:49,080 --> 01:34:50,800 WE DID SEE A LOT OF GREEN YOU 2456 01:34:50,800 --> 01:34:52,640 CAN SEE AND WHAT WE 2457 01:34:52,640 --> 01:34:52,960 HYPOTHESIZED. 2458 01:34:52,960 --> 01:34:55,240 THE CASES I WAS SEEING THAT I 2459 01:34:55,240 --> 01:34:56,960 SHARED AT THE BEGINNING OF MY 2460 01:34:56,960 --> 01:34:59,120 TALK AND WHAT'S INTERESTING IS 2461 01:34:59,120 --> 01:35:01,400 WE ALSO SAW A LOT OF RED 2462 01:35:01,400 --> 01:35:03,040 EXAMPLES AND THESE ARE 2463 01:35:03,040 --> 01:35:05,640 INDIVIDUALS THAT SHOWED BETTER 2464 01:35:05,640 --> 01:35:07,960 DECISION MAKING RELATIVE TO THE 2465 01:35:07,960 --> 01:35:10,840 COGNITIVE ABILITY. 2466 01:35:10,840 --> 01:35:12,840 SO WHEN AN OLDER ADULT BECOMES 2467 01:35:12,840 --> 01:35:15,720 THE VICTIM OF SCAM OR FRAUD OR 2468 01:35:15,720 --> 01:35:16,840 SHOWS POORER FINANCIAL DECISION 2469 01:35:16,840 --> 01:35:18,520 MAKING THE IMPACT IS DISPLACED 2470 01:35:18,520 --> 01:35:20,720 ON LOTS OF PEOPLE, FAMILY 2471 01:35:20,720 --> 01:35:23,800 MEMBERS, CAREGIVERS, ULTIMATELY 2472 01:35:23,800 --> 01:35:24,960 COMMUNITIES AND SOCIETY. 2473 01:35:24,960 --> 01:35:26,560 BUT HOW CAN WE UNDERSTAND THIS? 2474 01:35:26,560 --> 01:35:30,720 IT'S SUCH A COMPLEX TOPIC AND SO 2475 01:35:30,720 --> 01:35:31,920 ONE WAY AMONG OTHERS THAT WE'VE 2476 01:35:31,920 --> 01:35:34,360 BEEN TRYING TO USE IS TO LOOK AT 2477 01:35:34,360 --> 01:35:39,800 THE BRAINS OF OLDER AS USING 2478 01:35:39,800 --> 01:35:41,400 NEURO IMAGING AND IT'S HIGHLY 2479 01:35:41,400 --> 01:35:42,680 COLLABORATIVE WORK WHERE A 2480 01:35:42,680 --> 01:35:45,800 NUMBER OF EFFORTS TO COLLECT 2481 01:35:45,800 --> 01:35:46,840 DECISION MAKING AND COGNITIVE 2482 01:35:46,840 --> 01:35:49,160 MEASURES AND NEUROIMAGING 2483 01:35:49,160 --> 01:35:50,360 MEASURES ARE BEING UTILIZED TO 2484 01:35:50,360 --> 01:35:51,840 TRY TO LOOK AT THE WORK. 2485 01:35:51,840 --> 01:35:53,640 AND WE KNOW THAT WE CAN 2486 01:35:53,640 --> 01:35:55,520 POTENTIALLY SEE IN THE BRAINS OF 2487 01:35:55,520 --> 01:35:57,520 OLDER ADULTS CHANGES AHEAD OF 2488 01:35:57,520 --> 01:36:00,080 ANY NOTICEABLE COGNITIVE 2489 01:36:00,080 --> 01:36:00,360 DECLINE. 2490 01:36:00,360 --> 01:36:02,400 SO OUR GENERAL HYPOTHESIS IS WE 2491 01:36:02,400 --> 01:36:03,960 CAN USE NEUROIMAGING TO LOOK AT 2492 01:36:03,960 --> 01:36:06,040 THE BRAINS OF OLDER ADULTS TO 2493 01:36:06,040 --> 01:36:07,840 SEE ANY NOTICEABLE CHANGE IN 2494 01:36:07,840 --> 01:36:09,200 DECISION MAKING EVEN ACCOUNTING 2495 01:36:09,200 --> 01:36:12,560 FOR COGNITIVE ABILITY. 2496 01:36:12,560 --> 01:36:15,040 SO GENERALLY SPEAKING THIS IS 2497 01:36:15,040 --> 01:36:18,800 OUR CURRENT WORKING MODEL. 2498 01:36:18,800 --> 01:36:19,720 NEUROPATHOLOGICAL MARKERS OF 2499 01:36:19,720 --> 01:36:23,160 ALZHEIMER'S DISEASE OR DEMENTIA 2500 01:36:23,160 --> 01:36:24,760 IMPACT CERTAIN BRAIN REGIONS AND 2501 01:36:24,760 --> 01:36:26,560 DEPENDING ON HOW THEY'RE 2502 01:36:26,560 --> 01:36:27,960 IMPACTED YOU COULD IS A DECLINE 2503 01:36:27,960 --> 01:36:30,800 IN MEMORY ABILITIES WHICH IS 2504 01:36:30,800 --> 01:36:32,560 TYPICALLY WHAT IS THOUGHT OF IN 2505 01:36:32,560 --> 01:36:33,800 ALZHEIMER'S DEMENTIA OR HAVE A 2506 01:36:33,800 --> 01:36:36,920 DECLINE IN DECISION MAKING 2507 01:36:36,920 --> 01:36:42,480 ABILITY AND ONE COULD PROCEED 2508 01:36:42,480 --> 01:36:46,640 THE OTHER. 2509 01:36:46,640 --> 01:36:47,960 I WANTED TO SHOW ONE PART OF THE 2510 01:36:47,960 --> 01:36:48,200 WORK. 2511 01:36:48,200 --> 01:36:49,600 IN THIS PICTURE OF THE BRAIN 2512 01:36:49,600 --> 01:36:53,600 WHAT YOU CAN SEE IS THERE'S LESS 2513 01:36:53,600 --> 01:36:58,120 GRAY MATTER DENSITY IN THE RIGHT 2514 01:36:58,120 --> 01:37:00,840 HIPPOCAMPUS IN THE OLDER ADULTS 2515 01:37:00,840 --> 01:37:04,000 WITH DEMENTIA AND TO GREATER 2516 01:37:04,000 --> 01:37:05,920 SUSCEPTIBILITY TO SCAN AND 2517 01:37:05,920 --> 01:37:08,160 ADJUST FOR SEX, EDUCATION, AGE 2518 01:37:08,160 --> 01:37:10,720 AND COGNITIVE ABILITY. 2519 01:37:10,720 --> 01:37:13,480 IN DOING THE WORK IT BECAME 2520 01:37:13,480 --> 01:37:15,800 IMPORTANT TO ME TO CONSIDER 2521 01:37:15,800 --> 01:37:16,920 RACIAL DIFFERENCES IN OTHER 2522 01:37:16,920 --> 01:37:17,640 RACIAL GROUPS. 2523 01:37:17,640 --> 01:37:21,880 I NOTICED THERE WASN'T A LOT OF 2524 01:37:21,880 --> 01:37:24,360 ATTENTION TO THIS. 2525 01:37:24,360 --> 01:37:29,200 WE KNOW CONTEXTUAL FACTORS CAN 2526 01:37:29,200 --> 01:37:30,640 INDICATE UNEQUAL ACCESS TO 2527 01:37:30,640 --> 01:37:31,920 SUPPORTIVE RESOURCES. 2528 01:37:31,920 --> 01:37:35,240 SO THIS IS ACTUALLY THE 2529 01:37:35,240 --> 01:37:37,040 CURRENTLY ONGOING PROJECT WHERE 2530 01:37:37,040 --> 01:37:39,760 WE'RE TRYING TO UNDERSTAND THE 2531 01:37:39,760 --> 01:37:41,360 CONTEXTUAL FACTORS THAT MAY 2532 01:37:41,360 --> 01:37:43,000 EXPLAIN RACIAL DIFFERENCES IN 2533 01:37:43,000 --> 01:37:43,920 DECISION MAKING. 2534 01:37:43,920 --> 01:37:47,920 AND SO ONE EXAMPLE OF THIS WORK 2535 01:37:47,920 --> 01:37:50,280 HERE IS THIS STUDY WHERE WE SHOW 2536 01:37:50,280 --> 01:37:51,800 RACIAL DIFFERENCES IN DECISION 2537 01:37:51,800 --> 01:37:56,040 MAKING ARE ACTUALLY COMPLETELY 2538 01:37:56,040 --> 01:37:58,880 MEDIATED BY LITERACY AND WHAT WE 2539 01:37:58,880 --> 01:38:02,000 MEAN IS NOT JUST BROAD LITERACY 2540 01:38:02,000 --> 01:38:05,640 BUT IN FINANCIAL AND HEALTH 2541 01:38:05,640 --> 01:38:06,880 MATTERS. 2542 01:38:06,880 --> 01:38:08,400 SO THAT'S VERY CONTEXTUALLY 2543 01:38:08,400 --> 01:38:11,440 DIFFERENT AND RELATED TO THE 2544 01:38:11,440 --> 01:38:13,840 ABILITY AND ACCESS TO DEVELOP 2545 01:38:13,840 --> 01:38:16,680 LITERACY AND ACCESS TO 2546 01:38:16,680 --> 01:38:16,920 RESOURCES. 2547 01:38:16,920 --> 01:38:18,760 AND WE SEE THAT ACCOUNTS FOR ANY 2548 01:38:18,760 --> 01:38:19,520 RACIAL DIFFERENCES IN DECISION 2549 01:38:19,520 --> 01:38:23,400 MAKING HERE. 2550 01:38:23,400 --> 01:38:26,240 THIS IDEA OF FINANCIAL DECISION 2551 01:38:26,240 --> 01:38:27,760 MAKING THAT COULD PRECEDE EVEN 2552 01:38:27,760 --> 01:38:28,760 COGNITIVE DECLINE IS SOMETHING 2553 01:38:28,760 --> 01:38:33,120 WE'RE TRYING TO STUDY CURRENTLY 2554 01:38:33,120 --> 01:38:35,440 IN OUR LABORATORY USING 2555 01:38:35,440 --> 01:38:39,840 COGNITIVE AND NEUROIMAGING 2556 01:38:39,840 --> 01:38:40,040 TOOLS. 2557 01:38:40,040 --> 01:38:41,640 MORE WORK TO COME. 2558 01:38:41,640 --> 01:38:43,720 ONE QUICK EXAMPLE A RECENTLY 2559 01:38:43,720 --> 01:38:45,760 PUBLISHED STUDY LEVERAGING 2560 01:38:45,760 --> 01:38:47,320 BEHAVIORAL ECONOMICS BATTERY 2561 01:38:47,320 --> 01:38:50,920 DEVELOPED BY THE SECOND PICTURE 2562 01:38:50,920 --> 01:38:54,400 BELOW IS ACTUALLY AN ECONOMIST 2563 01:38:54,400 --> 01:38:57,160 AT U.C. S.D. AND THIS IS 2564 01:38:57,160 --> 01:39:00,760 SPEARHEADED BY A FORMER HELLO 2565 01:39:00,760 --> 01:39:02,520 KELLY WEISBERGER AND IN THE WORK 2566 01:39:02,520 --> 01:39:03,920 PART OF THE ECONOMICS WE'RE 2567 01:39:03,920 --> 01:39:07,080 USING THAT OLDER ADULTS WOULD 2568 01:39:07,080 --> 01:39:08,240 ANY COGNITIVE IMPAIRMENT BUT 2569 01:39:08,240 --> 01:39:10,040 OLDER ADULTS WILLING TO GIVE 2570 01:39:10,040 --> 01:39:12,600 AWAY MORE MONEY TO A STRANGER 2571 01:39:12,600 --> 01:39:15,240 ONLINE AND THIS IS 2572 01:39:15,240 --> 01:39:16,440 EXPERIMENTALLY TESTED PERFORMED 2573 01:39:16,440 --> 01:39:17,960 LOWER ON TESTS ON COGNITIVE 2574 01:39:17,960 --> 01:39:19,920 TESTS WE KNOW ARE SENSITIVE TO 2575 01:39:19,920 --> 01:39:21,320 ALZHEIMER'S DISEASE AND JUST 2576 01:39:21,320 --> 01:39:27,000 THOSE COGNITIVE TESTS NOT OTHER 2577 01:39:27,000 --> 01:39:34,360 COGNITIVE TESTS. 2578 01:39:34,360 --> 01:39:37,240 AND SHOWS CHANGES IN FINANCIAL 2579 01:39:37,240 --> 01:39:39,000 DECISIONS MAY BE AN EARLIER 2580 01:39:39,000 --> 01:39:41,320 INDICATION AND IT MAY IMPACT 2581 01:39:41,320 --> 01:39:44,800 FINANCIAL DECISION MAKING. 2582 01:39:44,800 --> 01:39:46,560 THOUGH POOR COGNITION IS 2583 01:39:46,560 --> 01:39:50,640 ASSOCIATED IT MAY NOT DUE SOLELY 2584 01:39:50,640 --> 01:39:53,040 TO POOR OR DECLINING COGNITION. 2585 01:39:53,040 --> 01:39:55,680 THERE'S OTHER FACTORS INVOLVED. 2586 01:39:55,680 --> 01:39:58,160 CERTAIN BRAIN REGIONS ARE 2587 01:39:58,160 --> 01:40:00,000 INDICATED BY THIS AND FINALLY 2588 01:40:00,000 --> 01:40:01,480 FOR CARE PROVIDERS THIS IS 2589 01:40:01,480 --> 01:40:04,320 SOMETHING WE ARE ENCOURAGING 2590 01:40:04,320 --> 01:40:07,160 EVERYONE TO CONSIDER. 2591 01:40:07,160 --> 01:40:08,560 FINANCIAL PLANNING AS EARLY AS 2592 01:40:08,560 --> 01:40:10,160 AND AS SOON AS POSSIBLE GIVEN 2593 01:40:10,160 --> 01:40:14,080 FINANCIAL DECISION MAKING MAY BE 2594 01:40:14,080 --> 01:40:16,360 AN EARLY CHANGE IN THE 2595 01:40:16,360 --> 01:40:17,880 PROGRESSION OF ALZHEIMER'S 2596 01:40:17,880 --> 01:40:21,080 DISEASE OR DEMENTIA ENSURING THE 2597 01:40:21,080 --> 01:40:22,080 PATIENT'S WISHES FOR FINANCES 2598 01:40:22,080 --> 01:40:25,240 ARE SET IN PLACE EARLY ON IS 2599 01:40:25,240 --> 01:40:27,360 IMPORTANT TO DO. 2600 01:40:27,360 --> 01:40:29,080 THIS IS HIGHLY INTERDISCIPLINARY 2601 01:40:29,080 --> 01:40:29,280 WORK. 2602 01:40:29,280 --> 01:40:31,920 I JUST NEEDED TO ACKNOWLEDGE THE 2603 01:40:31,920 --> 01:40:36,200 COLLABORATORS THAT WE HAVE 2604 01:40:36,200 --> 01:40:37,120 ACROSS THE COUNTRY AND THAT'S 2605 01:40:37,120 --> 01:40:38,880 ALL I HAVE TO SAY. 2606 01:40:38,880 --> 01:40:39,040 THANK YOU VERY MUCH. 2607 01:40:39,040 --> 01:40:40,000 >>HI. 2608 01:40:40,000 --> 01:40:41,640 THANKS SO MUCH TO THE ORGANIZERS 2609 01:40:41,640 --> 01:40:44,000 FOR THE OPPORTUNITY TO SPEAK AT 2610 01:40:44,000 --> 01:40:48,400 THIS IMPORTANT SUMMIT. 2611 01:40:48,400 --> 01:40:51,040 MY NAME IS MIREILLE JACOBSON A 2612 01:40:51,040 --> 01:40:52,200 HEALTH COMMITTEE AT USC. 2613 01:40:52,200 --> 01:40:56,880 I'LL TALK ABOUT WHAT WE KNOW AT 2614 01:40:56,880 --> 01:40:58,800 HEALTH CARE USE BEFORE AND AFTER 2615 01:40:58,800 --> 01:41:00,680 DEMENTIA DIAGNOSIS AND THE VAST 2616 01:41:00,680 --> 01:41:02,840 MAJORITY OF AGES 65 AND OLDER 2617 01:41:02,840 --> 01:41:05,520 WE'LL LOOK SPECIFICALLY AT 2618 01:41:05,520 --> 01:41:07,120 HEALTH CARE PAID FOR BY MEDICARE 2619 01:41:07,120 --> 01:41:11,600 AND FOCUS ON WHAT WE CALL 2620 01:41:11,600 --> 01:41:13,360 TRADITIONAL MEDICARE OR TM WHERE 2621 01:41:13,360 --> 01:41:14,920 THE FEDERAL GOVERNMENT PAYS 2622 01:41:14,920 --> 01:41:15,880 PROVIDERS FOR HEALTH CARE 2623 01:41:15,880 --> 01:41:20,680 DELIVERED TO BENEFICIARIES OR 2624 01:41:20,680 --> 01:41:24,600 MEDICARE ADVANTAGE WHERE THE 2625 01:41:24,600 --> 01:41:25,800 FEDERAL GOVERNMENT PAYS PRIVATE 2626 01:41:25,800 --> 01:41:27,720 HEALTH INSURANCE PLANS TO 2627 01:41:27,720 --> 01:41:28,880 ADMINISTER BENEFITS. 2628 01:41:28,880 --> 01:41:30,040 BECAUSE OF DATA CONSIDERATIONS 2629 01:41:30,040 --> 01:41:31,800 AND HISTORICAL ENROLLMENT 2630 01:41:31,800 --> 01:41:33,480 PATTERNS, MOST OF WHAT WE KNOW 2631 01:41:33,480 --> 01:41:35,680 ABOUT HEALTH CARE USE FOR OLDER 2632 01:41:35,680 --> 01:41:37,400 ADULTS WITHOUT AND WITHOUT 2633 01:41:37,400 --> 01:41:39,200 DEMENTIA FOCUSES ON THOSE IN 2634 01:41:39,200 --> 01:41:42,520 TRADITIONAL MEDICARE. 2635 01:41:42,520 --> 01:41:45,000 SOME WORK SUCH AS THOSE HERE 2636 01:41:45,000 --> 01:41:47,560 DEMONSTRATE INDIVIDUALS IN 2637 01:41:47,560 --> 01:41:49,520 TRADITIONAL MEDICARE HAVE 2638 01:41:49,520 --> 01:41:50,840 INCREASING RATES OF 2639 01:41:50,840 --> 01:41:53,040 HOSPITALIZATIONS, E.D. VISITS 2640 01:41:53,040 --> 01:41:54,560 AND AVOIDABLE HOSPITALIZATIONS 2641 01:41:54,560 --> 01:41:57,480 AND FALLS LEADING UP TO A 2642 01:41:57,480 --> 01:41:59,320 DEMENTIA DIAGNOSIS RELATIVE TO 2643 01:41:59,320 --> 01:42:01,520 THOSE WITHOUT A SUBSEQUENT 2644 01:42:01,520 --> 01:42:02,720 DEMENTIA DIAGNOSIS. 2645 01:42:02,720 --> 01:42:03,320 THIS SHOWS UP IN HEALTH CARE 2646 01:42:03,320 --> 01:42:08,680 SPENDING AS WELL. 2647 01:42:08,680 --> 01:42:13,080 WORK BY ONE OF OUR CO-CHAIRS AND 2648 01:42:13,080 --> 01:42:14,920 PANELISTS SHOWS BENEFICIARIES 2649 01:42:14,920 --> 01:42:17,800 ARE AT HIGH RISK OF AVOIDABLE 2650 01:42:17,800 --> 01:42:21,960 HOSPITALIZATIONS FOR CERTAIN 2651 01:42:21,960 --> 01:42:22,520 UNCONTROLLED COMORBIDITIES 2652 01:42:22,520 --> 01:42:25,000 DIABETES AND HYPERTENSION AFTER 2653 01:42:25,000 --> 01:42:28,800 A DEMENTIA DIAGNOSIS AND INCUR 2654 01:42:28,800 --> 01:42:30,040 HIGHER EXPENDITURES COMPARED TO 2655 01:42:30,040 --> 01:42:33,560 THOSE WITHOUT DEMENTIA. 2656 01:42:33,560 --> 01:42:35,040 MORE RECENT WORK DEMONSTRATE 2657 01:42:35,040 --> 01:42:37,360 HEALTH CARE USE AND MEDICAL 2658 01:42:37,360 --> 01:42:39,280 SPENDING SPIKE LEADING UP TO A 2659 01:42:39,280 --> 01:42:40,360 DEMENTIA DIAGNOSIS. 2660 01:42:40,360 --> 01:42:42,680 IT INCREASES LEADING UP TO AND 2661 01:42:42,680 --> 01:42:44,280 REMAINS HIGHER AFTER THE 2662 01:42:44,280 --> 01:42:44,640 DIAGNOSIS. 2663 01:42:44,640 --> 01:42:46,600 AND INTERESTINGLY THIS PATTERN 2664 01:42:46,600 --> 01:42:49,600 IS NOT FOUND AROUND CHANGES IN 2665 01:42:49,600 --> 01:42:50,880 COGNITIVE IMPAIRMENT. 2666 01:42:50,880 --> 01:42:52,160 THE GRAPH ON THE RIGHT 2667 01:42:52,160 --> 01:42:54,160 DOCUMENTED IN THIS CASE IN THE 2668 01:42:54,160 --> 01:42:55,760 HOUSEHOLD SURVEY MEANING OUTSIDE 2669 01:42:55,760 --> 01:42:56,880 THE HEALTH CARE SETTING. 2670 01:42:56,880 --> 01:42:59,600 THERE SEEMS TO BE SOMETHING 2671 01:42:59,600 --> 01:43:00,400 IMPORTANT ABOUT THE MEDICAL 2672 01:43:00,400 --> 01:43:03,320 DIAGNOSIS STAGE ABOVE AND BEYOND 2673 01:43:03,320 --> 01:43:08,240 DECLINES IN IMPAIRMENT PER SE. 2674 01:43:08,240 --> 01:43:09,320 TO SUMMARIZE THE PRIOR WORK 2675 01:43:09,320 --> 01:43:12,120 SHOWS INCREASES IN POTENTIALLY 2676 01:43:12,120 --> 01:43:15,600 AVOIDABLE AND OTHER HOSPITAL S 2677 01:43:15,600 --> 01:43:19,320 AND CARE BEFORE AND AFTER 2678 01:43:19,320 --> 01:43:19,920 DIAGNOSIS IN THE HEALTH CARE 2679 01:43:19,920 --> 01:43:21,480 SETTING BUT NOT AT THE FIRST 2680 01:43:21,480 --> 01:43:23,040 INDICATION OF IMPAIRMENT. 2681 01:43:23,040 --> 01:43:24,760 THIS IS SUGGESTIVE EVIDENCE OF 2682 01:43:24,760 --> 01:43:25,840 LATE DIAGNOSIS OR DIAGNOSIS 2683 01:43:25,840 --> 01:43:28,760 COMING AT A CRISIS POINT IN THE 2684 01:43:28,760 --> 01:43:29,800 IMPAIRMENT TRAJECTORY. 2685 01:43:29,800 --> 01:43:31,320 IMPORTANTLY IN TERMS OF WHAT WE 2686 01:43:31,320 --> 01:43:33,240 KNOW AND DON'T KNOW THIS WORK 2687 01:43:33,240 --> 01:43:35,040 HAS FOCUSSED LARGELY FOR DATA 2688 01:43:35,040 --> 01:43:36,760 REASONS ON INDIVIDUALS IN 2689 01:43:36,760 --> 01:43:37,840 TRADITIONAL MEDICARE AND NOT 2690 01:43:37,840 --> 01:43:42,840 THOSE IN MEDICARE ADVANTAGE. 2691 01:43:42,840 --> 01:43:44,920 BUT THERE'S A DRAMATIC 2692 01:43:44,920 --> 01:43:46,600 INCREASING TREND IN ENROLLMENT 2693 01:43:46,600 --> 01:43:48,880 OF MEDICARE BENEFICIARIES AND 2694 01:43:48,880 --> 01:43:50,680 MED ADVANTAGE PLANS. 2695 01:43:50,680 --> 01:43:53,120 AS OF 2022 NEARLY 50% OF 2696 01:43:53,120 --> 01:43:56,840 BENEFICIARIES ARE IN A MEDICARE 2697 01:43:56,840 --> 01:43:58,800 ADVANTAGE PLAN AND THIS TRENDS 2698 01:43:58,800 --> 01:44:00,960 SEEMS LIKELY TO SLOW AND 2699 01:44:00,960 --> 01:44:03,440 REQUIRED TO HARNESS NEW DATA ON 2700 01:44:03,440 --> 01:44:04,560 MEDICARE ADVANTAGE TO UNDERSTAND 2701 01:44:04,560 --> 01:44:07,440 THE EXPERIENCES OF BENEFITS AND 2702 01:44:07,440 --> 01:44:08,280 NOT JUST MEDICARE BUT MEDICARE 2703 01:44:08,280 --> 01:44:11,240 ADVANTAGE. 2704 01:44:11,240 --> 01:44:13,400 THERE'S MULTIPLE REASONS WE CAN 2705 01:44:13,400 --> 01:44:14,760 RELY ON EVIDENCE FROM 2706 01:44:14,760 --> 01:44:16,400 TRADITIONAL MEDICARE. 2707 01:44:16,400 --> 01:44:18,360 THE POPULATIONS IN TRADITIONAL 2708 01:44:18,360 --> 01:44:19,520 MEDICARE AND MEDICARE ADVANTAGE 2709 01:44:19,520 --> 01:44:22,000 DIFFER AND IMPORTANTLY THE 2710 01:44:22,000 --> 01:44:24,720 INCENTIVES DIFFER FOR PROVIDERS 2711 01:44:24,720 --> 01:44:27,360 AND PLANS ACROSS THESE TYPE OF 2712 01:44:27,360 --> 01:44:27,920 MEDICARE. 2713 01:44:27,920 --> 01:44:29,640 HEALTH PLANS IN MEDICARE 2714 01:44:29,640 --> 01:44:32,400 ADVANTAGE RECEIVE A CAPITATED 2715 01:44:32,400 --> 01:44:33,960 PAYMENT AND MEMBER FOR MONTH AND 2716 01:44:33,960 --> 01:44:36,480 FEE AND THEY HAVE INCENTIVES TO 2717 01:44:36,480 --> 01:44:37,920 MANAGE AND COORDINATE CARE TO 2718 01:44:37,920 --> 01:44:46,880 REDUCE REDUNDANCY AND TO SKIMP 2719 01:44:46,880 --> 01:44:54,280 ON CARE THOUGH THEY TRY TO KEEP 2720 01:44:54,280 --> 01:44:55,480 IT IN PERSPECTIVE AND DEMENTIA 2721 01:44:55,480 --> 01:44:59,840 DIAGNOSIS IS NOW USED IN 2722 01:44:59,840 --> 01:45:00,880 DETERMINING MEDICARE PLAN 2723 01:45:00,880 --> 01:45:03,120 PAYMENT ADJUSTMENTS AND IT'S AN 2724 01:45:03,120 --> 01:45:04,960 ISSUE I'LL COME BACK TO AT THE 2725 01:45:04,960 --> 01:45:05,280 END. 2726 01:45:05,280 --> 01:45:06,560 AND ON THE OTHER SIDE IN 2727 01:45:06,560 --> 01:45:08,120 TRADITIONAL MEDICARE THERE'S NO 2728 01:45:08,120 --> 01:45:11,760 CONSTRAINTS ON CARE SEEKING. 2729 01:45:11,760 --> 01:45:17,640 WEAKER INCENTIVE TO COORDINATE 2730 01:45:17,640 --> 01:45:18,360 AREA OR REDUCE UNNECESSARY CARE. 2731 01:45:18,360 --> 01:45:20,400 THOUGH THERE'S EXCEPTIONS WITH 2732 01:45:20,400 --> 01:45:22,400 ACCOUNTABLE CARE ORGANIZATIONS, 2733 01:45:22,400 --> 01:45:24,400 BUNDLED PAYMENTS, OTHER 2734 01:45:24,400 --> 01:45:27,040 ALTERNATIVE PAYMENT MODELS THE 2735 01:45:27,040 --> 01:45:28,560 BROAD DISTINCTION REMAINS TRUE 2736 01:45:28,560 --> 01:45:29,880 CARE IS GENERALLY MORE 2737 01:45:29,880 --> 01:45:30,360 CONSTRAINED IN MEDICARE 2738 01:45:30,360 --> 01:45:34,240 ADVANTAGE. 2739 01:45:34,240 --> 01:45:37,320 SO WHAT ARE THE IMPLICATIONS FOR 2740 01:45:37,320 --> 01:45:39,160 CARE GENERALLY AND FOR 2741 01:45:39,160 --> 01:45:41,640 BENEFICIARIES FOR DEMENTIA? 2742 01:45:41,640 --> 01:45:42,560 MULTIPLE STUDIES DOCUMENT 2743 01:45:42,560 --> 01:45:43,600 DIFFERENCES IN CARE IN 2744 01:45:43,600 --> 01:45:45,280 TRADITIONAL MEDICARE VERSUS 2745 01:45:45,280 --> 01:45:46,440 MEDICARE ADVANTAGE AND THIS IS A 2746 01:45:46,440 --> 01:45:49,600 TABLE FROM A REVIEW OF THIS VAST 2747 01:45:49,600 --> 01:45:50,880 LITERATURE WHICH IS NOT SPECIFIC 2748 01:45:50,880 --> 01:45:52,040 TO DEMENTIA. 2749 01:45:52,040 --> 01:45:55,160 THOSE STUDIES TEND TO FIND 2750 01:45:55,160 --> 01:45:57,480 APPROPRIATE AMBULATORY CARE LIKE 2751 01:45:57,480 --> 01:46:00,160 BREAST CANCER SCREENINGS, 2752 01:46:00,160 --> 01:46:02,280 COLORECTAL AND CHOLESTEROL 2753 01:46:02,280 --> 01:46:05,240 TESTING ARE MORE COMMON IN 2754 01:46:05,240 --> 01:46:05,920 MEDICARE ADVANTAGE THAN 2755 01:46:05,920 --> 01:46:09,320 TRADITIONAL MEDICARE AND ON THE 2756 01:46:09,320 --> 01:46:10,840 FLIP SIDE EMERGENCY CARE IS LESS 2757 01:46:10,840 --> 01:46:11,400 COMMON THAN IN TRADITIONAL 2758 01:46:11,400 --> 01:46:21,600 MEDICARE. 2759 01:46:38,520 --> 01:46:41,320 MORE RECENTLY AND THIS IS 2760 01:46:41,320 --> 01:46:46,280 ONGOING WORK WE'VE BEEN 2761 01:46:46,280 --> 01:46:47,600 ANALYZING ADMINISTRATIVE DATA 2762 01:46:47,600 --> 01:46:50,920 FROM MEDICARE TO LEADING UP TO 2763 01:46:50,920 --> 01:46:54,000 CARE AFTER A DIAGNOSIS AND YOU 2764 01:46:54,000 --> 01:46:56,840 CAN SEE THE HOSPITALIZATION BY 2765 01:46:56,840 --> 01:46:58,320 MONTH RELATIVE TO MONTH ZERO THE 2766 01:46:58,320 --> 01:47:02,000 MONTH OF DEMENTIA DIAGNOSIS AND 2767 01:47:02,000 --> 01:47:06,240 THE RIGHT WE THOUGHT THE MEAN 2768 01:47:06,240 --> 01:47:08,160 NUMBER OF OUTPATIENT COMPARED TO 2769 01:47:08,160 --> 01:47:09,800 THE DIAGNOSIS MONTH. 2770 01:47:09,800 --> 01:47:10,840 YOU CAN SEE HOSPITALIZATION 2771 01:47:10,840 --> 01:47:13,120 RATES ARE SIMILAR IN TRADITIONAL 2772 01:47:13,120 --> 01:47:15,920 MEDICARE IN BLUE AND MEDICARE 2773 01:47:15,920 --> 01:47:17,040 ADVANTAGE IN RED. 2774 01:47:17,040 --> 01:47:21,040 AND IN THE MONTHS PROCEEDING 2775 01:47:21,040 --> 01:47:23,120 DEMENTIA DIAGNOSIS THEY INCREASE 2776 01:47:23,120 --> 01:47:24,760 DRAMATICALLY IN BOTH GROUPS AND 2777 01:47:24,760 --> 01:47:31,080 MORE SO IN THE TRADITIONAL 2778 01:47:31,080 --> 01:47:41,280 MEDICARE. 2779 01:47:44,600 --> 01:47:50,240 THE RATES DECLINE BUT REMAIN 2780 01:47:50,240 --> 01:47:51,120 ELEVATED AFTER DIAGNOSIS AND 2781 01:47:51,120 --> 01:47:53,560 FIND A SIMILAR PATTERN FOR OUT 2782 01:47:53,560 --> 01:47:54,760 PATIENT VISITS INCLUDING THE 2783 01:47:54,760 --> 01:47:57,280 FACT THAT TRADITIONAL MEDICARE'S 2784 01:47:57,280 --> 01:47:59,640 ALWAYS HIGHER THAN MEDICARE 2785 01:47:59,640 --> 01:48:02,160 ADVANTAGE. 2786 01:48:02,160 --> 01:48:04,000 WE'RE SHOWING THE DIFFERENCES BY 2787 01:48:04,000 --> 01:48:07,120 TRADITIONAL MEDICARE RELATIVE TO 2788 01:48:07,120 --> 01:48:08,680 MEDICARE ADVANTAGE. 2789 01:48:08,680 --> 01:48:10,360 ADJUSTED FOR ALL SORTS OF 2790 01:48:10,360 --> 01:48:12,000 OBSERVABLE CHARACTERISTICS AND 2791 01:48:12,000 --> 01:48:14,160 THE FIRST THING TO KNOW IS WHAT 2792 01:48:14,160 --> 01:48:16,520 WE SAW IN THE RAW DATA IS STILL 2793 01:48:16,520 --> 01:48:21,360 APPARENT AND ADJUSTED MODELS 2794 01:48:21,360 --> 01:48:24,360 WHERE WE JUST FOR AGE, RACE AND 2795 01:48:24,360 --> 01:48:25,400 COMORBIDITIES AND SO FORTH AND 2796 01:48:25,400 --> 01:48:27,640 BASED ON THE MODELS WE FIND 2797 01:48:27,640 --> 01:48:28,760 THOUGH HOSPITALIZATION RATES 2798 01:48:28,760 --> 01:48:31,560 WERE INITIALLY SIMILAR IN 2799 01:48:31,560 --> 01:48:33,480 MEDICARE AND MEDICARE ADVANTAGE 2800 01:48:33,480 --> 01:48:36,120 PRIOR TO DIAGNOSES, DIFFERENCES 2801 01:48:36,120 --> 01:48:38,640 APPEAR THREE MONTHS PRIOR TO THE 2802 01:48:38,640 --> 01:48:41,600 DIAGNOSIS ARE PRONOUNCED AT 2803 01:48:41,600 --> 01:48:42,240 DIAGNOSIS AND REMAIN HIGHER MANY 2804 01:48:42,240 --> 01:48:47,520 MONTHS. 2805 01:48:47,520 --> 01:48:49,640 RECENT WORK SUGGESTS SOME OF THE 2806 01:48:49,640 --> 01:48:51,960 DIFFERENCES MAY BE DUE TO A 2807 01:48:51,960 --> 01:48:53,360 SHIFT TO OBSERVATION STAYS IN 2808 01:48:53,360 --> 01:48:54,720 MEDICARE ADVANTAGE THOUGH AS WE 2809 01:48:54,720 --> 01:48:56,320 LOOKED MORE INTO THIS IN THE 2810 01:48:56,320 --> 01:48:57,560 DEMENTIA CASE WE DON'T THINK 2811 01:48:57,560 --> 01:49:02,320 THAT'S WHAT'S GOING ON HERE. 2812 01:49:02,320 --> 01:49:05,320 WHAT DOES THIS MEAN FOR DEMENTIA 2813 01:49:05,320 --> 01:49:05,760 CARE? 2814 01:49:05,760 --> 01:49:07,840 MOST HAVE MEDICARE COVERAGE. 2815 01:49:07,840 --> 01:49:10,000 INCREASINGLY THE INDIVIDUALS ARE 2816 01:49:10,000 --> 01:49:11,880 ENROLLED IN MEDICARE ADVANTAGE 2817 01:49:11,880 --> 01:49:14,040 AND WE FIND HEALTH CARE 2818 01:49:14,040 --> 01:49:15,960 UTILIZATION SPIKES LEADING UP TO 2819 01:49:15,960 --> 01:49:18,040 A DEMENTIA DIAGNOSIS IN MEDICARE 2820 01:49:18,040 --> 01:49:19,440 AND MEDICARE ADVANTAGE THOUGH 2821 01:49:19,440 --> 01:49:22,120 THE INCREASE IS LESS DRAMATIC IN 2822 01:49:22,120 --> 01:49:23,240 MEDICARE ADVANTAGE. 2823 01:49:23,240 --> 01:49:25,600 IT REMAINS TO BE SEEN HOW MUCH 2824 01:49:25,600 --> 01:49:29,600 IS DUE FOR EXAMPLE DUE TO BETTER 2825 01:49:29,600 --> 01:49:33,320 CARE COORDINATE OR THE SHIFTING 2826 01:49:33,320 --> 01:49:35,640 OF THE BURDEN OF CARE. 2827 01:49:35,640 --> 01:49:39,480 WE KNOW RELATIVELY LITTLE HOW 2828 01:49:39,480 --> 01:49:44,440 THE PATTERNS DIFFER ACROSS 2829 01:49:44,440 --> 01:49:54,680 ADVANTAGE PLANS. 2830 01:50:01,320 --> 01:50:05,960 AND THERE'S CONSTRAINTS ON WHERE 2831 01:50:05,960 --> 01:50:07,280 PATIENTS RECEIVE MEDICARE 2832 01:50:07,280 --> 01:50:07,880 ADVANTAGE RATHER THAN CARE 2833 01:50:07,880 --> 01:50:09,440 COORDINATION PER SE. 2834 01:50:09,440 --> 01:50:11,200 WE DON'T FIND EVIDENCE THAT 2835 01:50:11,200 --> 01:50:13,240 LOWER CARE USE IN MEDICARE 2836 01:50:13,240 --> 01:50:14,960 ADVANTAGE LEADS TO HARM FOR 2837 01:50:14,960 --> 01:50:17,240 THOSE WITH DEMENTIA AS MEASURED 2838 01:50:17,240 --> 01:50:19,360 BY VERY SPECIFICALLY ONE YEAR 2839 01:50:19,360 --> 01:50:19,640 MORTALITY. 2840 01:50:19,640 --> 01:50:21,080 BUT WE CAN'T SAY ANYTHING ABOUT 2841 01:50:21,080 --> 01:50:23,840 OTHER OUTCOMES SUCH AS CARE 2842 01:50:23,840 --> 01:50:25,880 GIVING WELL BEING AND CARE 2843 01:50:25,880 --> 01:50:29,240 SATISFACTION, STRESS AND SO ON. 2844 01:50:29,240 --> 01:50:31,160 SO THERE'S REALLY INTENSE 2845 01:50:31,160 --> 01:50:32,320 INTEREST IN TRYING TO UNDERSTAND 2846 01:50:32,320 --> 01:50:35,480 THESE PATTERNS AND WHAT THEY 2847 01:50:35,480 --> 01:50:38,880 MEAN FOR TIMELY DIAGNOSIS, 2848 01:50:38,880 --> 01:50:46,120 QUALITY -- OUTCOMES FOR FAMILIES 2849 01:50:46,120 --> 01:50:46,680 AND CAREGIVERS. 2850 01:50:46,680 --> 01:50:47,800 NEXT SLIDE TO SAY THANK YOU AND 2851 01:50:47,800 --> 01:50:56,400 I APPRECIATE THE OPPORTUNITY. 2852 01:50:56,400 --> 01:50:57,920 >>HI, EVERYONE. 2853 01:50:57,920 --> 01:50:59,720 I'M PETER NEUMANN. 2854 01:50:59,720 --> 01:51:01,840 TUFT'S MEDICAL CENTER IN BOSTON. 2855 01:51:01,840 --> 01:51:03,480 I'M A HEALTH ECONOMIST AND 2856 01:51:03,480 --> 01:51:05,280 DIRECT THE RESEARCH CENTER AT 2857 01:51:05,280 --> 01:51:06,120 TUFTS AND PROFESSOR AT THE 2858 01:51:06,120 --> 01:51:07,560 SCHOOL OF MEDICINE. 2859 01:51:07,560 --> 01:51:09,440 I'M GOING TO TALK ABOUT COSTS 2860 01:51:09,440 --> 01:51:11,200 AND COST EFFECTIVENESS IN 2861 01:51:11,200 --> 01:51:13,600 DEMENTIA AND DEMENTIA CARE. 2862 01:51:13,600 --> 01:51:15,320 I WANT TO THANK THE ORGANIZERS 2863 01:51:15,320 --> 01:51:18,600 FOR INVITING ME AND FOR ALL THE 2864 01:51:18,600 --> 01:51:19,880 EFFORTS FOR PROVIDING GREAT 2865 01:51:19,880 --> 01:51:24,840 CONFERENCE ON THIS IMPORTANT 2866 01:51:24,840 --> 01:51:25,040 TOPIC. 2867 01:51:25,040 --> 01:51:26,320 I'D LIKE TO DO THREE THINGS IN 2868 01:51:26,320 --> 01:51:28,760 MY BRIEF REMARKS. 2869 01:51:28,760 --> 01:51:30,560 FIRST TALK A LITTLE BIT MORE 2870 01:51:30,560 --> 01:51:33,440 ABOUT THE ECONOMIC BURDEN OF 2871 01:51:33,440 --> 01:51:33,880 DEMENTIA. 2872 01:51:33,880 --> 01:51:36,560 I KNOW WE'VE TALKED ABOUT THIS 2873 01:51:36,560 --> 01:51:39,720 AND SECOND, COST EFFECTIVENESS 2874 01:51:39,720 --> 01:51:42,240 OF DEMENTIA CARE AND FINALLY 2875 01:51:42,240 --> 01:51:47,800 IMPLICATIONS FOR CARE. 2876 01:51:47,800 --> 01:51:48,960 LET ME START WITH ECONOMIC 2877 01:51:48,960 --> 01:51:50,040 BURDEN OF DEMENTIA. 2878 01:51:50,040 --> 01:51:52,880 AS MANY OF YOU KNOW THERE'S A 2879 01:51:52,880 --> 01:51:57,920 VERY LARGE LITERATURE OUT THERE 2880 01:51:57,920 --> 01:52:02,480 ON THE TOPIC. 2881 01:52:02,480 --> 01:52:03,800 MY COLLEAGUE AND I CONTRIBUTED 2882 01:52:03,800 --> 01:52:04,320 TO IT. 2883 01:52:04,320 --> 01:52:07,600 HERE'S WHAT I CALL FIVE STYLIZED 2884 01:52:07,600 --> 01:52:13,200 FACTS FROM THE LITERATURE ON 2885 01:52:13,200 --> 01:52:16,120 ALZHEIMER'S DISEASE AND RELATED 2886 01:52:16,120 --> 01:52:16,560 DEMENTIAS. 2887 01:52:16,560 --> 01:52:18,840 FIRST WE KNOW ALZHEIMER'S 2888 01:52:18,840 --> 01:52:22,960 DISEASE IMPOSES SUBSTANTIAL 2889 01:52:22,960 --> 01:52:23,160 COST. 2890 01:52:23,160 --> 01:52:24,480 WE KNOW THIS. 2891 01:52:24,480 --> 01:52:25,920 IN PARTICULAR SOME COSTS IN 2892 01:52:25,920 --> 01:52:28,000 PARTICULAR HEALTH COSTS ARE 2893 01:52:28,000 --> 01:52:33,920 DRIVEN BY HOSPITAL AND NURSING 2894 01:52:33,920 --> 01:52:38,040 HOME CARE AND IT RISES WITH 2895 01:52:38,040 --> 01:52:38,520 DISEASE STAGE. 2896 01:52:38,520 --> 01:52:41,280 I'LL SHARE DATA IN A MOMENT. 2897 01:52:41,280 --> 01:52:44,680 AND CAREGIVER COSTS ARE 2898 01:52:44,680 --> 01:52:46,560 PARTICULARLY HIGH IN DEMENTIA 2899 01:52:46,560 --> 01:52:46,920 AND ALZHEIMER'S. 2900 01:52:46,920 --> 01:52:48,840 FOR ALZHEIMER'S DISEASE 2901 01:52:48,840 --> 01:52:52,240 COMPLICATED OTHER HEALTH ISSUES 2902 01:52:52,240 --> 01:52:55,400 AND FINALLY ALZHEIMER'S DISEASE 2903 01:52:55,400 --> 01:52:58,840 CARE AND COST DIFFER BY RACE AND 2904 01:52:58,840 --> 01:52:59,120 ETHNICITY. 2905 01:52:59,120 --> 01:52:59,720 I'LL SHARE SOME RESEARCH WITH 2906 01:52:59,720 --> 01:53:04,040 YOU. 2907 01:53:04,040 --> 01:53:05,560 THERE'S A LOT OF NUMBERS OUT 2908 01:53:05,560 --> 01:53:05,760 THERE. 2909 01:53:05,760 --> 01:53:09,400 THERE'S A NICE STUDY FROM THE 2910 01:53:09,400 --> 01:53:11,640 ALZHEIMER'S ASSOCIATION. 2911 01:53:11,640 --> 01:53:13,680 $320 BILLION IN 2022 AND YOU CAN 2912 01:53:13,680 --> 01:53:15,640 SEE THE BREAK DOWN THERE IN THE 2913 01:53:15,640 --> 01:53:21,200 PIE CHART. 2914 01:53:21,200 --> 01:53:23,080 A LOT OF ON THE RIGHT IS 2915 01:53:23,080 --> 01:53:24,440 MEDICARE AND OUT POCKET SPENDING 2916 01:53:24,440 --> 01:53:26,440 IS PARTICULARLY HIGH. 2917 01:53:26,440 --> 01:53:29,960 25% AND ALSO MEDICAID AND OTHER 2918 01:53:29,960 --> 01:53:30,200 COSTS. 2919 01:53:30,200 --> 01:53:36,640 AND THE FAR TOP RIGHT THIS DOES 2920 01:53:36,640 --> 01:53:37,640 NOT EVEN INCLUDE THE SUBSTANTIAL 2921 01:53:37,640 --> 01:53:46,240 CAREGIVER COSTS. 2922 01:53:46,240 --> 01:53:47,760 WE KNOW ALZHEIMER'S COSTS RISE 2923 01:53:47,760 --> 01:53:48,880 WITH DISEASE STAGE. 2924 01:53:48,880 --> 01:53:51,440 THIS DATA TRIES TO QUANTIFY 2925 01:53:51,440 --> 01:53:54,040 THAT. 2926 01:53:54,040 --> 01:53:58,160 $27,000 MILD, $41 ,000 SEVERE. 2927 01:53:58,160 --> 01:54:01,200 THE IMPLICATION IS IF WE CAN 2928 01:54:01,200 --> 01:54:04,480 DELAY PROGRESSION TO MORE SEVERE 2929 01:54:04,480 --> 01:54:05,600 STAGES WE CAN POTENTIALLY SAVE A 2930 01:54:05,600 --> 01:54:12,320 LOT OF MONEY AND IF WE DELAY 2931 01:54:12,320 --> 01:54:14,640 PROGRESSION ALL TOGETHER ON THE 2932 01:54:14,640 --> 01:54:18,400 FAR RIGHT WE COULD SAVE THE 2933 01:54:18,400 --> 01:54:19,160 $113,000 REPRESENT ANNUAL 2934 01:54:19,160 --> 01:54:25,600 NURSING HOME COSTS. 2935 01:54:25,600 --> 01:54:30,160 WE ALSO KNOW FROM THAT 2936 01:54:30,160 --> 01:54:35,720 ALZHEIMER'S DISEASE COMPLICATES 2937 01:54:35,720 --> 01:54:36,560 ISSUES. 2938 01:54:36,560 --> 01:54:47,240 ALZHEIMER'S DISEASE WE ALSO KNOW 2939 01:55:04,280 --> 01:55:07,600 BLACK AND HISPANICS VERSUS WHITE 2940 01:55:07,600 --> 01:55:08,160 PATIENTS WITH ALZHEIMER'S 2941 01:55:08,160 --> 01:55:09,360 DISEASE HAVE ADDITIONAL 2942 01:55:09,360 --> 01:55:10,560 COMPLICATIONS AND ISSUES. 2943 01:55:10,560 --> 01:55:15,000 SO THIS IS FROM A SERIES OF 2944 01:55:15,000 --> 01:55:15,960 PAPERS THAT MY COLLEAGUE HAS 2945 01:55:15,960 --> 01:55:16,120 LED. 2946 01:55:16,120 --> 01:55:19,000 YOU CAN SEE IN THE BOTTOM RIGHT 2947 01:55:19,000 --> 01:55:23,240 SOME OF THE RECENT PAPERS THAT 2948 01:55:23,240 --> 01:55:26,480 SHE HAS AND ON THE LEFT OF THE 2949 01:55:26,480 --> 01:55:29,280 SPECTRUM WE KNOW BLACKS AND 2950 01:55:29,280 --> 01:55:30,400 HISPANICS HAVE DELAYED 2951 01:55:30,400 --> 01:55:31,000 DIAGNOSIS. 2952 01:55:31,000 --> 01:55:32,480 THEY TEND TO GET DELAYED LATER 2953 01:55:32,480 --> 01:55:35,120 IN THE COURSE OF THE DISEASE. 2954 01:55:35,120 --> 01:55:38,440 THEY TEND TO BE TREATMENT DLAID 2955 01:55:38,440 --> 01:55:39,840 DELAYS AND LOWER ACCESS TO 2956 01:55:39,840 --> 01:55:43,000 SPECIALTY CARE AND SO FORTH. 2957 01:55:43,000 --> 01:55:45,680 THEN ON THE FAR RIGHT OF THE 2958 01:55:45,680 --> 01:55:47,760 SPECTRUM WE ALSO KNOW BLACK AND 2959 01:55:47,760 --> 01:55:50,080 HISPANIC PATIENTS VERSUS WHITE 2960 01:55:50,080 --> 01:55:52,840 PATIENTS HAVE LOWER USE OF 2961 01:55:52,840 --> 01:55:54,400 HOSPICE CARE. 2962 01:55:54,400 --> 01:55:57,200 MORE EMERGENCY DEPARTMENT VISITS 2963 01:55:57,200 --> 01:55:59,840 AND HOSPITALIZATIONS AND A LOT 2964 01:55:59,840 --> 01:56:05,920 MORE DETAIL IN THESE PAPERS. 2965 01:56:05,920 --> 01:56:07,680 SO LET ME TURN FROM THE ECONOMIC 2966 01:56:07,680 --> 01:56:12,400 BURDEN OF DEMENTIA TO COST 2967 01:56:12,400 --> 01:56:14,160 EFFECTIVENESS OF DMRSH CARE. 2968 01:56:14,160 --> 01:56:15,600 SOMETHING WE HAVEN'T HEARD A LOT 2969 01:56:15,600 --> 01:56:17,360 ABOUT YET IN THE CONFERENCE. 2970 01:56:17,360 --> 01:56:20,400 SO WE KNOW THE COSTS ARE HIGH 2971 01:56:20,400 --> 01:56:22,680 AND THE COSTS VARY BY STAGE AND 2972 01:56:22,680 --> 01:56:27,360 RACE AND ETHNICITY AND SO FORTH. 2973 01:56:27,360 --> 01:56:30,240 WHAT DO WE KNOW FROM FORMAL COST 2974 01:56:30,240 --> 01:56:35,480 EFFECTIVENESS ANALYSES OF THE 2975 01:56:35,480 --> 01:56:36,560 VALUE OF DEMENTIA CARE WE'VE 2976 01:56:36,560 --> 01:56:40,520 WORKED ON FOR A NUMBER OF YEARS? 2977 01:56:40,520 --> 01:56:42,320 MOORES THREE POINTS. 2978 01:56:42,320 --> 01:56:44,880 THERE'S A GROWING NUMBER OF COST 2979 01:56:44,880 --> 01:56:45,720 EFFECTIVENESS ANALYSES ON 2980 01:56:45,720 --> 01:56:47,520 DEMENTIA INTERVENTIONS AND THEY 2981 01:56:47,520 --> 01:56:49,080 SPAN A WIDE RANGE OF TOPICS. 2982 01:56:49,080 --> 01:56:52,400 SOME OF THESE INTERVENTIONS ARE 2983 01:56:52,400 --> 01:56:53,640 FOUND TO BE QUITE COST 2984 01:56:53,640 --> 01:56:54,400 EFFECTIVE. 2985 01:56:54,400 --> 01:56:57,840 AND THEN THE FINAL QUESTION 2986 01:56:57,840 --> 01:56:59,680 OPPOSED WITH THE TREATMENTS THAT 2987 01:56:59,680 --> 01:57:01,360 WE'RE JUST STARTING TO SEE. 2988 01:57:01,360 --> 01:57:08,040 WE'RE STARTING TO SEE MONOCLONAL 2989 01:57:08,040 --> 01:57:13,680 ANTIBODIES TARGETING AMYLOIDS IN 2990 01:57:13,680 --> 01:57:16,680 THE BRAIN AND AWAITING FDA 2991 01:57:16,680 --> 01:57:16,920 APPROVAL. 2992 01:57:16,920 --> 01:57:19,160 WE'RE IN THE COST EFFECTIVENESS 2993 01:57:19,160 --> 01:57:21,360 LITERATURE AND IN THE QUALITY 2994 01:57:21,360 --> 01:57:24,640 RATIO WORLD SO WE HAVE COSTS AND 2995 01:57:24,640 --> 01:57:28,400 INTERVENTION COST AND NET 2996 01:57:28,400 --> 01:57:34,040 SAVINGS AND QALYs AS THE DE 2997 01:57:34,040 --> 01:57:34,400 NOMINATOR. 2998 01:57:34,400 --> 01:57:37,640 THIS IS SHOWING INCREASES OVER 2999 01:57:37,640 --> 01:57:38,600 TIME. 3000 01:57:38,600 --> 01:57:40,200 SIMPLY IN THE COST EFFECTIVENESS 3001 01:57:40,200 --> 01:57:43,000 ANALYSIS OF DEMENTIA CARE COMING 3002 01:57:43,000 --> 01:57:43,960 FROM THE REGISTRY MY COLLEAGUES 3003 01:57:43,960 --> 01:57:45,320 AND I MAINTAIN. 3004 01:57:45,320 --> 01:57:47,920 WE FOUND 87 STUDIES ON THE COST 3005 01:57:47,920 --> 01:57:51,640 EFFECTIVENESS OF DEMENTIA CARE 3006 01:57:51,640 --> 01:57:55,560 ALL IN THE COST OF QUALITY 3007 01:57:55,560 --> 01:57:55,760 GAINED. 3008 01:57:55,760 --> 01:57:56,280 THEY SPAN A RANGE OF 3009 01:57:56,280 --> 01:58:06,520 INTERVENTIONS. 3010 01:58:38,120 --> 01:58:40,280 UNDER THIS RANGE IS CONSIDERED 3011 01:58:40,280 --> 01:58:41,360 COST EFFECTIVE. 3012 01:58:41,360 --> 01:58:43,760 ABOVE THAT IS OFTEN CONSIDERED 3013 01:58:43,760 --> 01:58:48,640 NOT COST EFFECTIVE OR LESS COST 3014 01:58:48,640 --> 01:58:48,880 EFFECTIVE. 3015 01:58:48,880 --> 01:58:49,960 THERE'S ACTIVE DEBATE WHETHER HE 3016 01:58:49,960 --> 01:58:52,880 SHOULD HAVE HIGHER COST 3017 01:58:52,880 --> 01:58:54,720 EFFECTIVENESS RATIOS FOR 3018 01:58:54,720 --> 01:58:55,960 ALZHEIMER'S AND OTHERS WILL TALK 3019 01:58:55,960 --> 01:58:59,560 ABOUT THAT AND YOU SEE TWO OTHER 3020 01:58:59,560 --> 01:59:02,880 EXAMPLES HERE. 3021 01:59:02,880 --> 01:59:04,000 CEREBROSPIRAL BIOMARKER AND A 3022 01:59:04,000 --> 01:59:06,960 PAPER LOOKING AT HYPOTHETICAL 3023 01:59:06,960 --> 01:59:09,600 DISEASE MODIFYING TREATMENT 3024 01:59:09,600 --> 01:59:10,520 DEPENDING WHETHER YOU INCLUDE 3025 01:59:10,520 --> 01:59:11,640 CAREGIVER COST AND QUALITY OF 3026 01:59:11,640 --> 01:59:19,640 LIFE IN THE STUDY. 3027 01:59:19,640 --> 01:59:23,080 SO THERE'S BEEN STUDIES ON SOME 3028 01:59:23,080 --> 01:59:28,120 OF THE ANTIBODIES. 3029 01:59:28,120 --> 01:59:38,640 THIS IS FROM THE REPORT AND FDA 3030 01:59:39,200 --> 01:59:39,360 ACTION. 3031 01:59:39,360 --> 01:59:41,200 AND THEY LOOKED AT HEALTH CARE 3032 01:59:41,200 --> 01:59:51,760 SECTOR AND SOCIETAL PERSPECTIVE. 3033 01:59:54,080 --> 02:00:04,520 AND PATIENT AND SOMETIMES COSTS 3034 02:00:15,800 --> 02:00:18,080 COULD BE THREE AND FOUR TIMES 3035 02:00:18,080 --> 02:00:19,160 HIGHER FOR ALZHEIMER'S. 3036 02:00:19,160 --> 02:00:22,040 LET ME END ON IMPLICATIONS FOR 3037 02:00:22,040 --> 02:00:23,920 CARE WITH A COUPLE QUICK 3038 02:00:23,920 --> 02:00:24,960 REMARKS. 3039 02:00:24,960 --> 02:00:27,840 WE NEED TO DO MORE RESEARCH. 3040 02:00:27,840 --> 02:00:30,000 WE NEED BETTER DATA ON ECONOMIC 3041 02:00:30,000 --> 02:00:31,640 BURDEN AND WE DO NEED IN MY VIEW 3042 02:00:31,640 --> 02:00:34,320 TO BETTER UNDERSTAND THE COST OF 3043 02:00:34,320 --> 02:00:35,400 FAMILIES AND SOCIETY AND 3044 02:00:35,400 --> 02:00:37,320 IDENTIFY AND QUANTIFY THE 3045 02:00:37,320 --> 02:00:39,320 NON-MEDICAL COSTS AND THEN A LOT 3046 02:00:39,320 --> 02:00:41,560 MORE WORK ON COST EFFECTIVENESS 3047 02:00:41,560 --> 02:00:42,040 ANALYSIS. 3048 02:00:42,040 --> 02:00:43,720 IN PARTICULAR TO LOOK AT WHAT 3049 02:00:43,720 --> 02:00:47,400 MAY NOT BE INCLUDED IN 3050 02:00:47,400 --> 02:00:48,280 CONVENTIONAL STUDIES. 3051 02:00:48,280 --> 02:00:50,000 RISK PREFERENCES WITH PATIENTS 3052 02:00:50,000 --> 02:00:52,520 AND CAREGIVERS AND FAMILY 3053 02:00:52,520 --> 02:00:53,440 SPILLOVER EFFECTS. 3054 02:00:53,440 --> 02:00:54,360 THINGS LIKE THAT. 3055 02:00:54,360 --> 02:00:55,240 NEXT SLIDE. 3056 02:00:55,240 --> 02:00:55,840 THANK YOU VERY MUCH AND LOOK 3057 02:00:55,840 --> 02:00:57,840 FORWARD TO THE DISCUSSION. 3058 02:00:57,840 --> 02:01:07,080 THANKS. 3059 02:01:07,080 --> 02:01:09,240 >>THANK YOU, DR. HAN AND 3060 02:01:09,240 --> 02:01:11,760 DR. JACOBSON AND DR. NEWMAN FOR 3061 02:01:11,760 --> 02:01:13,560 YOUR EXCELLENT PRESENTATIONS. 3062 02:01:13,560 --> 02:01:15,360 I'M PAIGE LIN. 3063 02:01:15,360 --> 02:01:16,400 A HEALTH ECONOMIST AND ASSOCIATE 3064 02:01:16,400 --> 02:01:18,800 PROFESSOR AT TUFT'S MEDICAL 3065 02:01:18,800 --> 02:01:19,640 CENTER. 3066 02:01:19,640 --> 02:01:23,400 I'M A CO-CHAIR OF THE SESSION. 3067 02:01:23,400 --> 02:01:28,800 HERE ARE OUR PROPOSED RESEARCH 3068 02:01:28,800 --> 02:01:30,680 GAPS AND OPPORTUNITIES WHICH 3069 02:01:30,680 --> 02:01:33,200 HIGHLIGHT THREE COST-CUTTING 3070 02:01:33,200 --> 02:01:35,720 THEMES ACROSS THE INDIVIDUALS 3071 02:01:35,720 --> 02:01:37,040 WITH DEMENTIA AND FAMILIES AND 3072 02:01:37,040 --> 02:01:39,240 HEALTH CARE SYSTEM. 3073 02:01:39,240 --> 02:01:40,520 WE PROPOSE TO SOMEONE THE 3074 02:01:40,520 --> 02:01:42,840 RELATIONSHIP BETWEEN DEMENTIA, 3075 02:01:42,840 --> 02:01:45,520 HEALTH INSURANCE AND HEALTH CARE 3076 02:01:45,520 --> 02:01:47,200 DECISION MAKING FROM EARLY TO 3077 02:01:47,200 --> 02:01:49,280 LATE STAGES OF THE DISEASE. 3078 02:01:49,280 --> 02:01:51,640 THIS INCLUDES ANALYZING HOW 3079 02:01:51,640 --> 02:01:53,120 DEMENTIA INFLUENCES A PERSON'S 3080 02:01:53,120 --> 02:01:55,240 HEALTH CARE PLAN CHOICES SUCH AS 3081 02:01:55,240 --> 02:01:55,880 TRADITIONAL MEDICARE AND 3082 02:01:55,880 --> 02:02:01,840 MEDICARE ADVANTAGE. 3083 02:02:01,840 --> 02:02:05,160 AND ACCESS TO CARE AND DEMENTIA 3084 02:02:05,160 --> 02:02:07,640 DIAGNOSIS AND DISEASE 3085 02:02:07,640 --> 02:02:07,920 MANAGEMENT. 3086 02:02:07,920 --> 02:02:10,880 OUR SECOND GNO IS TO SOMEONE THE 3087 02:02:10,880 --> 02:02:13,560 RELATIONSHIP BETWEEN DEMENTIA 3088 02:02:13,560 --> 02:02:15,080 AND FINANCIAL DECISION MAKING. 3089 02:02:15,080 --> 02:02:16,640 WE MUST BETTER PREDICT THE 3090 02:02:16,640 --> 02:02:20,760 COURSE OF DEMENTIA BECAUSE THAT 3091 02:02:20,760 --> 02:02:21,720 INFORMATION IS CRUCIAL FOR 3092 02:02:21,720 --> 02:02:23,160 PERSONS LIVING WITH A CONDITION 3093 02:02:23,160 --> 02:02:25,400 AND THEIR FAMILIES. 3094 02:02:25,400 --> 02:02:27,640 WE'RE MAKING FINANCIAL AND 3095 02:02:27,640 --> 02:02:28,160 MEDICAL DECISIONS. 3096 02:02:28,160 --> 02:02:30,360 AND WE THINK RESEARCH SHOULD 3097 02:02:30,360 --> 02:02:32,400 ANALYZE HOW INDIVIDUALS AND 3098 02:02:32,400 --> 02:02:36,960 FAMILIES PAY FOR DEMENTIA CARE 3099 02:02:36,960 --> 02:02:39,280 ACROSS DISEASE STAGES AND HOW 3100 02:02:39,280 --> 02:02:40,760 THEIR RETIREMENT SAVINGS PLANS 3101 02:02:40,760 --> 02:02:42,720 CHANGE AND IT'S IMPORTANT TO 3102 02:02:42,720 --> 02:02:46,120 LOOK AT THESE ISSUES IN THE 3103 02:02:46,120 --> 02:02:50,480 CONTEXT OF SOCIAL DETERMINATES 3104 02:02:50,480 --> 02:02:51,920 OF HEALTH. 3105 02:02:51,920 --> 02:02:53,440 LASTLY, WE'RE IN THE EXCITING 3106 02:02:53,440 --> 02:02:54,400 ERA OF INNOVATION OF DIAGNOSTICS 3107 02:02:54,400 --> 02:02:58,160 AND TREATMENTS. 3108 02:02:58,160 --> 02:03:00,000 FROM BE AN ECONOMIC PERSPECTIVE 3109 02:03:00,000 --> 02:03:02,240 WE THINK IT'S IMPORTANT TO 3110 02:03:02,240 --> 02:03:04,040 EXPAND THE RESEARCH BY NEW 3111 02:03:04,040 --> 02:03:06,440 MEASUREMENT OF SUCH TECHNOLOGIES 3112 02:03:06,440 --> 02:03:07,640 INCLUDING BLOOD BASED 3113 02:03:07,640 --> 02:03:16,880 BIOMARKERS. 3114 02:03:16,880 --> 02:03:18,840 AND FAMILIES CAN MAKE DECISIONS 3115 02:03:18,840 --> 02:03:22,320 ABOUT TREATMENT AND HOW THEY 3116 02:03:22,320 --> 02:03:24,360 THINK ABOUT BENEFITS, RISK AND 3117 02:03:24,360 --> 02:03:26,680 SIDE EFFECTS AND MAKING 3118 02:03:26,680 --> 02:03:27,840 FINANCIAL TRADE-OFF WITH OTHER 3119 02:03:27,840 --> 02:03:29,360 DEMENTIA CARE AND SUPPORT 3120 02:03:29,360 --> 02:03:30,240 SERVICES. 3121 02:03:30,240 --> 02:03:34,000 SO I JUST QUICKLY SUMMARIZE OUR 3122 02:03:34,000 --> 02:03:35,960 PROPOSED RESEARCH GAPS AND 3123 02:03:35,960 --> 02:03:39,920 OPPORTUNITIES. 3124 02:03:39,920 --> 02:03:41,640 IN THE NEXT 10 MINUTES WE'LL 3125 02:03:41,640 --> 02:03:42,760 HEAR FROM THREE DISTINGUISHED 3126 02:03:42,760 --> 02:03:46,280 SPEAKERS ON THE ECONOMIC IMPACT 3127 02:03:46,280 --> 02:03:47,920 OF DEMENTIA AND HOW WE AS 3128 02:03:47,920 --> 02:03:50,880 RESEARCHERS CAN HELP MOVE THE 3129 02:03:50,880 --> 02:03:51,720 FIELD FORWARD. 3130 02:03:51,720 --> 02:03:54,280 I'M OVER THE MOVE ABOUT THE 3131 02:03:54,280 --> 02:03:57,760 LINEUP OF PANELISTS. 3132 02:03:57,760 --> 02:03:59,680 WE'LL HEAR FROM DR. DARIUS 3133 02:03:59,680 --> 02:04:01,160 LAKDAWALLA FROM THE UNIVERSITY 3134 02:04:01,160 --> 02:04:02,800 OF SOUTHERN CALIFORNIA AND 3135 02:04:02,800 --> 02:04:04,720 DR. RACHELER FROM THE UNIVERSITY 3136 02:04:04,720 --> 02:04:06,600 OF PENNSYLVANIA WILL SHARE 3137 02:04:06,600 --> 02:04:10,600 REMARKS FOLLOWED BY DR. HELEN 3138 02:04:10,600 --> 02:04:14,320 LAMONT FROM ASPE OR THE OFFICE 3139 02:04:14,320 --> 02:04:15,920 OF ASSISTANT SECRETARY FOR 3140 02:04:15,920 --> 02:04:16,640 PLANNING AND EVALUATION AND 3141 02:04:16,640 --> 02:04:18,200 THEIR BIOS CAN BE FOUND IN THE 3142 02:04:18,200 --> 02:04:18,800 ONLINE PROGRAM. 3143 02:04:18,800 --> 02:04:26,080 IF I CAN INVITE DR. LAKDAWALLA, 3144 02:04:26,080 --> 02:04:36,520 PLEASE COME ON CAMERA I'M 3145 02:04:41,400 --> 02:04:42,680 THANKFUL TO THE ORGANIZERS FOR 3146 02:04:42,680 --> 02:04:44,080 INVITING ME TO THE SESSION. 3147 02:04:44,080 --> 02:04:47,640 I WANT TO PICK UP ON SOME THINGS 3148 02:04:47,640 --> 02:04:49,720 PAIGE EMPHASIZED AND CAME UP 3149 02:04:49,720 --> 02:04:52,320 EARLIER THERE'S VALUE FROM 3150 02:04:52,320 --> 02:04:53,200 PROGNOSTIC AND DIAGNOSTIC 3151 02:04:53,200 --> 02:04:53,920 INFORMATION ABOUT THE COURSE OF 3152 02:04:53,920 --> 02:04:55,600 THE ILLNESS. 3153 02:04:55,600 --> 02:04:57,920 WE KNOW THE ILLNESS IMPOSES 3154 02:04:57,920 --> 02:05:01,320 ENORMOUS BURDENS AND KNOW THE 3155 02:05:01,320 --> 02:05:03,600 BURDENS EXTEND BEYOND HEALTH YET 3156 02:05:03,600 --> 02:05:05,200 TOO OFTEN WE FOCUS EXCLUSIVELY 3157 02:05:05,200 --> 02:05:07,760 ON HEALTH OUTCOMES AND IGNORE 3158 02:05:07,760 --> 02:05:10,520 THE VALUE OF INFORMATION ON 3159 02:05:10,520 --> 02:05:11,120 IMPROVING SOCIAL AND ECONOMIC 3160 02:05:11,120 --> 02:05:21,280 OUTCOMES. 3161 02:05:23,960 --> 02:05:25,400 WHEN MY FATHER WAS DIAGNOSED 3162 02:05:25,400 --> 02:05:27,600 WHAT WAS CHALLENGES WAS HOW 3163 02:05:27,600 --> 02:05:28,960 LITTLE WE WERE TOLD ABOUT WHAT 3164 02:05:28,960 --> 02:05:31,200 TO EXPECT REGARDING HIS FUTURE. 3165 02:05:31,200 --> 02:05:35,720 IT'S NOT THAT WE DIDN'T HAVE 3166 02:05:35,720 --> 02:05:37,320 FANTASTIC PHYSICIANS AND 3167 02:05:37,320 --> 02:05:38,640 PROVIDERS OF CARE BUT THESE 3168 02:05:38,640 --> 02:05:40,000 THINGS AREN'T KNOWN. 3169 02:05:40,000 --> 02:05:42,480 WE WERE TOLD IT COULD BE A 3170 02:05:42,480 --> 02:05:44,120 COUPLE YEARS OR 10 OR 15 YEARS 3171 02:05:44,120 --> 02:05:46,560 BEFORE THERE'S A DECLINE. 3172 02:05:46,560 --> 02:05:50,280 IT COULD BE RAPID OR SLOW. 3173 02:05:50,280 --> 02:05:52,200 HIS DECLINE COULD BE COMPROMISED 3174 02:05:52,200 --> 02:05:53,840 EARLIER OR LATER AND COULD GO ON 3175 02:05:53,840 --> 02:05:54,880 AND ON ABOUT THE THINGS YOU 3176 02:05:54,880 --> 02:05:55,880 DON'T KNOW. 3177 02:05:55,880 --> 02:05:57,160 IT COMPLICATES PLANNING IN A 3178 02:05:57,160 --> 02:05:58,160 NUMBER OF WAYS. 3179 02:05:58,160 --> 02:05:59,000 YOU DON'T KNOW HOW MUCH THE 3180 02:05:59,000 --> 02:06:00,160 DISEASE IS GOING TO COST. 3181 02:06:00,160 --> 02:06:02,280 YOU DON'T KNOW WHAT KIND OF 3182 02:06:02,280 --> 02:06:04,200 ASSISTANCE IS GOING TO BE NEEDED 3183 02:06:04,200 --> 02:06:06,920 AND EVEN AFFECTS OTHER CLINICAL 3184 02:06:06,920 --> 02:06:13,000 DECISIONS LIKE HOW AGGRESSIVELY 3185 02:06:13,000 --> 02:06:14,880 DO YOU MANAGE COMORBID 3186 02:06:14,880 --> 02:06:15,920 CONDITIONS IF YOU DON'T KNOW HOW 3187 02:06:15,920 --> 02:06:18,200 LONG THERE IS LEFT IN A PATIENT 3188 02:06:18,200 --> 02:06:18,400 LIFE. 3189 02:06:18,400 --> 02:06:20,200 PEOPLE RECOGNIZE THE VALUE OF 3190 02:06:20,200 --> 02:06:22,920 KNOWING THESE KINDS OF THINGS. 3191 02:06:22,920 --> 02:06:25,480 THE PROBLEM IS OUR POLICIES 3192 02:06:25,480 --> 02:06:26,840 OFTEN FOCUS EXCLUSIVELY ON 3193 02:06:26,840 --> 02:06:29,080 CLINICAL OUTCOMES INSTEAD OF 3194 02:06:29,080 --> 02:06:31,920 SOCIAL AND ECONOMIC OUTCOMES. 3195 02:06:31,920 --> 02:06:32,960 MEDICARE FOR INSTANCE VALUES 3196 02:06:32,960 --> 02:06:34,240 DIAGNOSTICS ACCORDING TO HOW 3197 02:06:34,240 --> 02:06:36,680 THEY CHANGE TREATMENT DECISIONS 3198 02:06:36,680 --> 02:06:37,040 ALONE. 3199 02:06:37,040 --> 02:06:38,120 SO THE VIEW HAS BEEN AS LONG AS 3200 02:06:38,120 --> 02:06:39,680 THERE ARE NO EFFECTIVE 3201 02:06:39,680 --> 02:06:41,720 TREATMENTS FOR ALZHEIMER'S WE 3202 02:06:41,720 --> 02:06:44,560 DON'T SEE WHY DIAGNOSTICS OR 3203 02:06:44,560 --> 02:06:46,720 PROGNOSTIC INFORMATION FOR SURE 3204 02:06:46,720 --> 02:06:48,200 ARE ALL THAT VALUABLE. 3205 02:06:48,200 --> 02:06:50,560 THAT'S CLEARLY NOT TRUE. 3206 02:06:50,560 --> 02:06:54,400 THE ISSUE BECOMES THAT BY 3207 02:06:54,400 --> 02:06:56,400 FOCUSSING EXCLUSIVELY ON 3208 02:06:56,400 --> 02:07:00,560 CLINICAL DIMENSIONS AND WE'RE 3209 02:07:00,560 --> 02:07:03,040 COMPROMISING SOME OTHER CARE 3210 02:07:03,040 --> 02:07:06,280 LIKE COMORBID CONDITIONS AND 3211 02:07:06,280 --> 02:07:07,600 COMPROMISING SOCIAL AND ECONOMIC 3212 02:07:07,600 --> 02:07:10,480 OUTCOMES WHICH IS THE FOCUS OF 3213 02:07:10,480 --> 02:07:13,520 CARE FOR PATIENTS TODAY AS WE 3214 02:07:13,520 --> 02:07:15,120 WAIT FOR NEW TECHNOLOGIES. 3215 02:07:15,120 --> 02:07:18,320 I'M NOT SUGGESTING WE GIVE A 3216 02:07:18,320 --> 02:07:19,240 BLANK CHECK FOR DIAGNOSTIC 3217 02:07:19,240 --> 02:07:20,480 TECHNOLOGY BUT WHEN THINKING OF 3218 02:07:20,480 --> 02:07:23,320 VALUE, THE IMPACTS ON SOCIAL AND 3219 02:07:23,320 --> 02:07:24,920 ECONOMIC OUTCOMES NEED TO BE 3220 02:07:24,920 --> 02:07:26,000 EXPLICITLY CONSIDERED AND IF 3221 02:07:26,000 --> 02:07:28,400 THEY ARE, THE INCENTIVES WILL BE 3222 02:07:28,400 --> 02:07:30,400 CREATED FOR BETTER DIAGNOSTICS, 3223 02:07:30,400 --> 02:07:32,200 MORE PROGNOSTIC INFORMATION AND 3224 02:07:32,200 --> 02:07:34,280 BETTER DATA ABOUT HOW THESE 3225 02:07:34,280 --> 02:07:34,920 TECHNOLOGIES AFFECT SOCIAL AND 3226 02:07:34,920 --> 02:07:37,040 ECONOMIC OUTCOMES. 3227 02:07:37,040 --> 02:07:38,680 THANKS VERY MUCH FOR YOUR TIME. 3228 02:07:38,680 --> 02:07:39,400 IT'S A PLEASURE TO BE HERE AND 3229 02:07:39,400 --> 02:07:49,920 LOOK FORWARD TO YOUR QUESTIONS. 3230 02:08:04,400 --> 02:08:05,840 >>AND HOW PAYMENT POLICIES 3231 02:08:05,840 --> 02:08:07,440 AFFECT COST AND HOW MEDICARE 3232 02:08:07,440 --> 02:08:09,800 POLICIES AND THE MOVE TOWARDS 3233 02:08:09,800 --> 02:08:11,200 VALUE-BASED PAYMENT SPILLS OVER 3234 02:08:11,200 --> 02:08:13,360 TO CARE FOR A NEEDING POPULATION 3235 02:08:13,360 --> 02:08:14,960 THE NEED FOR LONG-TERM SERVICES 3236 02:08:14,960 --> 02:08:16,280 AND SUPPORT. 3237 02:08:16,280 --> 02:08:18,520 AND SO IT'S WELL KNOWN IN THE 3238 02:08:18,520 --> 02:08:20,880 AUDIENCE THE USE OF SERVICES AND 3239 02:08:20,880 --> 02:08:22,560 SUPPORTS IS COMMON AMONG PEOPLE 3240 02:08:22,560 --> 02:08:25,200 LIVING WITH DEMENTIA AND THEIR 3241 02:08:25,200 --> 02:08:29,040 HIGH COST TO MEDICARE AND TO 3242 02:08:29,040 --> 02:08:29,920 MEDICAID ASSOCIATED WITH THE 3243 02:08:29,920 --> 02:08:31,840 SUPPORTS IS LARGELY FUNDED BY 3244 02:08:31,840 --> 02:08:32,120 MEDICAID. 3245 02:08:32,120 --> 02:08:34,680 SOME IS PAID FOR OUT OF POCKET. 3246 02:08:34,680 --> 02:08:37,480 A LOT OF IT IS PAID FOR MY 3247 02:08:37,480 --> 02:08:39,840 FAMILY MEMBERS WHO HAVE UNPAID 3248 02:08:39,840 --> 02:08:41,120 CAREGIVING. 3249 02:08:41,120 --> 02:08:42,440 75% OF DEMENTIA RECEIVE 3250 02:08:42,440 --> 02:08:45,080 CAREGIVING. 3251 02:08:45,080 --> 02:08:52,160 THESE COSTS ADD TO UP 300 AND 3252 02:08:52,160 --> 02:08:54,960 $600 PER CAREGIVER AND MEDICARE 3253 02:08:54,960 --> 02:08:56,720 IS A LONG-TERM PAYER OF SERVICE 3254 02:08:56,720 --> 02:08:58,360 AND SUPPORTS THOUGH THAT GOES 3255 02:08:58,360 --> 02:09:00,400 AGAINST SOME WISDOM AND SOME 3256 02:09:00,400 --> 02:09:04,440 HOME HEALTH EPISODES ARE 3257 02:09:04,440 --> 02:09:05,240 INITIATED IN THE COMMUNITY AND 3258 02:09:05,240 --> 02:09:07,320 NOT PROMPTED BY AN ACUTE EPISODE 3259 02:09:07,320 --> 02:09:09,720 LIKE A HOSPITAL STAY. 3260 02:09:09,720 --> 02:09:12,160 WHILE THERE'S A SKILL NEED 3261 02:09:12,160 --> 02:09:15,080 REQUIRED TO INITIATE COVERAGE 3262 02:09:15,080 --> 02:09:17,120 EPISODE TO BE COVERED, THE VAST 3263 02:09:17,120 --> 02:09:19,760 MAJORITY OF PEOPLE WHO RECEIVE 3264 02:09:19,760 --> 02:09:22,880 HOME HEALTH GET HELP WITH ADLs 3265 02:09:22,880 --> 02:09:26,320 AND IADLs AND PARTICULARLY TRUE 3266 02:09:26,320 --> 02:09:31,520 AMONG THOSE WITH DEMENTIA AND 3267 02:09:31,520 --> 02:09:33,120 POST-HOSPITAL MEDICAL CARE IS 3268 02:09:33,120 --> 02:09:43,640 FUNDED AND THERE'S RESPITE FOR 3269 02:09:46,120 --> 02:09:49,080 CAREGIVERS AND THE SERVICE ARE 3270 02:09:49,080 --> 02:09:50,720 DECLINING AND THERE'S BUNDLED 3271 02:09:50,720 --> 02:09:52,560 PAYMENT AND ACCOUNTABLE CARE 3272 02:09:52,560 --> 02:09:52,880 ORGANIZATIONS. 3273 02:09:52,880 --> 02:09:54,760 ONE IMPORTANT QUESTION IS WHAT 3274 02:09:54,760 --> 02:09:57,760 THE EFFECT OF THIS DECLINING 3275 02:09:57,760 --> 02:09:59,400 MEDICARE FUNDED SUPPORT HAS FOR 3276 02:09:59,400 --> 02:10:01,320 AN AGING POPULATION AND PEOPLE 3277 02:10:01,320 --> 02:10:06,120 LIVING WITH DEMENTIA. 3278 02:10:06,120 --> 02:10:07,600 WE KNOW AS A RESULT OF THIS CARE 3279 02:10:07,600 --> 02:10:13,040 IS DECLINING AND NON-REIMBURSED 3280 02:10:13,040 --> 02:10:14,600 HELP SUCH AS UNPAID CAREGIVERS 3281 02:10:14,600 --> 02:10:18,200 IS INCREASING AND THERE'S 3282 02:10:18,200 --> 02:10:19,440 EVIDENCE THE INCREASE IN 3283 02:10:19,440 --> 02:10:21,320 CAREGIVING IS CAUSED TO A CHANGE 3284 02:10:21,320 --> 02:10:22,840 IN MEDICARE PAYMENT. 3285 02:10:22,840 --> 02:10:24,720 THIS HAS IMPLICATIONS FOR PEOPLE 3286 02:10:24,720 --> 02:10:26,960 LIVING WITH DEMENTIA AND THE 3287 02:10:26,960 --> 02:10:29,080 DECLINING SUPPORT WITH 3288 02:10:29,080 --> 02:10:30,960 ALTERNATIVE PAYMENT MODELS RISK 3289 02:10:30,960 --> 02:10:32,320 INCREASES BURDEN WHICH WE KNOW 3290 02:10:32,320 --> 02:10:34,040 TO BE QUITE HIGH. 3291 02:10:34,040 --> 02:10:35,600 AS THE TRENDS TOWARDS MORE CARE 3292 02:10:35,600 --> 02:10:38,080 AT HOME HAVE ACCELERATED WE 3293 02:10:38,080 --> 02:10:42,800 MIGHT EXPECT FURTHER INCREASES 3294 02:10:42,800 --> 02:10:43,840 IN THE BURDEN. 3295 02:10:43,840 --> 02:10:45,960 IT ALSO HAS POLICY IMPLICATIONS 3296 02:10:45,960 --> 02:10:47,080 BUT HARD TO CONSIDER THE 3297 02:10:47,080 --> 02:10:48,760 INDIRECT COSTS WHEN YOU CONSIDER 3298 02:10:48,760 --> 02:10:52,560 PAYMENT POLICY AND REFORM AND 3299 02:10:52,560 --> 02:10:53,920 HIGHLIGHTS THE NEED TO PROVIDE 3300 02:10:53,920 --> 02:10:55,240 RATIONALE AND POLICY APPROACHES 3301 02:10:55,240 --> 02:10:58,440 TO LESSEN THE BURDEN ON 3302 02:10:58,440 --> 02:11:01,400 CAREGIVERS INCLUDING PROVIDING 3303 02:11:01,400 --> 02:11:02,440 MORE FINANCIAL SUPPORT TO 3304 02:11:02,440 --> 02:11:03,680 CAREGIVERS AND MORE 3305 02:11:03,680 --> 02:11:05,120 COMPREHENSIVE HOME-BASED OPTIONS 3306 02:11:05,120 --> 02:11:07,040 TO LESSEN THE BURDEN ON 3307 02:11:07,040 --> 02:11:07,320 CAREGIVERS. 3308 02:11:07,320 --> 02:11:11,640 I'LL STOP MY COMMENTS THERE. 3309 02:11:11,640 --> 02:11:14,720 THANK YOU FOR HAVING ME. 3310 02:11:14,720 --> 02:11:17,520 >>THANK YOU FOR HAVING ME 3311 02:11:17,520 --> 02:11:17,720 TODAY. 3312 02:11:17,720 --> 02:11:22,800 I'M FROM ASPE IS THE OFFICE FOR 3313 02:11:22,800 --> 02:11:23,680 ASSISTANT SECRETARY PLANNING AND 3314 02:11:23,680 --> 02:11:24,720 EVALUATION AND YEAR IN THE 3315 02:11:24,720 --> 02:11:26,840 OFFICE OF THE SECRETARY OF HHS. 3316 02:11:26,840 --> 02:11:29,080 SO IT SITS AT THE INTERSECTION 3317 02:11:29,080 --> 02:11:30,440 OF RESEARCH AND POLICY. 3318 02:11:30,440 --> 02:11:31,680 I WANTED TO JOIN YOU TODAY TO 3319 02:11:31,680 --> 02:11:33,400 BOTH APPLAUD YOUR WORK AND GIVE 3320 02:11:33,400 --> 02:11:34,840 YOU AN ADDITIONAL CHARGE. 3321 02:11:34,840 --> 02:11:38,400 SO IT'S BEEN SO ENCOURAGING TO 3322 02:11:38,400 --> 02:11:47,480 SEE PATIENT-CENTERED OUTCOME AT 3323 02:11:47,480 --> 02:11:49,440 PATIENT-CENTERED OUTCOMES AND 3324 02:11:49,440 --> 02:11:52,160 THE MOST COSTLY ARE 3325 02:11:52,160 --> 02:11:54,240 HOSPITALIZATIONS, NURSING HOME 3326 02:11:54,240 --> 02:11:56,080 PLACEMENT, FINANCIAL 3327 02:11:56,080 --> 02:11:56,400 EXPLOITATION. 3328 02:11:56,400 --> 02:11:58,200 WHAT POLICY MAKERS ARE TRYING TO 3329 02:11:58,200 --> 02:12:00,040 WORK TOWARDS IS HIGH VALUE CARE 3330 02:12:00,040 --> 02:12:01,760 AND IMPROVES OUTCOME AND OFTEN 3331 02:12:01,760 --> 02:12:03,040 THE CARE LESS COSTLY. 3332 02:12:03,040 --> 02:12:04,680 I'VE BEEN PART OF CONVERSATIONS 3333 02:12:04,680 --> 02:12:06,120 WITH POLICY MAKERS WHO WANT TO 3334 02:12:06,120 --> 02:12:08,160 IMPLEMENT A CHANGE BUT WE DON'T 3335 02:12:08,160 --> 02:12:09,880 HAVE THE SPECIFIC INFORMATION 3336 02:12:09,880 --> 02:12:11,560 THAT WE NEED OF WHAT THE 3337 02:12:11,560 --> 02:12:13,680 ECONOMIC INVESTMENTS ARE UP 3338 02:12:13,680 --> 02:12:15,520 FRONT AND WHERE THE VALUES WILL 3339 02:12:15,520 --> 02:12:17,760 BE A LITTLE BIT DOWN STREAM. 3340 02:12:17,760 --> 02:12:20,840 SO IN THE LAST DECADE DEMENTIA 3341 02:12:20,840 --> 02:12:22,960 RESEARCH HAS COME VERY FAR 3342 02:12:22,960 --> 02:12:24,160 ESPECIALLY DEMENTIA CARE 3343 02:12:24,160 --> 02:12:24,440 RESEARCH. 3344 02:12:24,440 --> 02:12:25,640 WE NEED MORE INFORMATION ABOUT 3345 02:12:25,640 --> 02:12:27,520 WHAT YOU ALL ARE DOING IN THE 3346 02:12:27,520 --> 02:12:28,440 RESEARCH COMMUNITY SO WE CAN GET 3347 02:12:28,440 --> 02:12:33,760 TO IMPLEMENTATION. 3348 02:12:33,760 --> 02:12:35,720 WE NEED TO KNOW HOW MUCH IT 3349 02:12:35,720 --> 02:12:37,840 COSTS TO RECRUIT AND RETAIN THE 3350 02:12:37,840 --> 02:12:41,840 PEOPLE WITH THE INTERVENTIONS 3351 02:12:41,840 --> 02:12:43,360 AND HOW MUCH IT COST TO MODIFY 3352 02:12:43,360 --> 02:12:45,520 AN E.H.R. FOR THE WORK FLOW AND 3353 02:12:45,520 --> 02:12:48,040 THE DETAILS RESEARCHERS USE TO 3354 02:12:48,040 --> 02:12:50,880 CALCULATE POWER SO THERE'S 3355 02:12:50,880 --> 02:12:53,160 ENOUGH STATISTICAL POWER TO FIND 3356 02:12:53,160 --> 02:12:54,760 AN EFFECT IS IMPORTANT TO SHARE 3357 02:12:54,760 --> 02:12:56,320 PUBLICLY AND IN YOUR 3358 02:12:56,320 --> 02:12:58,400 PUBLICATIONS SO BROADER 3359 02:12:58,400 --> 02:12:59,400 AUDIENCES, HEALTH CARE SYSTEMS, 3360 02:12:59,400 --> 02:13:01,640 POLICY MAKERS CAN USE THAT 3361 02:13:01,640 --> 02:13:03,200 INFORMATION AS THEY MAKE 3362 02:13:03,200 --> 02:13:03,440 DECISIONS. 3363 02:13:03,440 --> 02:13:04,960 I APPLAUD YOU ALL FOR 3364 02:13:04,960 --> 02:13:06,120 RECOGNIZING THE DIVERSITY OF 3365 02:13:06,120 --> 02:13:09,640 PEOPLE WITH DEMENTIA AND THEIR 3366 02:13:09,640 --> 02:13:10,760 CAREGIVERS, THE COMMUNITIES 3367 02:13:10,760 --> 02:13:12,600 WHERE THEY LIVE AND THE SYSTEMS 3368 02:13:12,600 --> 02:13:14,400 IN WHICH THEY GET CARE AND 3369 02:13:14,400 --> 02:13:16,480 PUBLISH THE DIFFERENTIAL IMPACTS 3370 02:13:16,480 --> 02:13:17,280 ON THE INTERVENTIONS BROKEN DOWN 3371 02:13:17,280 --> 02:13:18,760 BY THE CHARACTERISTICS AT ALL 3372 02:13:18,760 --> 02:13:21,080 THESE DIFFERENT LEVELS. 3373 02:13:21,080 --> 02:13:23,000 IT WOULD BE ESPECIALLY HELPFUL 3374 02:13:23,000 --> 02:13:24,520 TO HAVE DIFFERENCES BY 3375 02:13:24,520 --> 02:13:25,520 CHARACTERISTICS THAT LEND 3376 02:13:25,520 --> 02:13:27,400 THEMSELVES TO POLICY 3377 02:13:27,400 --> 02:13:28,480 INTERVENTION LIKE PEOPLE DULY 3378 02:13:28,480 --> 02:13:31,400 ELIGIBLE FOR MEDICARE AND 3379 02:13:31,400 --> 02:13:31,640 MEDICAID. 3380 02:13:31,640 --> 02:13:34,000 I ALSO ENCOURAGE YOU TO SHARE 3381 02:13:34,000 --> 02:13:35,200 SELECTION WITH RESEARCH TO 3382 02:13:35,200 --> 02:13:37,520 UNDERSTAND HOW FINDINGS CAN BE 3383 02:13:37,520 --> 02:13:38,640 GENERALIZED AND WHO CAN USE THE 3384 02:13:38,640 --> 02:13:40,440 RESEARCH AND WHERE WE HAVE GAPS 3385 02:13:40,440 --> 02:13:41,640 IN KNOWLEDGE. 3386 02:13:41,640 --> 02:13:43,440 UNLIKE MANY POLICY ISSUES THE 3387 02:13:43,440 --> 02:13:45,440 IMPACT OF DEMENTIA GOES FAR 3388 02:13:45,440 --> 02:13:46,320 BEYOND MEDICARE. 3389 02:13:46,320 --> 02:13:48,520 THE CARE FUNDED BY MEDICARE, 3390 02:13:48,520 --> 02:13:49,000 MEDICAID, COMMUNITY 3391 02:13:49,000 --> 02:13:50,040 ORGANIZATIONS AND FAMILY IMPACTS 3392 02:13:50,040 --> 02:13:52,120 THE COST OF CARE BY ALL THOSE 3393 02:13:52,120 --> 02:13:53,760 OTHER PAYERS. 3394 02:13:53,760 --> 02:13:56,520 WE THINK IMPROVING DEMENTIA CARE 3395 02:13:56,520 --> 02:13:58,400 THROUGH MEDICARE WILL DELAY 3396 02:13:58,400 --> 02:14:00,040 NURSING HOME PLACEMENT BUT FOR 3397 02:14:00,040 --> 02:14:01,480 HOW LONG AND FOR WHAT 3398 02:14:01,480 --> 02:14:02,920 POPULATIONS AT WHAT SAVINGS? 3399 02:14:02,920 --> 02:14:03,760 WE NEED INFRASTRUCTURE AND 3400 02:14:03,760 --> 02:14:05,880 UNDERSTAND HOW THE PAYERS 3401 02:14:05,880 --> 02:14:08,000 INTERACT AND WHERE COSTS ACCRUE 3402 02:14:08,000 --> 02:14:10,080 AND VALUE ACCRUE THROUGHOUT THE 3403 02:14:10,080 --> 02:14:11,200 DISEASE PROCESS. 3404 02:14:11,200 --> 02:14:12,360 FINALLY, I ENCOURAGE EVERYONE TO 3405 02:14:12,360 --> 02:14:14,440 THINK OF THE VALUE OF CARE 3406 02:14:14,440 --> 02:14:16,240 ACROSS THE DISEASE CONTINUUM. 3407 02:14:16,240 --> 02:14:18,600 WHILE THERE'S BEEN FOCUS ON 3408 02:14:18,600 --> 02:14:19,280 SLOWING DISEASE PROGRESSION 3409 02:14:19,280 --> 02:14:21,800 EARLY ON, I THINK WE NEED TO 3410 02:14:21,800 --> 02:14:24,360 CONSIDER WHETHER AND HOW IT WILL 3411 02:14:24,360 --> 02:14:26,360 IMPACT QUALITY OF LIFE DURING 3412 02:14:26,360 --> 02:14:29,320 THE HARD YEARS WHEN SOMEONE WITH 3413 02:14:29,320 --> 02:14:31,040 DEMENTIA NEEDS HIGH LEVEL, CARE 3414 02:14:31,040 --> 02:14:33,160 AND DOES THAT BRING VALUE FOR 3415 02:14:33,160 --> 02:14:34,320 THE PERSON OR ECONOMICALLY WHAT 3416 02:14:34,320 --> 02:14:35,920 YOU WANT TO INVEST IN AND HOW 3417 02:14:35,920 --> 02:14:37,880 DOES THAT CHANGE OUR VALUE 3418 02:14:37,880 --> 02:14:39,640 CALCULATIONS. 3419 02:14:39,640 --> 02:14:45,200 THANK YOU SO MUCH. 3420 02:14:45,200 --> 02:14:48,040 >>THANK YOU, DR. LAKDAWALLA AND 3421 02:14:48,040 --> 02:14:49,640 DR. WERNER AND DR. LAMONT. 3422 02:14:49,640 --> 02:14:55,240 WE APPRECIATE YOUR REMARKS. 3423 02:14:55,240 --> 02:14:55,920 I'VE BEEN TOLD THE TECHNICAL 3424 02:14:55,920 --> 02:14:59,200 TEAM NEED TO DO A QUICK CHECK OF 3425 02:14:59,200 --> 02:15:02,840 THE SYSTEM BEFORE WE MOVE ON TO 3426 02:15:02,840 --> 02:15:03,560 THE DISCUSSION. 3427 02:15:03,560 --> 02:15:05,920 SO I THINK IT'S GOING TO BE A 3428 02:15:05,920 --> 02:15:06,920 QUICK CHECK. 3429 02:15:06,920 --> 02:15:09,000 IF YOU NEED TO STAND UP, 3430 02:15:09,000 --> 02:15:12,920 STRETCH, GET SOME WATER, OR DO 3431 02:15:12,920 --> 02:15:17,080 DOWNWARD FACING DOG NOW IS A 3432 02:15:17,080 --> 02:15:18,720 GOOD TIME AND TAKE A VERY SHORT 3433 02:15:18,720 --> 02:15:43,240 ONE OR TWO-MINUTE BREAK. 3434 02:15:43,240 --> 02:15:46,600 I'M GOING TO START US OFF ON 3435 02:15:46,600 --> 02:15:55,000 DIAGNOSTIC INFORMATION AND TO 3436 02:15:55,000 --> 02:15:58,440 DR. LAKDAWALLA'S POINT ABOUT HOW 3437 02:15:58,440 --> 02:15:59,680 THIS CAN CHANGE -- THIS VARIES 3438 02:15:59,680 --> 02:16:02,440 FROM PERSON TO PERSON AND THAT 3439 02:16:02,440 --> 02:16:03,760 UNCERTAINTY IS A CHALLENGE FOR 3440 02:16:03,760 --> 02:16:05,680 PATIENTS AND FAMILIES TO SAY THE 3441 02:16:05,680 --> 02:16:07,520 LEAST WHEN MAKING PLANS FOR THE 3442 02:16:07,520 --> 02:16:11,720 FUTURE. 3443 02:16:11,720 --> 02:16:13,200 SO CAN YOU COMMENT ON THE 3444 02:16:13,200 --> 02:16:15,960 ECONOMIC VALUE OF DIAGNOSTIC 3445 02:16:15,960 --> 02:16:17,480 INFORMATION AND WHAT POLICY 3446 02:16:17,480 --> 02:16:19,560 TOOLS OR DATA SOURCES OUT THERE 3447 02:16:19,560 --> 02:16:21,720 CAN HELP ADDRESS THE 3448 02:16:21,720 --> 02:16:23,000 UNCERTAINTIES AND MAYBE MAYBE 3449 02:16:23,000 --> 02:16:24,800 THIS IS A QUESTION FOR 3450 02:16:24,800 --> 02:16:27,960 DR. LAMONT I KNOW IT'S MENTIONED 3451 02:16:27,960 --> 02:16:30,080 IN THE NAPA AND THE NEW DATA 3452 02:16:30,080 --> 02:16:33,880 SOURCE SUPPORTED BY THE NIA THE 3453 02:16:33,880 --> 02:16:34,640 H CAP PROJECT. 3454 02:16:34,640 --> 02:16:37,000 I WONDER IF YOU CAN ALL COMMENT 3455 02:16:37,000 --> 02:16:47,160 ON THAT. 3456 02:17:05,520 --> 02:17:08,720 >>WE DID A HYPOTHETICAL STUDY 3457 02:17:08,720 --> 02:17:11,680 ABOUT FINDING OUT ABOUT 3458 02:17:11,680 --> 02:17:13,520 ALZHEIMER'S AND WHAT THEY WOULD 3459 02:17:13,520 --> 02:17:15,880 DO ABOUT IT AND LOOK AT FINANCES 3460 02:17:15,880 --> 02:17:18,120 AND MAYBE SEEK OUT AN APPROVED 3461 02:17:18,120 --> 02:17:21,320 TREATMENT AND ON AND ON. 3462 02:17:21,320 --> 02:17:22,360 HOWEVER, THERE WAS A LOT OF 3463 02:17:22,360 --> 02:17:22,640 VARIATION. 3464 02:17:22,640 --> 02:17:23,960 SOME PEOPLE DON'T WANT THE TEST. 3465 02:17:23,960 --> 02:17:26,480 MOST SAID THEY WOULD. 3466 02:17:26,480 --> 02:17:34,560 IT SUGGESTS WHAT WAS SAID YEREAY 3467 02:17:34,560 --> 02:17:36,760 JUST KNOWING ONE'S STATS FROM 3468 02:17:36,760 --> 02:17:38,760 TREATMENT CONSEQUENCES. 3469 02:17:38,760 --> 02:17:40,400 AS FAR AS DATA AND RESEARCH I 3470 02:17:40,400 --> 02:17:43,800 THINK THIS IS AN AREA WE SHOULD 3471 02:17:43,800 --> 02:17:45,080 INVEST IN. 3472 02:17:45,080 --> 02:17:46,440 SOME OF THE RESEARCH WILL COME 3473 02:17:46,440 --> 02:17:48,920 FROM SURVEYS OR PREFERENCES OF 3474 02:17:48,920 --> 02:17:49,920 PEOPLE. 3475 02:17:49,920 --> 02:17:52,400 I THINK THAT'S ONE AREA OF 3476 02:17:52,400 --> 02:17:53,480 PATIENT-REPORTED OUTCOMES WERE 3477 02:17:53,480 --> 02:17:54,960 MENTIONED AND LOTS OF OTHER 3478 02:17:54,960 --> 02:17:55,200 THINGS. 3479 02:17:55,200 --> 02:18:05,400 I'LL STOP. 3480 02:18:06,080 --> 02:18:07,680 >>I'LL CHIME IN WHEN WE THINK 3481 02:18:07,680 --> 02:18:09,440 OF VALUE OF DIAGNOSIS AND WE 3482 02:18:09,440 --> 02:18:13,200 THINK ABOUT THE PATIENT AND THIS 3483 02:18:13,200 --> 02:18:14,680 AND A POINT THAT A LOT OF THE 3484 02:18:14,680 --> 02:18:16,320 VALUE COMES TO FAMILIES AND 3485 02:18:16,320 --> 02:18:16,800 CAREGIVERS. 3486 02:18:16,800 --> 02:18:18,800 WE DON'T REALLY TAKE THAT INTO 3487 02:18:18,800 --> 02:18:21,320 ACCOUNT WHEN WE'RE THINKING 3488 02:18:21,320 --> 02:18:25,960 ABOUT THESE DIAGNOSTICS AND SO I 3489 02:18:25,960 --> 02:18:27,280 THINK THAT ADDS A LAYER WE NEED 3490 02:18:27,280 --> 02:18:36,600 TO CONSIDER HERE. 3491 02:18:36,600 --> 02:18:40,040 >>THAT'S AN IMPORTANT POINT 3492 02:18:40,040 --> 02:18:42,160 JUST MADE THAT ALZHEIMER'S EVERY 3493 02:18:42,160 --> 02:18:44,440 DISEASE IS IT'S OWN 3494 02:18:44,440 --> 02:18:45,960 IDIOSYNCRATIC SET OF PROBLEMS 3495 02:18:45,960 --> 02:18:47,480 WILT ONE ISSUE WITH ALZHEIMER'S 3496 02:18:47,480 --> 02:18:48,560 IS SO MUCH OF THE BURDEN 3497 02:18:48,560 --> 02:18:50,680 SHIFTING TO FAMILIES AND 3498 02:18:50,680 --> 02:18:52,240 CAREGIVERS JUST BECAUSE IT'S 3499 02:18:52,240 --> 02:18:54,800 SUCH AN ALL-ENCOMPASSING SET OF 3500 02:18:54,800 --> 02:18:58,120 HEALTH PROBLEMS FOR THE PATIENT 3501 02:18:58,120 --> 02:19:01,000 AND I THINK THAT'S OFTEN UNDER 3502 02:19:01,000 --> 02:19:04,400 APPRECIATE AND THE OTHER ISSUE 3503 02:19:04,400 --> 02:19:05,240 IS INFORMATION IS VALUABLE ALSO 3504 02:19:05,240 --> 02:19:07,400 POST DIAGNOSIS TO HELP FAMILIES 3505 02:19:07,400 --> 02:19:08,520 AND PATIENTS UNDERSTAND THE 3506 02:19:08,520 --> 02:19:10,600 TRAJECTORY OF THE ILLNESS TO THE 3507 02:19:10,600 --> 02:19:21,080 EXTENT IT CAN BE PREDICTED. 3508 02:19:29,840 --> 02:19:33,320 >>I AGREE AND AN INFUSION 3509 02:19:33,320 --> 02:19:37,480 THERAPY THAT REQUIRES SOMEONE TO 3510 02:19:37,480 --> 02:19:43,000 TAKE SOMEONE AN HOUR AWAY MAY 3511 02:19:43,000 --> 02:19:44,400 HAVE A DIFFERENT VALUE 3512 02:19:44,400 --> 02:19:48,360 CALCULATION AND TELEHEALTH MAY 3513 02:19:48,360 --> 02:19:50,440 BE VALUABLE FOR THE CAREGIVERS 3514 02:19:50,440 --> 02:19:52,000 BUT MAYBE NOT FOR THE EFFICIENT 3515 02:19:52,000 --> 02:19:55,280 AND WHAT CAN WE BRING TO BEAR ON 3516 02:19:55,280 --> 02:19:55,840 THE DECISION MAKING PROCESS 3517 02:19:55,840 --> 02:20:00,200 RELATED TO THESE. 3518 02:20:00,200 --> 02:20:02,560 >>IF I CAN FOLLOW UP ON THE 3519 02:20:02,560 --> 02:20:05,200 VALUE OF DIAGNOSTIC AND 3520 02:20:05,200 --> 02:20:06,960 INCORPORATING CAREGIVERS' 3521 02:20:06,960 --> 02:20:07,280 PERSPECTIVE. 3522 02:20:07,280 --> 02:20:10,200 WE KNOW MOST COST-EFFECTIVENESS 3523 02:20:10,200 --> 02:20:12,320 ANALYSIS OF DEMENTIA TREATMENT 3524 02:20:12,320 --> 02:20:14,560 TYPICALLY START WITH A DIAGNOSED 3525 02:20:14,560 --> 02:20:14,840 POPULATION. 3526 02:20:14,840 --> 02:20:18,440 AND THESE MODELS DO NOT DEAL 3527 02:20:18,440 --> 02:20:19,440 WITH DIAGNOSTIC UNCERTAINTIES OR 3528 02:20:19,440 --> 02:20:22,920 DISPARITIES. 3529 02:20:22,920 --> 02:20:25,360 AND HOW DO WE THINK OF THE VALUE 3530 02:20:25,360 --> 02:20:26,440 OF DIFFERENT DIAGNOSTIC 3531 02:20:26,440 --> 02:20:28,920 STRATEGIES AND WHAT DO YOU THINK 3532 02:20:28,920 --> 02:20:29,960 HOW THEY WILL INFLUENCE THE 3533 02:20:29,960 --> 02:20:40,320 VALUE OF TREATMENTS. 3534 02:20:51,040 --> 02:20:53,560 >>THERE'S COST EFFECTIVENESS OF 3535 02:20:53,560 --> 02:20:57,200 THE MEAN MODEL BUT DON'T INCLUDE 3536 02:20:57,200 --> 02:20:57,440 DIAGNOSIS. 3537 02:20:57,440 --> 02:21:02,200 THEY START WITH THE DIAGNOSED 3538 02:21:02,200 --> 02:21:03,720 POPULATION. 3539 02:21:03,720 --> 02:21:04,520 WE KNOW THAT DIAGNOSTIC PROCESS 3540 02:21:04,520 --> 02:21:09,920 IS VERY VARIABLE AND OFTEN 3541 02:21:09,920 --> 02:21:12,080 COSTLY IN THE PREFERENCES PEOPLE 3542 02:21:12,080 --> 02:21:13,000 HAVE. 3543 02:21:13,000 --> 02:21:14,040 WE SHOULD ATTACHED DIAGNOSIS TO 3544 02:21:14,040 --> 02:21:17,400 THE ANALYSIS DURING THE BEST WE 3545 02:21:17,400 --> 02:21:18,720 CAN WITH ASSUMPTIONS AND 3546 02:21:18,720 --> 02:21:19,840 COLLECTING MORE DATA ON 3547 02:21:19,840 --> 02:21:30,240 PREFERENCES AND COSTS. 3548 02:21:33,680 --> 02:21:35,800 >>UNDERSTANDING PEOPLE'S RISK 3549 02:21:35,800 --> 02:21:36,480 PREFERENCES IS CRITICAL AND THE 3550 02:21:36,480 --> 02:21:39,000 ROLE OF RISK, UNCERTAINTY AND 3551 02:21:39,000 --> 02:21:40,600 PEOPLE'S ATTITUDES TOWARDS RISK 3552 02:21:40,600 --> 02:21:42,160 VALUABLE TO REDUCE THAT RISK AND 3553 02:21:42,160 --> 02:21:44,600 ALSO ONE THING WE LEARNED FROM 3554 02:21:44,600 --> 02:21:47,360 COVID IS THAT IT'S NOT JUST 3555 02:21:47,360 --> 02:21:50,480 ABOUT DIAGNOSING A PATIENT. 3556 02:21:50,480 --> 02:21:51,160 IT'S ABOUT POPULATION 3557 02:21:51,160 --> 02:21:52,160 SURVEILLANCE AS WELL TO SOME 3558 02:21:52,160 --> 02:21:55,000 EXTENT AND UNDERSTANDING WHO IS 3559 02:21:55,000 --> 02:21:57,120 AT RISK, WHO IS SUFFERING 3560 02:21:57,120 --> 02:21:58,880 FUNCTIONAL LIMITATIONS, WHO 3561 02:21:58,880 --> 02:22:01,240 MIGHT SUFFER THEM IN THE FUTURE 3562 02:22:01,240 --> 02:22:04,880 IF THEY DON'T. 3563 02:22:04,880 --> 02:22:05,920 UNDERSTANDING THE RISK CAN HELP 3564 02:22:05,920 --> 02:22:07,680 MAKE BETTER DECISIONS AS WELL. 3565 02:22:07,680 --> 02:22:08,520 THAT'S IMPORTANT TO UNDERSTAND 3566 02:22:08,520 --> 02:22:09,920 FROM THE EARLIER DISCUSSIONS. 3567 02:22:09,920 --> 02:22:11,720 >>A COUPLE YEARS AGO AT THE 3568 02:22:11,720 --> 02:22:13,640 RELATED DEMENTIA SUMMIT THEY 3569 02:22:13,640 --> 02:22:16,640 PRESENTED ON THE PREVALENCE OF 3570 02:22:16,640 --> 02:22:18,320 DIFFERENT PATHOLOGIES IN THE 3571 02:22:18,320 --> 02:22:20,560 BRAINS OF PEOPLE WHO DIED FROM 3572 02:22:20,560 --> 02:22:22,000 DEMENTIA AND AMYLOID ALONE WAS 3573 02:22:22,000 --> 02:22:23,000 LESS THAN 10%. 3574 02:22:23,000 --> 02:22:25,320 AS WE HAVE NEW TREATMENTS 3575 02:22:25,320 --> 02:22:27,560 TARGETED TO SPECIFIC 3576 02:22:27,560 --> 02:22:28,800 PATHOLOGIES, WE'RE GOING TO 3577 02:22:28,800 --> 02:22:32,600 DISCOVER MOST PEOPLE HAVE MIXED 3578 02:22:32,600 --> 02:22:34,680 ETIOLOGY AND THAT THE VALUE 3579 02:22:34,680 --> 02:22:35,720 CALCULATION WILL BE DIFFERENT 3580 02:22:35,720 --> 02:22:38,120 THAN IF WE ASSUME EVERYONE HAS 3581 02:22:38,120 --> 02:22:39,160 ALZHEIMER'S DISEASE AND THE CARE 3582 02:22:39,160 --> 02:22:40,680 SYSTEM WILL NEED TO CATCH UP 3583 02:22:40,680 --> 02:22:46,120 PRETTY QUICKLY TO ACCURATELY 3584 02:22:46,120 --> 02:22:47,200 DIAGNOSE THE PATHOLOGY PEOPLE 3585 02:22:47,200 --> 02:22:49,000 HAVE IN THEIR BRAINS WITH THE 3586 02:22:49,000 --> 02:22:50,920 MORE SPECIFIC TREATMENTS. 3587 02:22:50,920 --> 02:22:54,880 >>HELEN SHARED THE SAME POINT I 3588 02:22:54,880 --> 02:22:56,400 WAS GOING MAKE FROM THE 3589 02:22:56,400 --> 02:22:57,720 EPIDEMIOLOGY RESEARCH TYPICALLY 3590 02:22:57,720 --> 02:23:01,520 WHAT MOST PEOPLE TALK ABOUT IN 3591 02:23:01,520 --> 02:23:04,360 TERMS OF ALZHEIMER'S DEMENTIA 3592 02:23:04,360 --> 02:23:07,640 AND THERE'S A MIX OF DEMENTIA 3593 02:23:07,640 --> 02:23:08,840 AND DIAGNOSIS FROM A CLINICAL 3594 02:23:08,840 --> 02:23:10,840 PERSPECTIVE IT'S NOT JUST GOING 3595 02:23:10,840 --> 02:23:11,440 TO BE ONE THING. 3596 02:23:11,440 --> 02:23:14,560 IT'S NOT JUST GOING TO BE AN 3597 02:23:14,560 --> 02:23:16,680 AMYLOID TRACER OR COGNITION. 3598 02:23:16,680 --> 02:23:21,600 I THINK IN AN IDEAL WORLD WE'LL 3599 02:23:21,600 --> 02:23:23,200 HAVE MULTIPLE POTENTIAL 3600 02:23:23,200 --> 02:23:25,960 DIAGNOSTIC SIGNS FOR DEMENTIAS. 3601 02:23:25,960 --> 02:23:27,320 MULTIPLE DIFFERENT DEMENTIAS. 3602 02:23:27,320 --> 02:23:30,080 I THINK WE'LL HAVE TO CONSIDER 3603 02:23:30,080 --> 02:23:33,400 THE COMPLEXITY OF ALL THOSE 3604 02:23:33,400 --> 02:23:35,000 CONTRIBUTING FACTORS WHEN WE'RE 3605 02:23:35,000 --> 02:23:36,440 CONSIDERING PARTICULARLY THE 3606 02:23:36,440 --> 02:23:37,920 ECONOMIC BENEFITS ACTUALLY. 3607 02:23:37,920 --> 02:23:39,400 IT COULD BE A COMPLICATED 3608 02:23:39,400 --> 02:23:41,920 PICTURE TO TRY TO MAP IT ALL 3609 02:23:41,920 --> 02:23:42,080 OUT. 3610 02:23:42,080 --> 02:23:44,800 I THINK WORTHWHILE FOR SURE 3611 02:23:44,800 --> 02:23:46,320 WORTHWHILE AND THE BETTER 3612 02:23:46,320 --> 02:23:47,920 DIAGNOSTICS THE EARLIER WE CAN 3613 02:23:47,920 --> 02:23:49,880 INTERVENE SPEAKING AS A 3614 02:23:49,880 --> 02:23:50,560 CLINICIAN. 3615 02:23:50,560 --> 02:23:51,760 THAT'S ALWAYS FIRST AND 3616 02:23:51,760 --> 02:23:52,040 FOREMOST. 3617 02:23:52,040 --> 02:23:53,440 WHAT'S THE MOST EFFECTIVE 3618 02:23:53,440 --> 02:23:54,720 TREATMENT IT'S GOING TO BE 3619 02:23:54,720 --> 02:23:55,800 TREATMENT MOST LIKELY THAT'S 3620 02:23:55,800 --> 02:23:56,440 GOING TO BE TREATMENT 3621 02:23:56,440 --> 02:24:01,800 ADMINISTERED EARLY ON. 3622 02:24:01,800 --> 02:24:05,040 THIGHS ARE ALL ISSUES OF TIME 3623 02:24:05,040 --> 02:24:07,280 AND NEUROPATHOLOGICAL FACTORS 3624 02:24:07,280 --> 02:24:08,200 AND ALL NEEDS TO BE A PART OF 3625 02:24:08,200 --> 02:24:10,160 THE PICTURE. 3626 02:24:10,160 --> 02:24:12,840 >>THAT'S GREAT, THANK YOU. 3627 02:24:12,840 --> 02:24:15,480 PRISCILLA I'LL KICK THE BALL 3628 02:24:15,480 --> 02:24:16,200 OVER TO YOU. 3629 02:24:16,200 --> 02:24:17,760 SHOULD WE GO TO AUDIENCE 3630 02:24:17,760 --> 02:24:18,040 QUESTIONS? 3631 02:24:18,040 --> 02:24:22,680 >>YES, PRODUCTION TEAM. 3632 02:24:22,680 --> 02:24:28,160 IF YOU COULD UNMUTE MICHAEL 3633 02:24:28,160 --> 02:24:29,240 ELLENBOGEN IF YOU CAN UNMUTE 3634 02:24:29,240 --> 02:24:29,400 HIM. 3635 02:24:29,400 --> 02:24:33,600 >>THANK YOU FOR THIS. 3636 02:24:33,600 --> 02:24:35,440 WHILE THIS MAY BE REPETITIVE 3637 02:24:35,440 --> 02:24:37,000 BECAUSE MANY OF YOU KNOW MY 3638 02:24:37,000 --> 02:24:40,480 STORY. 3639 02:24:40,480 --> 02:24:41,600 AND THEY'LL FOCUS ON PEOPLE 65 3640 02:24:41,600 --> 02:24:42,360 AND OLDER. 3641 02:24:42,360 --> 02:24:45,640 I THINK IT'S VERY IMPORTANT TO 3642 02:24:45,640 --> 02:24:48,520 ALSO LOOK AT THE PEOPLE MUCH 3643 02:24:48,520 --> 02:24:50,920 YOUNGER ESPECIALLY BELOW 65. 3644 02:24:50,920 --> 02:24:53,960 THE IMPACT TO THOSE PEOPLE IS 3645 02:24:53,960 --> 02:24:55,280 ENORMOUS. 3646 02:24:55,280 --> 02:25:01,000 I SEE PEOPLE GOING BANKRUPT 3647 02:25:01,000 --> 02:25:01,880 EVERY DAY AFTER DIAGNOSIS. 3648 02:25:01,880 --> 02:25:04,400 IN MY CASE A TIMELY DIAGNOSIS 3649 02:25:04,400 --> 02:25:06,920 WOULD HAVE MEANT ME NOT GETTING 3650 02:25:06,920 --> 02:25:09,040 FIRED FROM MY JOB, LOSING ALL 3651 02:25:09,040 --> 02:25:11,080 THE HEALTH BENEFITS FROM HEALTH 3652 02:25:11,080 --> 02:25:12,480 INSURANCE AND EVERYTHING ELSE ON 3653 02:25:12,480 --> 02:25:17,600 TOP OF IT I LOST MY SALARY, FAST 3654 02:25:17,600 --> 02:25:19,000 FORWARD 10 YEARS LATER MY WIFE 3655 02:25:19,000 --> 02:25:21,160 NOW HAS TO TAKE CARE OF ME AND 3656 02:25:21,160 --> 02:25:22,280 HAS HAD TO LEAVE HER JOB. 3657 02:25:22,280 --> 02:25:23,400 THERE'S NO MONEY COMING IN 3658 02:25:23,400 --> 02:25:26,400 ANYMORE. 3659 02:25:26,400 --> 02:25:29,280 I MEAN, WE'RE PEOPLE MAKING 3660 02:25:29,280 --> 02:25:31,160 TOGETHER OVER $250,000. 3661 02:25:31,160 --> 02:25:33,360 ALL THAT IS LOST. 3662 02:25:33,360 --> 02:25:35,920 NOT ONLY HAS IT LOST US BUT THE 3663 02:25:35,920 --> 02:25:36,960 IMPACT TO THE GOVERNMENT SIDE 3664 02:25:36,960 --> 02:25:38,320 BECAUSE THEY'RE NO LONGER 3665 02:25:38,320 --> 02:25:40,160 GETTING TAXES OR MONEY AND 3666 02:25:40,160 --> 02:25:41,960 THEY'RE HELPING US OUT NOW. 3667 02:25:41,960 --> 02:25:44,240 IT'S IMPORTANT TO THINK ABOUT 3668 02:25:44,240 --> 02:25:45,200 THE CONSEQUENCES THOUGH IT MAY 3669 02:25:45,200 --> 02:25:46,880 BE A SMALL PERCENTAGE OF PEOPLE, 3670 02:25:46,880 --> 02:25:48,360 IT'S GOT A HUGE IMPACT ON 3671 02:25:48,360 --> 02:25:49,040 PEOPLE'S LIVES AND THEIR 3672 02:25:49,040 --> 02:25:58,640 FAMILIES GOING FORWARD. 3673 02:25:58,640 --> 02:26:01,600 >>THANK YOU FOR SHARING THAT 3674 02:26:01,600 --> 02:26:01,880 STORY. 3675 02:26:01,880 --> 02:26:04,680 I MIGHT DOVETAIL THAT WITH A 3676 02:26:04,680 --> 02:26:07,960 QUESTION IN CHAT ABOUT THINKING 3677 02:26:07,960 --> 02:26:12,720 ABOUT THE ECONOMIC IMPACTS OF 3678 02:26:12,720 --> 02:26:13,800 ALZHEIMER'S DISEASE ON THE 3679 02:26:13,800 --> 02:26:15,960 RETIREMENT SAVINGS OF CHILDREN 3680 02:26:15,960 --> 02:26:17,680 OR CAREGIVERS. 3681 02:26:17,680 --> 02:26:18,760 I'M WONDERING IF THERE'S ANYONE 3682 02:26:18,760 --> 02:26:21,600 ON THE PANEL WHO MIGHT WANT TO 3683 02:26:21,600 --> 02:26:23,120 PROVIDE SOME COMMENT ABOUT HOW 3684 02:26:23,120 --> 02:26:27,640 WE CAN ADEQUATELY MEASURE 3685 02:26:27,640 --> 02:26:28,640 FINANCIAL CHALLENGES THAT HAPPEN 3686 02:26:28,640 --> 02:26:32,440 NOT JUST TO THE PERSON WITH THE 3687 02:26:32,440 --> 02:26:33,600 DIAGNOSIS OF ALZHEIMER'S DISEASE 3688 02:26:33,600 --> 02:26:37,000 BUT THE CAREGIVER NETWORK THAT 3689 02:26:37,000 --> 02:26:41,840 SURROUNDS THAT INDIVIDUAL. 3690 02:26:41,840 --> 02:26:43,400 I'M WONDERING IF YOU KNOW 3691 02:26:43,400 --> 02:26:45,680 STUDIES ON THE TOPIC OR HOW TO 3692 02:26:45,680 --> 02:26:46,320 BEST MEASURE SECONDARY ECONOMIC 3693 02:26:46,320 --> 02:26:56,440 IMPACTS. 3694 02:26:57,400 --> 02:26:59,240 >>IT'S A HARD AND GREAT 3695 02:26:59,240 --> 02:27:00,560 QUESTION AND EVERYONE'S SILENT 3696 02:27:00,560 --> 02:27:04,120 BECAUSE I THINK IT HASN'T BEEN 3697 02:27:04,120 --> 02:27:10,920 SUFFICIENTLY STUDIED. 3698 02:27:10,920 --> 02:27:13,880 WE KNOW CAREGIVERS HAVE IMPACT 3699 02:27:13,880 --> 02:27:19,680 AND IT'S LIKELY -- WELL WE KNOW 3700 02:27:19,680 --> 02:27:21,560 THERE'S CONSIDERABLE FINANCIAL 3701 02:27:21,560 --> 02:27:22,640 AND ECONOMIC IMPACT AND THERE 3702 02:27:22,640 --> 02:27:24,160 ARE DATA SETS THAT CAN HELP DO 3703 02:27:24,160 --> 02:27:27,160 IT FOR THE FAMILY. 3704 02:27:27,160 --> 02:27:29,200 NON-FAMILY CAREGIVERS ARE OFTEN 3705 02:27:29,200 --> 02:27:31,280 A CHALLENGE TO FIND IN NATIONAL 3706 02:27:31,280 --> 02:27:33,760 DATA BUT DOESN'T MEAN IT 3707 02:27:33,760 --> 02:27:35,400 WOULDN'T BE USEFUL TO LOOK AT 3708 02:27:35,400 --> 02:27:42,520 CAREGIVERS. 3709 02:27:42,520 --> 02:27:44,440 >>WELL, I DON'T HEAR ANYBODY 3710 02:27:44,440 --> 02:27:46,160 ELSE PIPING UP SO MAYBE IF YOU 3711 02:27:46,160 --> 02:27:47,880 THINK OF SOMETHING AS YOU GO 3712 02:27:47,880 --> 02:27:50,640 ALONG FEEL FREE TO CHIME IN. 3713 02:27:50,640 --> 02:27:53,360 I THINK WE MIGHT ADDRESS A 3714 02:27:53,360 --> 02:27:58,160 QUESTION IN THE CHAT FROM IAN 3715 02:27:58,160 --> 02:27:59,440 KREMMER. 3716 02:27:59,440 --> 02:28:01,600 HAVE THERE BEEN COST 3717 02:28:01,600 --> 02:28:02,520 EFFECTIVENESS OR OTHER 3718 02:28:02,520 --> 02:28:03,960 ANALYSTSES OF PUBLIC HEALTH 3719 02:28:03,960 --> 02:28:06,240 INTERVENTIONS AIMED AT REDUCING 3720 02:28:06,240 --> 02:28:09,600 RISK FACTORS FOR DEMENTIA. 3721 02:28:09,600 --> 02:28:12,080 TO MAKE AN EXAMPLE LIKE ANALYSIS 3722 02:28:12,080 --> 02:28:20,360 AT SMOKING CREESSATION OR EXPOSE 3723 02:28:20,360 --> 02:28:21,560 OF CHRONIC STRESS. 3724 02:28:21,560 --> 02:28:23,960 >>I MENTIONED THE DATABASE MY 3725 02:28:23,960 --> 02:28:26,480 COLLEAGUES AND I MAINTAIN HAS 3726 02:28:26,480 --> 02:28:27,880 12,000 COST EFFECTIVE ANALYSES 3727 02:28:27,880 --> 02:28:29,160 IN THEM. 3728 02:28:29,160 --> 02:28:31,840 WE FOUND 87 RELATED TO DEMENTIA 3729 02:28:31,840 --> 02:28:37,400 CARE AND THOSE SPAN A RANGE OF 3730 02:28:37,400 --> 02:28:39,400 TOP 3731 02:28:39,400 --> 02:28:42,920 TOP 3732 02:28:42,920 --> 02:28:44,160 TOPICS LIKE PHARMACEUTICALS. 3733 02:28:44,160 --> 02:28:47,080 I DON'T KNOW IF THERE'S ANYTHING 3734 02:28:47,080 --> 02:28:49,000 ADDRESSING A PARTICULAR AREA. 3735 02:28:49,000 --> 02:28:51,080 WE CAN CERTAINLY LOOK AND SEE 3736 02:28:51,080 --> 02:28:54,120 BUT WE HAVE QUITE A NUMBER OF 3737 02:28:54,120 --> 02:29:01,000 STUDIES THAT ADDRESS 3738 02:29:01,000 --> 02:29:01,720 COMORBIDITIES ADDRESS PUBLIC 3739 02:29:01,720 --> 02:29:02,560 HEALTH OUTREACH PROGRAMS AND 3740 02:29:02,560 --> 02:29:04,440 THINGS LIKE THAT. 3741 02:29:04,440 --> 02:29:05,080 IF THERE'S NOTHING IN THE 3742 02:29:05,080 --> 02:29:06,000 LITERATURE THAT WOULD BE A GREAT 3743 02:29:06,000 --> 02:29:10,880 STUDY TO DO. 3744 02:29:10,880 --> 02:29:12,400 >>I THINK MANY OF YOU KNOW WE 3745 02:29:12,400 --> 02:29:20,400 RECENTLY ADDED A SIXFOLD TO THE 3746 02:29:20,400 --> 02:29:23,080 RISK REDUCTION AND HEALTHY AGING 3747 02:29:23,080 --> 02:29:25,000 BUT WE DON'T KNOW WHAT THE BEST 3748 02:29:25,000 --> 02:29:26,600 AGE TO INTERVENE IS. 3749 02:29:26,600 --> 02:29:30,920 IS 65 TOO LATE TO DO A SMOKING 3750 02:29:30,920 --> 02:29:33,800 CESSATION PROGRAM IF YOUR GOAL 3751 02:29:33,800 --> 02:29:35,880 IS DEMENTIA RISK REDUCTION. 3752 02:29:35,880 --> 02:29:38,280 WHERE SHOULD WE BE INTERVENING 3753 02:29:38,280 --> 02:29:40,160 AND A NUMBER OF QUESTIONS THAT 3754 02:29:40,160 --> 02:29:41,600 REMAIN TO BE ANSWERED IN THIS 3755 02:29:41,600 --> 02:29:44,400 SPACE BUT A LOT OF WORK COULD BE 3756 02:29:44,400 --> 02:29:47,000 DONE AS WE THINK OF VASCULAR 3757 02:29:47,000 --> 02:29:48,440 DEMENTIA AS SO PREVALENT IN THE 3758 02:29:48,440 --> 02:29:48,760 POPULATION. 3759 02:29:48,760 --> 02:29:50,680 THERE'S PROBABLY MORE THAT COULD 3760 02:29:50,680 --> 02:29:52,200 BE DONE THAT'S NOT BEING DONE 3761 02:29:52,200 --> 02:30:00,000 AND TIED TO DEMENTIA. 3762 02:30:00,000 --> 02:30:02,840 >>THERE'S ALSO AN IN THE CHAT 3763 02:30:02,840 --> 02:30:07,040 IN THE Q&A BOX MENTIONING THING 3764 02:30:07,040 --> 02:30:09,320 LIKE HEARING LOSS IS AN 3765 02:30:09,320 --> 02:30:11,400 ADDRESSABLE RISK FACTOR AND LOW 3766 02:30:11,400 --> 02:30:15,400 COST AND HIGHLY EFFECTIVE WAY OF 3767 02:30:15,400 --> 02:30:19,680 DEALING WITH COGNITIVE 3768 02:30:19,680 --> 02:30:21,360 IMPAIRMENT AND THAT'S SOMETHING 3769 02:30:21,360 --> 02:30:22,440 THAT NOT DISCUSSED OFTEN ENOUGH 3770 02:30:22,440 --> 02:30:25,040 AND MAYBE SOME OF US IN THE 3771 02:30:25,040 --> 02:30:27,920 RESEARCH WORLD IS FAMILIAR WITH 3772 02:30:27,920 --> 02:30:29,880 THE LITERATURE BUT A LOT OF 3773 02:30:29,880 --> 02:30:31,280 PEOPLE OUT THERE WHO ARE 3774 02:30:31,280 --> 02:30:33,560 EXPERIENCING HEARING LOSS MAY 3775 02:30:33,560 --> 02:30:35,640 NOT HAVE THE INFORMATION TO KNOW 3776 02:30:35,640 --> 02:30:37,400 OKAY HOW IS THIS IMPACTING THEIR 3777 02:30:37,400 --> 02:30:45,920 COGNITION. 3778 02:30:45,920 --> 02:30:47,320 PRISCILLA ARE THERE QUESTIONS WE 3779 02:30:47,320 --> 02:30:47,880 SHOULD ADDRESS OR SHOULD WE 3780 02:30:47,880 --> 02:30:49,320 CLOSE IT UP? 3781 02:30:49,320 --> 02:30:53,600 >>WE HAVE JUST ONE MINUTE LEFT. 3782 02:30:53,600 --> 02:30:55,440 PERHAPS IF YOU'RE ABLE TO 3783 02:30:55,440 --> 02:30:57,800 DR. NEUMANN, WE HAD SOMEONE 3784 02:30:57,800 --> 02:30:59,760 REQUEST THE CITATION FOR THE 3785 02:30:59,760 --> 02:31:02,920 CAREGIVER RESPITE STUDY THE COST 3786 02:31:02,920 --> 02:31:03,440 EFFECTIVENESS ANALYSIS. 3787 02:31:03,440 --> 02:31:04,960 I'M NOT SURE IF YOU HAD A CHANCE 3788 02:31:04,960 --> 02:31:07,440 TO SHARE THAT IN THE CHAT. 3789 02:31:07,440 --> 02:31:09,320 ALL QUESTIONS WILL BE SAVED AN 3790 02:31:09,320 --> 02:31:12,320 AND ADDRESS THEM AS WE GO ON. 3791 02:31:12,320 --> 02:31:14,080 THANK YOU VERY MUCH TO EVERYONE 3792 02:31:14,080 --> 02:31:15,480 FOR YOUR ATTENTION DURING THIS 3793 02:31:15,480 --> 02:31:16,600 SESSION AND IF I UNDERSTAND 3794 02:31:16,600 --> 02:31:19,080 CORRECTLY WE'RE GOING TO HAVE A 3795 02:31:19,080 --> 02:31:19,840 BRIEF BREAK. 3796 02:31:19,840 --> 02:31:22,800 I THINK EITHER JULIE OR ANDREA 3797 02:31:22,800 --> 02:31:24,800 WOULD YOU LIKE TO SAY SOMETHING 3798 02:31:24,800 --> 02:31:26,400 BEFORE WE GO TO BREAK? 3799 02:31:26,400 --> 02:31:29,640 >>YES, THANK YOU VERY MUCH. 3800 02:31:29,640 --> 02:31:33,240 I WANTED TO THANK ALL THE 3801 02:31:33,240 --> 02:31:35,280 PANELISTS AND SPEAKERS FOR THEIR 3802 02:31:35,280 --> 02:31:36,440 PRESENTATIONS AND REMARKS AND 3803 02:31:36,440 --> 02:31:36,720 DISCUSSION. 3804 02:31:36,720 --> 02:31:40,880 WE HAVE A 15-MINUTE BREAK. 3805 02:31:40,880 --> 02:31:42,160 WE'LL RETURN AT 2:20 EASTERN 3806 02:31:42,160 --> 02:31:43,120 STANDARD TIME FOR OUR FINAL 3807 02:31:43,120 --> 02:31:43,440 SESSION. 3808 02:31:43,440 --> 02:31:44,080 ENJOY THE BREAK AND SEE YOU 3809 02:31:44,080 --> 02:31:48,400 SOON. 3810 02:31:48,400 --> 02:31:49,520 >>WELCOME BACK. 3811 02:31:49,520 --> 02:31:51,240 I AM PLEASED TO WELCOME 3812 02:31:51,240 --> 02:31:53,320 DR. CRYSTAL GLOVER AND 3813 02:31:53,320 --> 02:31:55,920 DR. ELLIOTT CO-CHAIRS FOR OUR 3814 02:31:55,920 --> 02:32:00,720 FINAL SESSION, APPROACH TO 3815 02:32:00,720 --> 02:32:02,720 PARTICIPATORY RESEARCH AND 3816 02:32:02,720 --> 02:32:03,280 RETENTION IN DEMENTIA CARE 3817 02:32:03,280 --> 02:32:04,560 RESEARCH. 3818 02:32:04,560 --> 02:32:07,760 >>THANK YOU, JULIE. 3819 02:32:07,760 --> 02:32:09,000 THANK YOU EVERYONE FOR BEING 3820 02:32:09,000 --> 02:32:11,920 HERE AND STICKING AROUND FOR THE 3821 02:32:11,920 --> 02:32:12,840 TIME SCIENTIFIC SESSION. 3822 02:32:12,840 --> 02:32:14,040 LAST BUT NOT LEAST. 3823 02:32:14,040 --> 02:32:18,160 I'M ONE OF YOUR SESSION 3824 02:32:18,160 --> 02:32:21,160 CO-CHAIRS WITH DR. CERISE 3825 02:32:21,160 --> 02:32:21,400 ELLIOTT. 3826 02:32:21,400 --> 02:32:22,960 THANKS FOR ALL YOU'VE DONE WITH 3827 02:32:22,960 --> 02:32:23,240 ME. 3828 02:32:23,240 --> 02:32:25,800 THE BIGGEST GOAL OF OUR SESSION 3829 02:32:25,800 --> 02:32:26,800 HERE WE'RE CENTERING THINGS 3830 02:32:26,800 --> 02:32:31,760 AROUND HOW TO INCORPORATE, 3831 02:32:31,760 --> 02:32:34,280 CENTER AND FULLY CONSIDER 3832 02:32:34,280 --> 02:32:35,280 DEMOGRAPHICALLY DIVERSE 3833 02:32:35,280 --> 02:32:36,480 CAREGIVERS AND PARTNERS 3834 02:32:36,480 --> 02:32:37,640 THROUGHOUT THE RESEARCH PROCESS. 3835 02:32:37,640 --> 02:32:42,520 OF COURSE THIS IS KEY FOR 3836 02:32:42,520 --> 02:32:46,800 RECRUITMENT AND SUSTAINABILITY 3837 02:32:46,800 --> 02:32:49,200 AND HOW DO YOU GO ABOUT YOUR 3838 02:32:49,200 --> 02:32:50,720 RESEARCH QUESTION AND SAMPLING 3839 02:32:50,720 --> 02:32:54,120 OUTREACH AND ENGAGEMENT AND 3840 02:32:54,120 --> 02:32:56,640 ANALYSES AND INTERPRETATIONS AND 3841 02:32:56,640 --> 02:32:58,400 HOW TO ADDRESS CHALLENGES IN THE 3842 02:32:58,400 --> 02:32:59,400 RESEARCH PROCESS. 3843 02:32:59,400 --> 02:33:02,360 THESE DIFFERENT ELEMENTS THE 3844 02:33:02,360 --> 02:33:04,520 CENTERING OF THE DIVERSE 3845 02:33:04,520 --> 02:33:05,640 CAREGIVERS REQUIRE CONSIDERATION 3846 02:33:05,640 --> 02:33:09,280 OF STUDY DESIGNS ACROSS THAT MAY 3847 02:33:09,280 --> 02:33:12,240 GO ABOUT ADDING TO OUR TOOL KIT 3848 02:33:12,240 --> 02:33:14,400 IN TERMS OF HOW WE APPROACH THE 3849 02:33:14,400 --> 02:33:16,120 AGING RESEARCH. 3850 02:33:16,120 --> 02:33:17,560 PRESENTERS WILL SHARE OUR 3851 02:33:17,560 --> 02:33:19,240 EMERGING OR HIGHLIGHT THE 3852 02:33:19,240 --> 02:33:20,520 INNOVATIVE TECHNOLOGIES, 3853 02:33:20,520 --> 02:33:21,440 PRACTICES AND RESEARCH DESIGNS 3854 02:33:21,440 --> 02:33:24,160 THEY CURRENTLY USE IN TERMS OF 3855 02:33:24,160 --> 02:33:27,800 INCORPORATING, CENTERING AND 3856 02:33:27,800 --> 02:33:29,320 FOCUSSING ON DEMOGRAPHICALLY 3857 02:33:29,320 --> 02:33:29,960 DIVERSE CAREGIVERS. 3858 02:33:29,960 --> 02:33:31,800 FIRST OFF WE'LL START WITH 3859 02:33:31,800 --> 02:33:32,760 DR. JORDAN LEWIS. 3860 02:33:32,760 --> 02:33:35,440 HE WILL TAKE US BACK TO HOW WE 3861 02:33:35,440 --> 02:33:39,640 MAY THINK ABOUT, IDENTIFY AND 3862 02:33:39,640 --> 02:33:41,320 NAME CAREGIVERS AND CARE 3863 02:33:41,320 --> 02:33:43,280 PARTNERS THOSE BELONGING TO 3864 02:33:43,280 --> 02:33:45,360 DIVERSE COMMUNITY AND HAS 3865 02:33:45,360 --> 02:33:46,680 IMPLICATIONS FOR WHO IS INCLUDED 3866 02:33:46,680 --> 02:33:48,400 IN STUDIES AND RECRUITING AND 3867 02:33:48,400 --> 02:33:49,720 SUSTAINABILITY. 3868 02:33:49,720 --> 02:33:51,120 THEN WE'LL MOVE TO DR. VAN PARK. 3869 02:33:51,120 --> 02:33:52,440 SHE'LL SPEAK ABOUT THE ROLE OF 3870 02:33:52,440 --> 02:33:54,960 COMMUNITY OUTREACH AND 3871 02:33:54,960 --> 02:33:55,240 ENGAGEMENT. 3872 02:33:55,240 --> 02:33:58,200 THIS HAS BIG IMPLICATIONS FOR 3873 02:33:58,200 --> 02:33:59,320 RESEARCH RECRUITMENT, HAVING 3874 02:33:59,320 --> 02:34:01,800 EQUITABLE RECRUITMENT AND 3875 02:34:01,800 --> 02:34:03,800 FINALLY WE'LL END WITH 3876 02:34:03,800 --> 02:34:05,480 DR. FAYRON EPPS TO SPEAK ABOUT 3877 02:34:05,480 --> 02:34:07,240 CONTINUOUS ENGAGEMENT AND THE 3878 02:34:07,240 --> 02:34:11,320 ROLE WITH RETENTION OR 3879 02:34:11,320 --> 02:34:13,920 SUSTAINABILITY OF PARTICIPATION. 3880 02:34:13,920 --> 02:34:15,520 I THINK WE HAVE A FEW MINUTES 3881 02:34:15,520 --> 02:34:16,880 MORE SO THAT'S GREAT. 3882 02:34:16,880 --> 02:34:23,960 OVER TO JORDAN. 3883 02:34:23,960 --> 02:34:27,640 >>HOW TO FOR THE INTRODUCTION. 3884 02:34:27,640 --> 02:34:31,160 I APOLOGIZE FOR MY VOICE I'M 3885 02:34:31,160 --> 02:34:32,960 GETTING OVER A COLD AND I HAVE 3886 02:34:32,960 --> 02:34:35,160 UNIQUE ITE TI CHALLENGE FOR THE 3887 02:34:35,160 --> 02:34:41,120 RECRUITMENT OF AI/AM OR ALASKAN 3888 02:34:41,120 --> 02:34:43,480 CAREGIVERS INTO DEMENTIA CARE 3889 02:34:43,480 --> 02:34:43,760 RESEARCH. 3890 02:34:43,760 --> 02:34:46,320 SO STARTING TALKING ABOUT 3891 02:34:46,320 --> 02:34:47,440 BARRIERS TO ACCESSING DEMENTIA 3892 02:34:47,440 --> 02:34:51,640 CARE SPECIFICALLY IN THIS 3893 02:34:51,640 --> 02:34:52,800 POPULATION. 3894 02:34:52,800 --> 02:34:53,840 AND UNDERSTANDING MANY PEOPLE WE 3895 02:34:53,840 --> 02:34:55,760 WORK WITH HAVE PRECONCEIVED 3896 02:34:55,760 --> 02:34:56,640 IDEAS OF TREATMENT. 3897 02:34:56,640 --> 02:34:59,720 SEEING THEM IS NOT EFFECTIVE OR 3898 02:34:59,720 --> 02:35:01,240 PRIORITY WHEN THERE'S COMPETING 3899 02:35:01,240 --> 02:35:03,240 NEEDS IN THEIR FAMILY OR 3900 02:35:03,240 --> 02:35:05,320 COMMUNITY AND COMING IN THE 3901 02:35:05,320 --> 02:35:06,720 RESEARCH HAVING ANXIETY OR TRUST 3902 02:35:06,720 --> 02:35:07,760 ISSUES ABOUT OUTSIDE SUPPORTS, 3903 02:35:07,760 --> 02:35:12,000 BAD EXPERIENCES OR UNHAPPY 3904 02:35:12,000 --> 02:35:13,040 EXPERIENCES WITH THE MEDICAL 3905 02:35:13,040 --> 02:35:13,280 SETTING. 3906 02:35:13,280 --> 02:35:17,120 IT'S TIED TO THE HISTORY OF WHAT 3907 02:35:17,120 --> 02:35:17,840 INDIGENOUS POPULATION HAVE BEEN 3908 02:35:17,840 --> 02:35:19,240 THROUGH AND THE LACK OF TRUST 3909 02:35:19,240 --> 02:35:22,080 AND EXPERIENCE WITH RACISM IN 3910 02:35:22,080 --> 02:35:25,280 MEDICINE AND THE STILL LINGERING 3911 02:35:25,280 --> 02:35:27,080 STIGMA AROUND DEMENTIA OR MENTAL 3912 02:35:27,080 --> 02:35:29,040 HEALTH IN GENERAL AND BEING SEEN 3913 02:35:29,040 --> 02:35:31,440 AS HAVING A MENTAL HEALTH 3914 02:35:31,440 --> 02:35:32,680 DISORDER OR COGNITIVE IMPAIRMENT 3915 02:35:32,680 --> 02:35:34,720 FOR SOME COMMUNITIES CAN BE VERY 3916 02:35:34,720 --> 02:35:37,520 CHALLENGING AND MAY BE A BARRIER 3917 02:35:37,520 --> 02:35:38,400 TO ACCESSING DEMENTIA CARE. 3918 02:35:38,400 --> 02:35:39,960 WE ALSO KNOW THERE'S CULTURAL 3919 02:35:39,960 --> 02:35:42,240 ISSUES IMPACTING UNDERSTANDING 3920 02:35:42,240 --> 02:35:44,440 OF WESTERN MEDICINE TIED UP TO 3921 02:35:44,440 --> 02:35:46,200 THE FIRST BULLET WHETHER OR NOT 3922 02:35:46,200 --> 02:35:47,880 SEEING IT AS EFFECTIVE OR 3923 02:35:47,880 --> 02:35:49,680 PROVIDERS NOT WANTING TO WORK 3924 02:35:49,680 --> 02:35:51,840 WITH THEM TO INTEGRATE 3925 02:35:51,840 --> 02:35:52,520 TRADITIONAL AND WESTERN MEDICINE 3926 02:35:52,520 --> 02:35:56,080 TOGETHER. 3927 02:35:56,080 --> 02:35:57,840 THEY ALSO HAVE EXPERIENCES AND 3928 02:35:57,840 --> 02:36:00,520 SHARED THE DISMISSAL OF FEARS. 3929 02:36:00,520 --> 02:36:03,000 WHEN THEY GO TO THEIR PROVIDER 3930 02:36:03,000 --> 02:36:04,480 NOT BEING ABLE TO UNDERSTAND THE 3931 02:36:04,480 --> 02:36:06,160 CULTURAL STANDING OF WHAT IS 3932 02:36:06,160 --> 02:36:07,400 HAPPENING TO THEM BEING ACCEPTED 3933 02:36:07,400 --> 02:36:08,320 OR SHARING THE CONCERNS OR NOT 3934 02:36:08,320 --> 02:36:09,920 BEING HEARD. 3935 02:36:09,920 --> 02:36:11,200 ON TOP OF ALL THAT SOMETIMES 3936 02:36:11,200 --> 02:36:13,920 YOU'RE COMING INTO A CARE 3937 02:36:13,920 --> 02:36:16,560 SETTING WHERE YOU HAVE CULTURAL, 3938 02:36:16,560 --> 02:36:17,320 FAMILIAL AND COMMUNITY 3939 02:36:17,320 --> 02:36:19,280 PERSPECTIVES ON CARE DECISIONS 3940 02:36:19,280 --> 02:36:20,720 AND HAVING THOSE DIFFERENT 3941 02:36:20,720 --> 02:36:22,200 PERSPECTIVES, WHO DO YOU LISTEN 3942 02:36:22,200 --> 02:36:23,520 TO AND WHO'S IMPORTANT AND NOT 3943 02:36:23,520 --> 02:36:25,720 FORGETTING THE PERSON WITH 3944 02:36:25,720 --> 02:36:28,880 DEMENTIA HAS A SAY IN WHAT'S 3945 02:36:28,880 --> 02:36:30,480 GOING ON WITH THEM. 3946 02:36:30,480 --> 02:36:32,160 WE HEAR FROM CAREGIVERS 3947 02:36:32,160 --> 02:36:33,680 SPECIFICALLY THE IDEA OF 3948 02:36:33,680 --> 02:36:36,480 INFERIORITY OR EMBARRASSMENT OR 3949 02:36:36,480 --> 02:36:39,280 FEELING THEY COULD NOT DO THE 3950 02:36:39,280 --> 02:36:42,000 JOB AFFECTING THE PERSON THEY'RE 3951 02:36:42,000 --> 02:36:43,720 CARING FOR OR BEING REMOVED FROM 3952 02:36:43,720 --> 02:36:44,600 THEIR CARE. 3953 02:36:44,600 --> 02:36:48,440 THEY DON'T FEEL THEY ARE 3954 02:36:48,440 --> 02:36:50,200 EQUIPPED OR HAVE THE TRAINING 3955 02:36:50,200 --> 02:36:52,080 AND THE BULK OF THE WORK WE DO 3956 02:36:52,080 --> 02:37:00,040 IN TRAINING EDUCATION. 3957 02:37:00,040 --> 02:37:00,680 SPECIFICALLY WITH INDIGENOUS 3958 02:37:00,680 --> 02:37:04,400 CAREGIVER AND THE WORK WE'VE 3959 02:37:04,400 --> 02:37:06,080 DONE WITH INDIGENOUS AND ALASKAN 3960 02:37:06,080 --> 02:37:08,720 NATIVE COMMUNITIES THERE'S STILL 3961 02:37:08,720 --> 02:37:10,880 A STRONG COMMITMENT TO 3962 02:37:10,880 --> 02:37:11,280 CAREGIVER. 3963 02:37:11,280 --> 02:37:15,080 THERE'S A STRONG VALUE AND IT'S 3964 02:37:15,080 --> 02:37:17,360 AN HONOR TO CARE FOR THEM AND 3965 02:37:17,360 --> 02:37:20,760 CARE FOR ELDERS WHO RAISED US 3966 02:37:20,760 --> 02:37:25,640 AND PROVIDED FOR US AND ENGRAVED 3967 02:37:25,640 --> 02:37:26,440 IN EVERY GENERATION AND FAMILY 3968 02:37:26,440 --> 02:37:29,040 CAREGIVERS IN ADDITION TO 3969 02:37:29,040 --> 02:37:29,840 PROVIDING CARE FOR SOMEONE WITH 3970 02:37:29,840 --> 02:37:34,440 DEMENTIA OR OLDER ADULTS MY 3971 02:37:34,440 --> 02:37:36,440 STILL BE PARENTS AND MAY SERVE 3972 02:37:36,440 --> 02:37:38,800 ON TRIBAL COUNCILS AND 3973 02:37:38,800 --> 02:37:39,720 CAREGIVERS NOT ALWAYS IDENTIFY 3974 02:37:39,720 --> 02:37:40,280 WITH WHAT WE'LL TALK ABOUT 3975 02:37:40,280 --> 02:37:44,520 LATER. 3976 02:37:44,520 --> 02:37:46,320 WE ALSO KNOW THEY POSSESS WEALTH 3977 02:37:46,320 --> 02:37:49,040 OF KNOWLEDGE AND EXPERIENCE 3978 02:37:49,040 --> 02:37:53,560 WHETHER IN THE CAREGIVING REALM 3979 02:37:53,560 --> 02:37:54,440 AND THE KNOWLEDGE THEY WERE 3980 02:37:54,440 --> 02:37:56,680 RAISED WITH FROM THEIR ELDERS 3981 02:37:56,680 --> 02:37:58,800 SERVES AN IMPORTANT ROLE AS THEY 3982 02:37:58,800 --> 02:38:00,280 STEP IN THE CAREGIVER ROLE AND 3983 02:38:00,280 --> 02:38:03,200 SEE WHAT THEY LEARNED FROM 3984 02:38:03,200 --> 02:38:08,040 ELDERS PLAYING OUT UNHOW -- IN 3985 02:38:08,040 --> 02:38:09,560 HOW THEY CARE FOR ELDERS AND HOW 3986 02:38:09,560 --> 02:38:11,160 DO WE TAP INTO THE KNOWLEDGE 3987 02:38:11,160 --> 02:38:12,880 WHETHER THEY'RE NEW OR 3988 02:38:12,880 --> 02:38:15,480 EXPERIENCED BUT ENTRENCHED IN 3989 02:38:15,480 --> 02:38:17,600 THUR COMMUNITIES AND HAVE A 3990 02:38:17,600 --> 02:38:18,920 STRONG COMMUNITY CONNECTION AND 3991 02:38:18,920 --> 02:38:21,280 FAMILY CONNECTION TO DEVELOP 3992 02:38:21,280 --> 02:38:22,960 CULTURALLY RESPONSIVE TRAINING 3993 02:38:22,960 --> 02:38:25,160 AND EDUCATION. 3994 02:38:25,160 --> 02:38:27,040 NOT ONLY FOR CAREGIVERS BUT FOR 3995 02:38:27,040 --> 02:38:28,520 FUTURE CAREGIVERS AND PUTTING 3996 02:38:28,520 --> 02:38:30,240 THAT EMPHASIS ON WHAT WE'RE 3997 02:38:30,240 --> 02:38:31,160 LEARNING FROM YOU TODAY WILL 3998 02:38:31,160 --> 02:38:32,560 HELP SEVEN GENERATIONS FROM NOW. 3999 02:38:32,560 --> 02:38:34,440 AND HOW DO WE TRANSLATE WHAT 4000 02:38:34,440 --> 02:38:37,040 WE'RE LEARNING FROM THEM TO ALSO 4001 02:38:37,040 --> 02:38:39,000 EDUCATE PROVIDERS WHO EITHER 4002 02:38:39,000 --> 02:38:42,680 WORK DIRECTLY WITH THE PROVIDER 4003 02:38:42,680 --> 02:38:45,360 OR CAREGIVERS OR WORK WITH 4004 02:38:45,360 --> 02:38:47,280 CAREGIVERS OR PEOPLE WITH 4005 02:38:47,280 --> 02:38:52,000 DEMENTIA. 4006 02:38:52,000 --> 02:38:53,760 WHEN I WORKED WITH THE DISCOVERY 4007 02:38:53,760 --> 02:38:56,920 TEAM AND OTHER RESEARCH WE 4008 02:38:56,920 --> 02:38:57,600 DEVELOPED ADVISORY COMMITTEES 4009 02:38:57,600 --> 02:39:00,000 FOR THE PROJECTS AND THE GOAL IS 4010 02:39:00,000 --> 02:39:03,240 TO GET THE INTENSE OR CLOSE 4011 02:39:03,240 --> 02:39:05,000 CONNECTION TO THE COMMUNITY, 4012 02:39:05,000 --> 02:39:06,320 LEARN THE COMMUNITY VALUES AND 4013 02:39:06,320 --> 02:39:11,440 SO WE AIM TO RECRUIT CURRENT AND 4014 02:39:11,440 --> 02:39:12,920 PREVIOUS DEMENTIA CAREGIVERS 4015 02:39:12,920 --> 02:39:13,960 FROM THE LOCAL COMMUNITY WHO 4016 02:39:13,960 --> 02:39:15,560 WANT TO LEARN FROM THEIR 4017 02:39:15,560 --> 02:39:16,120 EXPERIENCES. 4018 02:39:16,120 --> 02:39:17,880 THEY KNOW HOW BEST TO MAKE THE 4019 02:39:17,880 --> 02:39:20,000 PROJECT SUCCESSFUL AND BE 4020 02:39:20,000 --> 02:39:21,280 GROUNDED IN THE COMMUNITY VALUES 4021 02:39:21,280 --> 02:39:24,680 AND CONTEXT. 4022 02:39:24,680 --> 02:39:26,560 WE ALSO WORK TOWARDS RECRUITING 4023 02:39:26,560 --> 02:39:28,600 TRIBAL HEALTH AND AGENCY 4024 02:39:28,600 --> 02:39:32,200 PROVIDER. 4025 02:39:32,200 --> 02:39:33,080 AS WELL AS ANYONE ELSE WHO 4026 02:39:33,080 --> 02:39:34,280 SUPPORTS WITH CAREGIVER PROGRAMS 4027 02:39:34,280 --> 02:39:37,480 OR SERVICES OR CAREGIVERS 4028 02:39:37,480 --> 02:39:37,840 THEMSELVES. 4029 02:39:37,840 --> 02:39:40,360 THE GOAL IS TO DEVELOP CAREGIVER 4030 02:39:40,360 --> 02:39:40,600 PROGRAMS. 4031 02:39:40,600 --> 02:39:43,000 WE WANT TO INVOLVE EVERYONE WHO 4032 02:39:43,000 --> 02:39:45,360 HAS A SAY OR WORKS DIRECTLY WITH 4033 02:39:45,360 --> 02:39:52,320 CAREGIVERS IN SOME CAPACITY. 4034 02:39:52,320 --> 02:39:54,720 ALSO HAVING ADVISORY COMMITTEES 4035 02:39:54,720 --> 02:39:56,520 MAKING SURE THEY'RE CULTURALLY 4036 02:39:56,520 --> 02:39:57,520 APPROPRIATE AND RESPONSIBLE AND 4037 02:39:57,520 --> 02:39:59,920 USE THE APPROPRIATE LANGUAGE AND 4038 02:39:59,920 --> 02:40:03,240 CARE AND VALUES, APPROACHES TO 4039 02:40:03,240 --> 02:40:05,760 CARE AND ALSO OTHER AREAS AROUND 4040 02:40:05,760 --> 02:40:07,240 SURFACE CHANGES AROUND WHAT KIND 4041 02:40:07,240 --> 02:40:10,600 OF SYMBOLS AND PHOTOS AND WHAT 4042 02:40:10,600 --> 02:40:12,760 IS APPROPRIATE TO USE. 4043 02:40:12,760 --> 02:40:14,680 FINALLY THE ADVISORY COMMITTEES 4044 02:40:14,680 --> 02:40:16,120 HELP US ASSIST US IN REACHING 4045 02:40:16,120 --> 02:40:24,440 THOSE WHO DO NOT IDENTIFY AS A 4046 02:40:24,440 --> 02:40:25,600 CAREGI 4047 02:40:25,600 --> 02:40:25,880 CAREGIVER. 4048 02:40:25,880 --> 02:40:34,040 GIVING CARING FOR ELDERS IS A 4049 02:40:34,040 --> 02:40:35,920 CULTURAL VALUE THEY RAISED WITH 4050 02:40:35,920 --> 02:40:37,400 AND MAY CARE FOR SOMEONE WITH 4051 02:40:37,400 --> 02:40:39,600 MEMORY LOSS OR SOMEONE IN THEIR 4052 02:40:39,600 --> 02:40:39,800 HOME. 4053 02:40:39,800 --> 02:40:40,720 WE NEED TO BE STRATEGY AND WORK 4054 02:40:40,720 --> 02:40:42,920 WITH OUR COMMITTEES TO LOOK AT 4055 02:40:42,920 --> 02:40:44,520 WORDING, LOOK AT CREATIVITY IN 4056 02:40:44,520 --> 02:40:46,080 OUR RECRUITMENT STRATEGIES AND 4057 02:40:46,080 --> 02:40:48,040 FIGURE OUT HOW TO WE ACCESS THE 4058 02:40:48,040 --> 02:40:49,240 POPULATION THAT DOESN'T ADHERE 4059 02:40:49,240 --> 02:40:54,320 TO THE IDEA OF A CAREGIVER. 4060 02:40:54,320 --> 02:40:55,720 SO SOME RECOMMENDATIONS I'D LIKE 4061 02:40:55,720 --> 02:40:56,960 TO LEAVE YOU WITH. 4062 02:40:56,960 --> 02:40:58,480 WHEN YOU'RE WORKING WITH YOUR 4063 02:40:58,480 --> 02:40:59,640 ADVISORY COMMITTEE AND STARTING 4064 02:40:59,640 --> 02:41:01,200 THE PROJECTS MAYBE NOT ALWAYS 4065 02:41:01,200 --> 02:41:02,840 STARTING OFF WITH USING THE TERM 4066 02:41:02,840 --> 02:41:04,520 CAREGIVER WHEN RECRUITING. 4067 02:41:04,520 --> 02:41:06,280 SEEK OUT OTHER WORDS AND TERMS 4068 02:41:06,280 --> 02:41:10,760 AND OTHER STATEMENTS THAT MAY BE 4069 02:41:10,760 --> 02:41:11,080 APPROPRIATE. 4070 02:41:11,080 --> 02:41:13,360 AGAIN IT'S SEEN AS A PRIVILEGE 4071 02:41:13,360 --> 02:41:15,160 OR HONOR TO CARE FOR THOSE WHO 4072 02:41:15,160 --> 02:41:18,800 CARED FOR YOU AND HOW WE CHANGE 4073 02:41:18,800 --> 02:41:20,160 THE LANGUAGE. 4074 02:41:20,160 --> 02:41:22,520 AND SO MANY TIMES WE THINK WE 4075 02:41:22,520 --> 02:41:25,920 ASSUME BEING A CAREGIVER IS A 4076 02:41:25,920 --> 02:41:28,560 BURDEN AND IS A STRESSFUL 4077 02:41:28,560 --> 02:41:32,560 BURDENSOME JOB BUT MANY 4078 02:41:32,560 --> 02:41:33,720 CAREGIVERS EXPERIENCE SOME 4079 02:41:33,720 --> 02:41:34,680 STRESS BUT FOCUS ON THE 4080 02:41:34,680 --> 02:41:35,760 BLESSINGS AND THE THINGS THAT 4081 02:41:35,760 --> 02:41:36,760 ARE IMPORTANT AND DESPITE 4082 02:41:36,760 --> 02:41:38,440 CHALLENGES KNOW THEY'RE DOING IT 4083 02:41:38,440 --> 02:41:40,680 FOR THE RIGHT REASONS AND GIVE 4084 02:41:40,680 --> 02:41:42,880 THEIR LOVED ONE THE BEST LIFE 4085 02:41:42,880 --> 02:41:43,760 THEY CAN. 4086 02:41:43,760 --> 02:41:46,240 THE THIRD IS THEY MAY BE 4087 02:41:46,240 --> 02:41:47,320 DIRECTLY INVOLVED WITH CARE. 4088 02:41:47,320 --> 02:41:48,760 FOR EXAMPLE TYPICAL PROGRAMS 4089 02:41:48,760 --> 02:41:50,600 FOCUS ON DIADS. 4090 02:41:50,600 --> 02:41:55,160 AND WE EXPAND THE DEFINITION 4091 02:41:55,160 --> 02:41:56,360 LOOKING AT DIFFERENT DEFINITIONS 4092 02:41:56,360 --> 02:42:00,040 OF FAMILIES AND WHEN WE LOOK AT 4093 02:42:00,040 --> 02:42:02,640 CAREGIVERS AND RECEIVING 4094 02:42:02,640 --> 02:42:05,520 SERVICES MULTIPLE CAREGIVERS ONE 4095 02:42:05,520 --> 02:42:06,560 CAREGIVER DOES THE FINANCIALS 4096 02:42:06,560 --> 02:42:07,720 AND ANOTHER IS RESPONSIBLE FOR 4097 02:42:07,720 --> 02:42:09,160 THE HOME BASED CARE AND ANOTHER 4098 02:42:09,160 --> 02:42:11,680 INVOLVED IN A DIFFERENT ASPECT. 4099 02:42:11,680 --> 02:42:12,280 THEY COME TOGETHER TO SUPPORT 4100 02:42:12,280 --> 02:42:15,040 THAT PERSON. 4101 02:42:15,040 --> 02:42:16,200 EXPANDING THAT DEFINITION. 4102 02:42:16,200 --> 02:42:19,520 AND THEN FINALLY PROVIDING 4103 02:42:19,520 --> 02:42:21,360 RESPITE, TRANSPORTATION, 4104 02:42:21,360 --> 02:42:21,800 SUPPORT, FOOD. 4105 02:42:21,800 --> 02:42:23,520 FOOD IS BIG IN OUR COMMUNITIES. 4106 02:42:23,520 --> 02:42:24,760 PROVIDING TRANSPORTATION. 4107 02:42:24,760 --> 02:42:27,000 HOW DO WE DEVELOP RESPITE OR 4108 02:42:27,000 --> 02:42:29,640 FIND WAYS WHEN WE'RE ENGAGING 4109 02:42:29,640 --> 02:42:30,600 CAREGIVERS IN RESEARCH WE 4110 02:42:30,600 --> 02:42:31,800 SUPPORT THEM AND LET THEM KNOW 4111 02:42:31,800 --> 02:42:33,760 WE CARE ABOUT THEM AND PROVIDE 4112 02:42:33,760 --> 02:42:35,480 THAT NEEDED SUPPORT THEY CAN 4113 02:42:35,480 --> 02:42:39,480 TAKE THE TIME AWAY EITHER GO TO 4114 02:42:39,480 --> 02:42:40,640 THEM PROVIDE TRANSPORTATION TO 4115 02:42:40,640 --> 02:42:42,520 AND FROM WHERE THE RESEARCH IS 4116 02:42:42,520 --> 02:42:43,680 HAPPENING SUCH AS A FOCUS GROUP. 4117 02:42:43,680 --> 02:42:44,680 PROVIDE SUPPORT. 4118 02:42:44,680 --> 02:42:47,160 ARE THERE WAYS TO HAVE COMMUNITY 4119 02:42:47,160 --> 02:42:50,000 MEMBERS AVAILABLE TO STEP IN AND 4120 02:42:50,000 --> 02:42:53,600 PROVIDE RESPITE BY PROVIDING 4121 02:42:53,600 --> 02:42:54,720 DAYCARE SUPPORT FOR A COUPLE 4122 02:42:54,720 --> 02:42:56,640 HOURS OR WHATEVER ELSE IS 4123 02:42:56,640 --> 02:42:56,880 NEEDED. 4124 02:42:56,880 --> 02:42:59,320 THIS IS VERY COMMUNITY SPECIFIC. 4125 02:42:59,320 --> 02:43:04,600 MAKING SURE WE WORK OUR ADVISORY 4126 02:43:04,600 --> 02:43:05,520 COMMITTEES AND REMEMBER EACH 4127 02:43:05,520 --> 02:43:06,400 COMMUNITY HAS DIFFERENT NEEDS 4128 02:43:06,400 --> 02:43:07,760 AND STRENGTHS AND FIGURING OUT 4129 02:43:07,760 --> 02:43:09,240 WHAT THEY ARE AND INTEGRATING 4130 02:43:09,240 --> 02:43:13,400 THEM TO YOUR RESEARCH STUDY. 4131 02:43:13,400 --> 02:43:15,240 THANK YOU FOR YOUR TIME. 4132 02:43:15,240 --> 02:43:25,520 I APPRECIATE IT. 4133 02:43:49,880 --> 02:43:53,320 >>I'LL TALK ABOUT DEMENTIA 4134 02:43:53,320 --> 02:43:55,920 CAREGIVING AND COMMUNITY-BASED 4135 02:43:55,920 --> 02:43:59,240 PARTICIPATORY RESEARCH AND 4136 02:43:59,240 --> 02:44:00,120 PROJECTS. 4137 02:44:00,120 --> 02:44:02,880 SOW BRIEFLY MANY OF YOU ARE 4138 02:44:02,880 --> 02:44:05,360 LIKELY FAMILIAR WITH WHO ASIAN 4139 02:44:05,360 --> 02:44:06,760 AMERICANS ARE. 4140 02:44:06,760 --> 02:44:08,360 ASIAN AMERICANS ARE THE MOST 4141 02:44:08,360 --> 02:44:10,680 RAPIDLY GROWING POPULATION OF 4142 02:44:10,680 --> 02:44:11,800 OLDER AMERICANS. 4143 02:44:11,800 --> 02:44:15,520 THEY ARE AT RISK FOR DEMENTIA. 4144 02:44:15,520 --> 02:44:19,280 THERE IS SIGNIFICANT DIVERSITY 4145 02:44:19,280 --> 02:44:21,920 AMONG ASIAN AMERICANS WITH OVER 4146 02:44:21,920 --> 02:44:24,320 100 LANGUAGES AND DIALECTS 4147 02:44:24,320 --> 02:44:26,240 SPOKEN AND MORE THAN 50 CULTURAL 4148 02:44:26,240 --> 02:44:26,480 GROUPS. 4149 02:44:26,480 --> 02:44:29,760 THERE'S DIVERSITY IN IMMIGRATION 4150 02:44:29,760 --> 02:44:32,000 PATTERNS, RELIGIONS, DIETS AND 4151 02:44:32,000 --> 02:44:36,320 SOCIAL ECONOMIC STATUS. 4152 02:44:36,320 --> 02:44:38,960 COMPARED TO OTHER ETHNIC 4153 02:44:38,960 --> 02:44:41,840 CAREGIVERS ASIAN AMERICANS ARE 4154 02:44:41,840 --> 02:44:43,240 LIKELY TO WANT HEALTH CARE 4155 02:44:43,240 --> 02:44:45,680 PROFESSIONALS TO ASK ABOUT CARE 4156 02:44:45,680 --> 02:44:47,920 RECIPIENTS NEEDS AND FIND THEIR 4157 02:44:47,920 --> 02:44:49,600 ROLE TO BE EMOTIONALLY STRESSFUL 4158 02:44:49,600 --> 02:44:51,280 AND MOST FELT THEY DID NOT HAVE 4159 02:44:51,280 --> 02:44:59,200 A CHOICE IN TAKING ON CAREGIVING 4160 02:44:59,200 --> 02:45:09,520 RESPONSIBILITIES. 4161 02:45:16,560 --> 02:45:19,000 THERE'S AN EVIDENCE BASED 4162 02:45:19,000 --> 02:45:22,920 PROGRAM FOR VIETNAMESE DEMENTIA 4163 02:45:22,920 --> 02:45:24,520 CAREGIVERS FUNDED BY THE 4164 02:45:24,520 --> 02:45:27,160 ALZHEIMER'S DISEASE. 4165 02:45:27,160 --> 02:45:29,720 THE FIRST THING WE DID WAS A 4166 02:45:29,720 --> 02:45:30,360 NEEDS ASSET. 4167 02:45:30,360 --> 02:45:34,160 WE DID QUALITATIVE INTERVIEWS 4168 02:45:34,160 --> 02:45:35,240 WITH HEALTH CARE PROFESSIONALS 4169 02:45:35,240 --> 02:45:38,360 AND STAKEHOLDERS WHO SERVE 4170 02:45:38,360 --> 02:45:42,400 VIETNAMESE AMERICANS AND ASKED 4171 02:45:42,400 --> 02:45:43,600 THEM ABOUT THEIR THOUGHTS ABOUT 4172 02:45:43,600 --> 02:45:46,480 DEMENTIA CAREGIVING PROGRAM FOR 4173 02:45:46,480 --> 02:45:48,160 VIETNAMESE AMERICANS AND 4174 02:45:48,160 --> 02:45:50,200 ELICITED SUGGESTIONS HOW TO GO 4175 02:45:50,200 --> 02:45:52,240 ABOUT DOING SO. 4176 02:45:52,240 --> 02:45:54,760 ONE OF THE MAJOR RECOMMENDATIONS 4177 02:45:54,760 --> 02:45:56,680 WAS USING COMMUNITY-ENGAGED 4178 02:45:56,680 --> 02:45:57,680 RESEARCH AND PARTICIPATORY 4179 02:45:57,680 --> 02:46:02,120 RESEARCH PRINCE PELS -- 4180 02:46:02,120 --> 02:46:03,320 PRINCIPLES IN OUR RECRUIT MANY 4181 02:46:03,320 --> 02:46:06,560 AND TAILORED OUR OUTREACH AND 4182 02:46:06,560 --> 02:46:11,760 STUDY MATERIALS AND OF COURSE 4183 02:46:11,760 --> 02:46:14,760 HAVE BILINGUAL, VIETNAMESE 4184 02:46:14,760 --> 02:46:14,960 STAFF. 4185 02:46:14,960 --> 02:46:17,200 WE NEED TO APPRECIATE CULTURAL 4186 02:46:17,200 --> 02:46:20,640 VALUES AND PRACTICES AS WELL AS 4187 02:46:20,640 --> 02:46:23,600 THE HISTORY OF THE JOURNEY FOR 4188 02:46:23,600 --> 02:46:34,120 VIETNAMESE AMERICANS TO THE U.S. 4189 02:46:40,080 --> 02:46:41,320 OVERALL THE PARTICIPANTS FROM 4190 02:46:41,320 --> 02:46:45,320 THE CONTROL AND INTERVENTION 4191 02:46:45,320 --> 02:46:49,120 ARMS OF THE STUDY WERE SATISFIED 4192 02:46:49,120 --> 02:46:51,560 WITH THE PROGRAM. 4193 02:46:51,560 --> 02:46:55,200 WHILE WE HAD MORE POSITIVE 4194 02:46:55,200 --> 02:46:56,840 FINDINGS IN REGARDS TO WELL 4195 02:46:56,840 --> 02:47:00,600 BEING AND MENTAL HEALTH FOR 4196 02:47:00,600 --> 02:47:02,080 EXAMPLE WHERE THE INTERVENTION 4197 02:47:02,080 --> 02:47:04,360 PARTICIPANTS WHAT WAS SURPRISING 4198 02:47:04,360 --> 02:47:08,480 TO US WAS THAT THE CONTROL 4199 02:47:08,480 --> 02:47:10,560 PARTICIPANTS HAD POSITIVE 4200 02:47:10,560 --> 02:47:15,240 FEEDBACK AND OUTCOMES AS WELL. 4201 02:47:15,240 --> 02:47:18,240 AND WE DISCOVERED THAT BECAUSE 4202 02:47:18,240 --> 02:47:21,880 THERE'S A LACK OF MATERIALS IN 4203 02:47:21,880 --> 02:47:23,240 VIETNAMESE AND AT THIS TIME OF 4204 02:47:23,240 --> 02:47:26,640 THE STUDY THIS WAS THE FIRST 4205 02:47:26,640 --> 02:47:29,360 STUDY IN THE U.S. IN THE AREA 4206 02:47:29,360 --> 02:47:31,480 FOR VIETNAMESE AMERICAN DEMENTIA 4207 02:47:31,480 --> 02:47:31,800 CAREGIVERS. 4208 02:47:31,800 --> 02:47:36,280 DUE TO THE LIMITED RESOURCES IN 4209 02:47:36,280 --> 02:47:37,760 DEMENTIA CARE FOR VIETNAMESE 4210 02:47:37,760 --> 02:47:40,880 AMERICANS IN THE LANGUAGE OF 4211 02:47:40,880 --> 02:47:43,680 VIETNAMESE ALL OUR PARTICIPANTS 4212 02:47:43,680 --> 02:47:50,480 PARTICIPATED IN VIETNAMESE, BY 4213 02:47:50,480 --> 02:47:51,800 THE WAY, THEY HAD POSITIVE 4214 02:47:51,800 --> 02:47:53,800 FEEDBACK AND DID NOT HAVE 4215 02:47:53,800 --> 02:47:56,000 TESTING CONTROLS. 4216 02:47:56,000 --> 02:47:58,640 WHAT WE REALIZED WAS THERE'S A 4217 02:47:58,640 --> 02:48:03,640 GREAT NEED FOR DEMENTIA CARE -- 4218 02:48:03,640 --> 02:48:05,440 CULTURALLY TAILORED DEMENTIA 4219 02:48:05,440 --> 02:48:06,200 CARE PROGRAMS FOR VIETNAMESE 4220 02:48:06,200 --> 02:48:16,360 AMERICANS. 4221 02:48:18,120 --> 02:48:20,640 THERE'S A PICTURE OF ONE OF THE 4222 02:48:20,640 --> 02:48:22,360 THINGS WE TAUGHT DURING OUR 4223 02:48:22,360 --> 02:48:23,360 PROGRAM. 4224 02:48:23,360 --> 02:48:25,720 MINDFUL BREATHING, AND OTHER 4225 02:48:25,720 --> 02:48:31,080 THINGS THAT WERE INCLUDED IN THE 4226 02:48:31,080 --> 02:48:32,960 PROGRAM WERE HOW TO COMMUNICATE 4227 02:48:32,960 --> 02:48:33,800 WITH YOUR HEALTH CARE PROVIDER 4228 02:48:33,800 --> 02:48:35,240 AND HOW TO ASK FAMILY AND 4229 02:48:35,240 --> 02:48:40,200 FRIENDS FOR HELP. 4230 02:48:40,200 --> 02:48:44,960 HOW TO ENCOURAGES PARTICIPANTS 4231 02:48:44,960 --> 02:48:46,760 HOW TO ENGAGE IN PLEASANT 4232 02:48:46,760 --> 02:48:57,080 ACTIVITIES, DAILY. 4233 02:49:07,320 --> 02:49:09,040 I WANTED TO SHARE A NEW PROJECT 4234 02:49:09,040 --> 02:49:17,360 FUNDED BY PCORI CALLED KIMCHI 4235 02:49:17,360 --> 02:49:25,160 AND IT'S COREIANS INVESTED IN 4236 02:49:25,160 --> 02:49:26,680 MAKING CAREGIVERS HEALTH 4237 02:49:26,680 --> 02:49:29,520 IMPORTANT AND WE LOOKED AT THE 4238 02:49:29,520 --> 02:49:32,240 LITERATURE WHAT'S BEEN LOOKED AT 4239 02:49:32,240 --> 02:49:34,760 IN CAREGIVERS AND SPECIFICALLY 4240 02:49:34,760 --> 02:49:38,320 ARE THERE ANY PUBLISHED DEMENTIA 4241 02:49:38,320 --> 02:49:42,880 CAREGIVER INTERVENTION STUDIES 4242 02:49:42,880 --> 02:49:49,200 IN THIS AREA OF DEMENTIA 4243 02:49:49,200 --> 02:49:49,480 CAREGIVING. 4244 02:49:49,480 --> 02:49:54,800 IN OUR PAPER WE STATED WE DID 4245 02:49:54,800 --> 02:49:56,760 NOT FIND ANYTHING, 4246 02:49:56,760 --> 02:49:57,120 UNFORTUNATELY. 4247 02:49:57,120 --> 02:49:58,360 AS FIRST STEPS OF TRYING TO GET 4248 02:49:58,360 --> 02:50:02,840 TO THAT POINT OF DEVELOPING A 4249 02:50:02,840 --> 02:50:05,920 CULTURALLY AND LINGUISTICALLY 4250 02:50:05,920 --> 02:50:09,840 DEMENTIA CAREGIVING PROGRAM FOR 4251 02:50:09,840 --> 02:50:13,600 KOREAN AMERICANS AND 4252 02:50:13,600 --> 02:50:15,640 SPECIFICALLY INTERVENTION 4253 02:50:15,640 --> 02:50:18,360 PROGRAM WE DEVELOPED KIMCHI TO 4254 02:50:18,360 --> 02:50:21,440 ENGAGE WITH THE COMMUNITIES, 4255 02:50:21,440 --> 02:50:25,880 KOREAN AMERICAN STAKEHOLDERS 4256 02:50:25,880 --> 02:50:27,640 ABOUT WHAT DEMENTIA CAREGIVING 4257 02:50:27,640 --> 02:50:31,400 IS OR UP TO DATE INFORMATION ON 4258 02:50:31,400 --> 02:50:32,720 CARE AS WELL AS ADVANCED 4259 02:50:32,720 --> 02:50:33,000 DIRECTIVES. 4260 02:50:33,000 --> 02:50:35,200 IF YOU'D LIKE TO LEARN MORE, THE 4261 02:50:35,200 --> 02:50:36,920 WEBSITE IS HERE AND YOU CAN SEE 4262 02:50:36,920 --> 02:50:39,520 HERE WE HAVE BILINGUAL KOREAN 4263 02:50:39,520 --> 02:50:50,040 AND ENGLISH MATERIALS AS WELL. 4264 02:50:57,280 --> 02:51:01,760 AND WE HAVE THIS REGISTRY AND WE 4265 02:51:01,760 --> 02:51:06,000 HAVE A MULTILINGUAL WEBSITE AND 4266 02:51:06,000 --> 02:51:07,480 OTHER OUTREACH MATERIALS. 4267 02:51:07,480 --> 02:51:09,240 IF YOU VISIT OUR WEBSITE YOU'LL 4268 02:51:09,240 --> 02:51:12,600 SEE ONE OF THE THINGS WE FOCUS 4269 02:51:12,600 --> 02:51:18,120 ON IS CAREGIVING, DEMENTIA 4270 02:51:18,120 --> 02:51:19,640 CAREGIVING, SPECIFICALLY IN 4271 02:51:19,640 --> 02:51:20,640 COLLABORATION WITH OUR COMMUNITY 4272 02:51:20,640 --> 02:51:21,320 ADVISORY BOARD AND OTHER 4273 02:51:21,320 --> 02:51:22,920 COMMUNITY PARTNERS. 4274 02:51:22,920 --> 02:51:24,600 WE HAVE IDENTIFIED SEVERAL 4275 02:51:24,600 --> 02:51:27,240 CAREGIVERS WILLING TO SHARE 4276 02:51:27,240 --> 02:51:29,480 THEIR STORY AND ONE OF THE 4277 02:51:29,480 --> 02:51:32,120 THEMES OUR COMMUNITY MEMBERS 4278 02:51:32,120 --> 02:51:35,920 CONTINUALLY ASK US OR MENTION IS 4279 02:51:35,920 --> 02:51:40,440 HOW THERE'S SO MUCH STIGMA AS IT 4280 02:51:40,440 --> 02:51:43,000 RELATES TO ALZHEIMER'S DISEASE 4281 02:51:43,000 --> 02:51:46,200 AND RELATED DEMENTIA AND ALL 4282 02:51:46,200 --> 02:51:49,600 THAT ENCOMPASSES. 4283 02:51:49,600 --> 02:51:52,640 BY US HAVING THESE CAREGIVING 4284 02:51:52,640 --> 02:51:54,400 AUDIO STORIES AVAILABLE, IT'S 4285 02:51:54,400 --> 02:51:55,840 OUR WAY OF SHOWING TO THE 4286 02:51:55,840 --> 02:51:59,880 COMMUNITY THAT YOUR NOT ALONE 4287 02:51:59,880 --> 02:52:01,600 AND IT'S OKAY TO REACH OUT FOR 4288 02:52:01,600 --> 02:52:12,120 HELP AND TO SHARE YOUR STORY. 4289 02:52:15,320 --> 02:52:16,880 IN HERE IS THE WEBSITE FOR CARE 4290 02:52:16,880 --> 02:52:19,280 AND I WANT TO THANK THE 4291 02:52:19,280 --> 02:52:24,120 CO-CHAIRS AND THE CAREGIVERS. 4292 02:52:24,120 --> 02:52:25,720 >>THANK YOU, DR. PARK. 4293 02:52:25,720 --> 02:52:31,640 LAST BUT NOT LEAST, DR. EPPS. 4294 02:52:31,640 --> 02:52:34,760 >>THANK YOU, CRYSTAL. 4295 02:52:34,760 --> 02:52:36,080 GOOD AFTERNOON, EVERYONE. 4296 02:52:36,080 --> 02:52:37,800 I WANT TO TALK ABOUT THE 4297 02:52:37,800 --> 02:52:38,960 COMMUNITY RELATIONSHIPS AND HOW 4298 02:52:38,960 --> 02:52:43,200 THEY'RE CRITICAL FOR THE RECRUIT 4299 02:52:43,200 --> 02:52:45,280 MANY OF AFRICAN AMERICAN 4300 02:52:45,280 --> 02:52:47,640 FAMILIES AND I'M AN ASSOCIATE 4301 02:52:47,640 --> 02:52:49,920 PROFESSOR AND IN THE OFFICE OF 4302 02:52:49,920 --> 02:52:50,960 DEI AT EMORY UNIVERSITY SCHOOL 4303 02:52:50,960 --> 02:52:55,960 OF NURSING. 4304 02:52:55,960 --> 02:52:58,520 WE'LL START OFF WITH COMMON 4305 02:52:58,520 --> 02:53:00,400 CHALLENGES OF RECRUITING AFRICAN 4306 02:53:00,400 --> 02:53:02,360 AMERICANS FOR DEMENTIA RESEARCH. 4307 02:53:02,360 --> 02:53:03,240 YOU PROBABLY HEARD SOME EARLIER 4308 02:53:03,240 --> 02:53:04,920 WHEN JORDAN WAS SPEAKING. 4309 02:53:04,920 --> 02:53:06,520 ONE OF THE FIRST THINGS I WANTED 4310 02:53:06,520 --> 02:53:11,240 TO SAY BEFORE I GO THROUGH THE 4311 02:53:11,240 --> 02:53:13,400 LIST IS SOMETHING THAT 4312 02:53:13,400 --> 02:53:17,160 DR. ANDERSON SAID ABOUT A YEAR 4313 02:53:17,160 --> 02:53:18,320 OR SO AGO. 4314 02:53:18,320 --> 02:53:19,720 THESE POPULATIONS ARE NOT HARD 4315 02:53:19,720 --> 02:53:22,880 TO REACH AND WE'VE SEEN THAT SO 4316 02:53:22,880 --> 02:53:25,280 OFTEN AND READ THAT THAT AFRICAN 4317 02:53:25,280 --> 02:53:26,440 AMERICAN FAMILIES, CAREGIVERS 4318 02:53:26,440 --> 02:53:27,560 ARE HARD TO REACH AND THAT'S NOT 4319 02:53:27,560 --> 02:53:27,800 THE CASE. 4320 02:53:27,800 --> 02:53:31,280 THEY ARE NOT. 4321 02:53:31,280 --> 02:53:37,640 WE ACTUALLY NEED TO UNDERSTAND 4322 02:53:37,640 --> 02:53:38,800 THEIR THOUGHTS ABOUT RESEARCH 4323 02:53:38,800 --> 02:53:40,560 AND ONE IS CLEAR DISRUPT OF 4324 02:53:40,560 --> 02:53:42,400 RESEARCHERS AND RESEARCH STILL 4325 02:53:42,400 --> 02:53:42,640 EXISTS. 4326 02:53:42,640 --> 02:53:45,880 AND WE KNOW OF SOME OF THE 4327 02:53:45,880 --> 02:53:48,440 COMMON OR HISTORICAL STUDIES 4328 02:53:48,440 --> 02:53:50,400 THAT HAVE INITIATED THE MISTRUST 4329 02:53:50,400 --> 02:53:53,400 BUT I WANT TO LET YOU ALL KNOW 4330 02:53:53,400 --> 02:53:55,600 THAT STILL GOES ON TODAY. 4331 02:53:55,600 --> 02:54:00,240 AND SO IT'S VERY IMPORTANT THAT 4332 02:54:00,240 --> 02:54:03,600 WE TRY TO WORK TOWARD BUILDING 4333 02:54:03,600 --> 02:54:04,480 THAT TRUST. 4334 02:54:04,480 --> 02:54:06,320 AND LETTING THEM KNOW. 4335 02:54:06,320 --> 02:54:08,360 THROUGH MY PRESENTATION I'LL BE 4336 02:54:08,360 --> 02:54:08,880 EMBEDDING RECOMMENDATIONS. 4337 02:54:08,880 --> 02:54:12,240 ONE OF THE THINGS FOR US TO 4338 02:54:12,240 --> 02:54:15,960 BUILD THAT TRUST IS BEING OPEN 4339 02:54:15,960 --> 02:54:17,640 AND SHARING EVERYTHING THEY NEED 4340 02:54:17,640 --> 02:54:21,440 TO KNOW ABOUT OUR RESEARCH. 4341 02:54:21,440 --> 02:54:27,280 BEING THERE TO ANSWER THE 4342 02:54:27,280 --> 02:54:27,520 QUESTIONS. 4343 02:54:27,520 --> 02:54:29,160 THAT'S REALLY KEY. 4344 02:54:29,160 --> 02:54:32,000 THERE'S A FEAR AND DISRUPT AND 4345 02:54:32,000 --> 02:54:33,720 EFFORT TO KEEP INFORMATION 4346 02:54:33,720 --> 02:54:34,960 CONFIDENTIAL AND PRIVATE AND 4347 02:54:34,960 --> 02:54:36,400 THAT COMES UP A LOT WHEN I WORK 4348 02:54:36,400 --> 02:54:37,280 IN THE COMMUNITY. 4349 02:54:37,280 --> 02:54:38,840 PEOPLE ARE REALLY FEARFUL THAT 4350 02:54:38,840 --> 02:54:39,840 OTHERS ARE GOING TO KNOW WHAT'S 4351 02:54:39,840 --> 02:54:47,200 GOING ON. 4352 02:54:47,200 --> 02:54:49,280 WHEN WE'RE LOOKING AT DEMENTIA 4353 02:54:49,280 --> 02:54:51,440 THIS IS SOMETHING MANY STILL 4354 02:54:51,440 --> 02:54:54,360 DON'T FEEL COMFORTABLE SHARING 4355 02:54:54,360 --> 02:54:56,520 WITH THEIR FAMILY AND CO-WORKERS 4356 02:54:56,520 --> 02:54:57,760 AND CHURCH FAMILY AND WE NEED TO 4357 02:54:57,760 --> 02:54:59,720 KEEP IT PRIVATE AND WE NEED TO 4358 02:54:59,720 --> 02:55:00,160 RESPECT THAT. 4359 02:55:00,160 --> 02:55:01,840 I WILL TELL YOU MANY TIMES I 4360 02:55:01,840 --> 02:55:04,720 FEEL I'M TESTED WHEN I'M IN THE 4361 02:55:04,720 --> 02:55:06,720 COMMUNITY BECAUSE PEOPLE SHARE 4362 02:55:06,720 --> 02:55:08,600 THINGS WITH ME AND I'M THINKING 4363 02:55:08,600 --> 02:55:09,480 THEY'RE WATCHING ME AND 4364 02:55:09,480 --> 02:55:11,400 OBSERVING TO SEE IF I'M GOING TO 4365 02:55:11,400 --> 02:55:13,000 SHARE IT WITH THE NEXT PERSON 4366 02:55:13,000 --> 02:55:14,080 BUT I DON'T. 4367 02:55:14,080 --> 02:55:16,400 THAT'S HOW I'VE BEEN ABLE TO 4368 02:55:16,400 --> 02:55:17,240 BUILD THE TRUST. 4369 02:55:17,240 --> 02:55:21,240 I'VE HAD PROMINENT FAMILIES 4370 02:55:21,240 --> 02:55:23,560 REACH OUT TO ME, FAITH LEADERS 4371 02:55:23,560 --> 02:55:25,880 NOW TRUSTING ME TO SEND THEIR 4372 02:55:25,880 --> 02:55:27,880 CHURCH MEMBERS, THEIR 4373 02:55:27,880 --> 02:55:30,320 PARISHIONERS TO ME IS ALL ABOUT 4374 02:55:30,320 --> 02:55:31,760 BUILDING THE TRUST AND SHOWING 4375 02:55:31,760 --> 02:55:35,280 THEM I CAN KEEP THINGS PRIVATE 4376 02:55:35,280 --> 02:55:39,160 AND CONFIDENTIAL. 4377 02:55:39,160 --> 02:55:43,040 ALSO IN THE AFRICAN AMERICAN 4378 02:55:43,040 --> 02:55:43,800 COMMUNITY THERE'S OTHER NEEDS 4379 02:55:43,800 --> 02:55:46,960 AND WE HAVE TO THINK OF MANY 4380 02:55:46,960 --> 02:55:48,000 INDIVIDUALS ARE WORKING PROBABLY 4381 02:55:48,000 --> 02:55:51,240 MORE THAN ONE JOB. 4382 02:55:51,240 --> 02:55:53,240 ALSO TAKING CARE OF GRAND KIDS. 4383 02:55:53,240 --> 02:55:55,680 THERE'S A LOT OF THINGS THEY'RE 4384 02:55:55,680 --> 02:55:55,880 DOING. 4385 02:55:55,880 --> 02:55:58,280 WE NEED TO BE MINDFUL OF THAT 4386 02:55:58,280 --> 02:55:59,320 AND KNOW OUR RESEARCH IS 4387 02:55:59,320 --> 02:56:01,600 IMPORTANT FOR US AND IS A 4388 02:56:01,600 --> 02:56:02,320 PRIORITY FOR US BUT MAY NOT BE 4389 02:56:02,320 --> 02:56:04,320 FOR THEM. 4390 02:56:04,320 --> 02:56:05,200 SO AGAIN JUST KEEPING THAT IN 4391 02:56:05,200 --> 02:56:09,280 MIND. 4392 02:56:09,280 --> 02:56:11,320 THE NEXT IS HAVING INFLEXIBLE 4393 02:56:11,320 --> 02:56:13,360 RESEARCH PROTOCOLS. 4394 02:56:13,360 --> 02:56:17,800 AND I KNOW SOME OF THE EARLIER 4395 02:56:17,800 --> 02:56:18,360 PRESENTATIONS I BELIEVE 4396 02:56:18,360 --> 02:56:20,240 YESTERDAY SOMEONE SPOKE ABOUT 4397 02:56:20,240 --> 02:56:21,360 PROMOTING EQUITY IN OUR RESEARCH 4398 02:56:21,360 --> 02:56:27,000 AND THIS IS ONE OF THE THINGS I 4399 02:56:27,000 --> 02:56:28,640 DO MY BEST WITH OR TRY TO WHEN 4400 02:56:28,640 --> 02:56:30,360 WE HAVE RESEARCH PROTOCOLS 4401 02:56:30,360 --> 02:56:31,320 KNOWING THEY NEED TO BE FLEXIBLE 4402 02:56:31,320 --> 02:56:34,240 AND THEY NEED TO BE ABLE TO 4403 02:56:34,240 --> 02:56:34,680 BEND. 4404 02:56:34,680 --> 02:56:35,480 WHEN YOU'RE WORKING UNDER THE 4405 02:56:35,480 --> 02:56:39,240 COMMUNITY AND I WORKED WITH THE 4406 02:56:39,240 --> 02:56:40,040 AFRICAN AMERICAN COMMUNITY 4407 02:56:40,040 --> 02:56:41,840 EVERYTHING MAY IN THE GO 4408 02:56:41,840 --> 02:56:43,760 STRICTLY AS I WROTE IN MY 4409 02:56:43,760 --> 02:56:44,800 PROTOCOL AND NEED TO BE OPEN TO 4410 02:56:44,800 --> 02:56:46,240 THAT AND BEFORE I GO OUT IN THE 4411 02:56:46,240 --> 02:56:48,200 COMMUNITY AND RECRUIT I THINK 4412 02:56:48,200 --> 02:56:51,880 ABOUT PLAN B, PLAN C, PLAN D. 4413 02:56:51,880 --> 02:56:53,600 THAT'S VERY IMPORTANT BECAUSE 4414 02:56:53,600 --> 02:56:57,240 I'M PROBABLY GOING TO GO THROUGH 4415 02:56:57,240 --> 02:56:58,360 ALL THOSE PLANS AND THINGS COME 4416 02:56:58,360 --> 02:56:58,520 UP. 4417 02:56:58,520 --> 02:57:02,480 I WANT TO THINK ABOUT THE 4418 02:57:02,480 --> 02:57:04,480 CRITERIA. 4419 02:57:04,480 --> 02:57:05,400 THE INCLUSION/EXCLUSION 4420 02:57:05,400 --> 02:57:06,280 CRITERIA. 4421 02:57:06,280 --> 02:57:08,920 SOME OF US WANT TO BE SO STRICT 4422 02:57:08,920 --> 02:57:13,280 BUT WE LEAVE MANY PEOPLE OUT SO 4423 02:57:13,280 --> 02:57:14,520 WE NEED TO THINK ABOUT THE 4424 02:57:14,520 --> 02:57:16,960 TIMING OF WHEN WE'RE DOING 4425 02:57:16,960 --> 02:57:17,280 CONSENT. 4426 02:57:17,280 --> 02:57:19,280 THE TIMING OF THE EVENTS WE WANT 4427 02:57:19,280 --> 02:57:19,960 TO RECRUIT AT. 4428 02:57:19,960 --> 02:57:23,000 IS THERE GOING TO BE A TIME MANY 4429 02:57:23,000 --> 02:57:25,400 PEOPLE IN THE COMMUNITY WE'RE 4430 02:57:25,400 --> 02:57:26,360 TARGETING WILL BE AVAILABLE. 4431 02:57:26,360 --> 02:57:27,840 THAT'S IMPORTANT AND WE DON'T 4432 02:57:27,840 --> 02:57:29,480 WANT TO BEND OUR PROTOCOLS AND 4433 02:57:29,480 --> 02:57:30,680 THINGS TOO MUCH WHERE IT'S GOING 4434 02:57:30,680 --> 02:57:31,720 TO THREATEN THE SCIENCE. 4435 02:57:31,720 --> 02:57:33,640 WE DON'T WANT TO DO THAT BUT DO 4436 02:57:33,640 --> 02:57:38,360 NEED TO KEEP IN MIND THE 4437 02:57:38,360 --> 02:57:39,440 COMMUNITIES WE'RE WORKING WITH 4438 02:57:39,440 --> 02:57:45,320 AND HOW WE CAN BEST ALIGN OUR 4439 02:57:45,320 --> 02:57:52,800 RESEARCH TO THEIR NEEDS SO 4440 02:57:52,800 --> 02:57:53,760 DEVELOPING RELATIONSHIPS WITH 4441 02:57:53,760 --> 02:57:55,000 MINORITY-SERVING COMMUNITIES. 4442 02:57:55,000 --> 02:57:57,360 THIS IS ONE OF THE THINGS I DO 4443 02:57:57,360 --> 02:58:00,760 IN MY WORK IN ORDER FOR ME TO 4444 02:58:00,760 --> 02:58:01,000 RECRUIT. 4445 02:58:01,000 --> 02:58:04,680 I DO WORK WITH FRATERNITIES AND 4446 02:58:04,680 --> 02:58:05,400 SORORITIES. 4447 02:58:05,400 --> 02:58:09,280 THIS IS KEY AND NOT ONLY FOR 4448 02:58:09,280 --> 02:58:10,160 FRATERNITIES AND PRIORITIES BUT 4449 02:58:10,160 --> 02:58:12,280 OTHER CIVIC ORGANIZATIONS AND 4450 02:58:12,280 --> 02:58:14,080 ORGANIZATIONS THAT HAS 4451 02:58:14,080 --> 02:58:15,680 PREDOMINANTLY BLACK MEMBERSHIP. 4452 02:58:15,680 --> 02:58:22,200 PARTNERING WITH THEM IS KEY. 4453 02:58:22,200 --> 02:58:24,840 BECAUSE WITHIN THEIR MEMBERSHIP 4454 02:58:24,840 --> 02:58:27,320 THEY HAVE CAREGIVERS AND HAVE 4455 02:58:27,320 --> 02:58:29,160 PERSONS THAT HAVE CHRONIC 4456 02:58:29,160 --> 02:58:30,360 ILLNESSES AND OTHER THINGS WE'RE 4457 02:58:30,360 --> 02:58:30,920 LOOKING FOR AND HEALTH IS 4458 02:58:30,920 --> 02:58:35,360 IMPORTANT TO THEM. 4459 02:58:35,360 --> 02:58:37,480 SO ESTABLISHING THE PARTNERSHIPS 4460 02:58:37,480 --> 02:58:42,160 IS KEY AND LET'S NOT OVERLOOK 4461 02:58:42,160 --> 02:58:45,280 BARBERSHOPS AND HAIR SALONS.IN 4462 02:58:45,280 --> 02:58:51,000 THE BLACK COMMUNITY IT'S A KEY 4463 02:58:51,000 --> 02:58:55,280 PLACE. 4464 02:58:55,280 --> 02:58:56,320 OF GATHERING AND IT'S IMPORTANT 4465 02:58:56,320 --> 02:59:02,040 WE REACH OUT TO THEM AND PARTNER 4466 02:59:02,040 --> 02:59:03,600 WITH THEM. 4467 02:59:03,600 --> 02:59:04,440 THERE'S A LOT OF PROGRAMS THAT 4468 02:59:04,440 --> 02:59:06,520 DO EXIST ESPECIALLY WITH MENTAL 4469 02:59:06,520 --> 02:59:10,000 HEALTH TRAINING FOR BARBERS AND 4470 02:59:10,000 --> 02:59:11,040 HAIRSTYLERS BUT I DON'T WANT US 4471 02:59:11,040 --> 02:59:13,120 TO STOP THERE. 4472 02:59:13,120 --> 02:59:14,840 I THINK THERE'S SO MANY THINGS 4473 02:59:14,840 --> 02:59:16,240 THAT CAN BE DONE BEYOND MENTAL 4474 02:59:16,240 --> 02:59:17,080 HEALTH TRAINING. 4475 02:59:17,080 --> 02:59:19,880 AND FOR THOSE WHO MAY NOT 4476 02:59:19,880 --> 02:59:21,600 UNDERSTAND WHY IS IT PARTNERING 4477 02:59:21,600 --> 02:59:23,920 WITH THE BARBERSHOP SO 4478 02:59:23,920 --> 02:59:24,200 IMPORTANT? 4479 02:59:24,200 --> 02:59:25,760 IN THE BLACK COMMUNITY THIS IS 4480 02:59:25,760 --> 02:59:27,160 WHERE YOU COME AND THIS IS 4481 02:59:27,160 --> 02:59:27,920 ALMOST THERAPY. 4482 02:59:27,920 --> 02:59:29,880 THIS IS WHERE YOU LET EVERYTHING 4483 02:59:29,880 --> 02:59:30,040 OUT. 4484 02:59:30,040 --> 02:59:32,400 THIS IS ALSO THE PLACE WHERE YOU 4485 02:59:32,400 --> 02:59:34,080 FIND INFORMATION. 4486 02:59:34,080 --> 02:59:35,280 YOU SEEK RESOURCES AND YOU SEEK 4487 02:59:35,280 --> 02:59:41,400 SUPPORT HERE. 4488 02:59:41,400 --> 02:59:43,440 AS I THINK OF MY PERSONAL LIFE 4489 02:59:43,440 --> 02:59:51,280 I'D GO TO MY HAIRSTY STYLEST AN 4490 02:59:51,280 --> 02:59:53,680 WOULD ASK IF SHE KNOWS SOMEONE 4491 02:59:53,680 --> 02:59:56,640 TO FIX SOMETHING IN MY HOUSE AND 4492 02:59:56,640 --> 02:59:59,880 UP RETURN SHE HAS SENT ME 4493 02:59:59,880 --> 03:00:02,520 SEVERAL CAREGIVERS SUPPORTING 4494 03:00:02,520 --> 03:00:03,320 SOMEONE LIVING WITH DEMENTIA 4495 03:00:03,320 --> 03:00:05,440 BECAUSE WHEN THEY GET IN HER 4496 03:00:05,440 --> 03:00:06,840 CHAIR THEY OPEN UP ABOUT THEIR 4497 03:00:06,840 --> 03:00:08,560 LIFE AND CHALLENGES AND HELP 4498 03:00:08,560 --> 03:00:09,360 THEY NEED. 4499 03:00:09,360 --> 03:00:10,320 SHE'S ABLE TO PROVIDE EDUCATION 4500 03:00:10,320 --> 03:00:11,680 AND SAY I KNOW WHO YOU NEED TO 4501 03:00:11,680 --> 03:00:20,840 CALL. 4502 03:00:20,840 --> 03:00:23,040 THIS IS WHY IT'S IMPORTANT TO 4503 03:00:23,040 --> 03:00:25,320 NOT OVERLOOK BARBERSHOPS AND 4504 03:00:25,320 --> 03:00:29,400 HAIR SALONS. 4505 03:00:29,400 --> 03:00:32,320 NEXT IS PLACE OF WORSHIP AND 4506 03:00:32,320 --> 03:00:32,600 CHURCHES. 4507 03:00:32,600 --> 03:00:34,000 THIS IS ANOTHER GATHERING PLACE 4508 03:00:34,000 --> 03:00:34,680 FOR AFRICAN AMERICAN INDIVIDUALS 4509 03:00:34,680 --> 03:00:37,640 AND FAMILIES AND WE CANNOT 4510 03:00:37,640 --> 03:00:43,000 OVERLOOK THEM AND IT'S NOT US 4511 03:00:43,000 --> 03:00:49,600 GOING IN AND WE WANT TO 4512 03:00:49,600 --> 03:00:52,000 ESTABLISH THE RELATIONSHIPS. 4513 03:00:52,000 --> 03:00:53,640 MANY THINK FAITH LEADERS ARE 4514 03:00:53,640 --> 03:00:58,680 HARD TO REACH BUT THEY'RE NOT. 4515 03:00:58,680 --> 03:01:02,560 YOU JUST HAVE TO GO TO THEM AND 4516 03:01:02,560 --> 03:01:04,840 EXPLAIN TO THEM THE SENSE OF 4517 03:01:04,840 --> 03:01:07,480 URGENCY, WHY THIS IS NEEDED. 4518 03:01:07,480 --> 03:01:10,360 TAKE YOUR TIME AND EXPLAIN THE 4519 03:01:10,360 --> 03:01:10,880 RESEARCH. 4520 03:01:10,880 --> 03:01:12,360 YOU WOULD BE SURPRISED HOW 4521 03:01:12,360 --> 03:01:13,040 THEY'LL OPEN UP THEIR CHURCH FOR 4522 03:01:13,040 --> 03:01:22,960 YOU. 4523 03:01:22,960 --> 03:01:24,920 WEEKS AGO A BISHOP OPENED UP HIS 4524 03:01:24,920 --> 03:01:27,280 CHURCH TO COLLECT SURVEYS AFTER 4525 03:01:27,280 --> 03:01:27,720 WORSHIP SERVICE. 4526 03:01:27,720 --> 03:01:30,920 HE MADE THE ANNOUNCEMENT DURING 4527 03:01:30,920 --> 03:01:33,080 WORSHIP AND ASKED THEM TO 4528 03:01:33,080 --> 03:01:36,320 PARTICIPATE IN OUR SURVEY. 4529 03:01:36,320 --> 03:01:38,080 OUT OF EVERYONE THERE WE GOT 90% 4530 03:01:38,080 --> 03:01:38,960 OF INDIVIDUALS THAT COMPLETED 4531 03:01:38,960 --> 03:01:49,160 OUR SURVEY. 4532 03:01:49,600 --> 03:01:52,160 MANY SAID THIS WILL NOT HAPPEN. 4533 03:01:52,160 --> 03:01:54,440 ALSO ESTABLISHING A PARTNERSHIP 4534 03:01:54,440 --> 03:01:56,000 WITH THE FAITH COMMUNITIES AND 4535 03:01:56,000 --> 03:01:57,840 WE'RE PUTTING ON A DEMENTIA 4536 03:01:57,840 --> 03:01:58,200 SUMMIT. 4537 03:01:58,200 --> 03:02:00,200 WE TALK ABOUT THE ROLE OF THE 4538 03:02:00,200 --> 03:02:01,360 BLACK CHURCH AND THAT WILL BE 4539 03:02:01,360 --> 03:02:02,600 HELD NEXT YEAR BUT AGAIN THAT'S 4540 03:02:02,600 --> 03:02:05,440 THROUGH PARTNERSHIP WITH OUR 4541 03:02:05,440 --> 03:02:06,080 FAITH COMMUNITIES. 4542 03:02:06,080 --> 03:02:08,800 THEY WANT TO KNOW HOW THEY CAN 4543 03:02:08,800 --> 03:02:15,280 BETTER SERVE THEIR PRIGS NERS. 4544 03:02:15,280 --> 03:02:15,920 -- PARISHIONER. 4545 03:02:15,920 --> 03:02:18,160 SO PEOPLE HAVE COME TO ME AND 4546 03:02:18,160 --> 03:02:19,720 ASKED HOW TO ENGAGE WITH THE 4547 03:02:19,720 --> 03:02:24,040 COMMUNITY TO CONDUCT RESEARCH. 4548 03:02:24,040 --> 03:02:25,200 EARLIER THIS YEAR SOMEONE SAID 4549 03:02:25,200 --> 03:02:26,800 HOW DO YOU DO IT? 4550 03:02:26,800 --> 03:02:32,000 ONE OF THE FIRST THINGS IS 4551 03:02:32,000 --> 03:02:34,880 LISTENING, BEING RESPONSIVE, 4552 03:02:34,880 --> 03:02:38,120 BUILD TRUST, AND BE PRESENT AND 4553 03:02:38,120 --> 03:02:38,360 ACTIVE. 4554 03:02:38,360 --> 03:02:39,640 AND MANY SAY WE LISTEN BUT WE 4555 03:02:39,640 --> 03:02:42,480 WANT TO MAKE SURE THAT WE ALSO 4556 03:02:42,480 --> 03:02:43,920 ARE RESPONSIVE AND HEAR WHAT 4557 03:02:43,920 --> 03:02:47,280 THEY'RE SAYING. 4558 03:02:47,280 --> 03:02:48,280 BUILD THE TRUST AND BE PRESENT 4559 03:02:48,280 --> 03:02:49,080 AND ACTIVE. 4560 03:02:49,080 --> 03:02:51,760 I SEE MY TIMER'S OUT SO I'LL RUN 4561 03:02:51,760 --> 03:02:55,440 THROUGH THE REMAINDER OF THE 4562 03:02:55,440 --> 03:02:55,680 SLIDES. 4563 03:02:55,680 --> 03:02:56,760 10 MINUTES WENT QUICK. 4564 03:02:56,760 --> 03:02:58,400 ENGAGING IN COMMUNITY PARTNERS 4565 03:02:58,400 --> 03:02:58,960 AND RECRUITMENT. 4566 03:02:58,960 --> 03:03:02,960 THIS IS JUST AN EXAMPLE FOR A 4567 03:03:02,960 --> 03:03:04,200 CAREGIVER BLACK STUDY FUNDED 4568 03:03:04,200 --> 03:03:06,720 THROUGH THE RF FOUNDATION FOR 4569 03:03:06,720 --> 03:03:11,120 AGING WHERE I PARTNERED WITH 4570 03:03:11,120 --> 03:03:14,080 BLACK ORGANIZATIONS TO HELP 4571 03:03:14,080 --> 03:03:16,760 RECRUIT AND WE RECRUITED 75 4572 03:03:16,760 --> 03:03:17,920 BLACK CAREGIVERS. 4573 03:03:17,920 --> 03:03:20,160 THEY ASKED FOR MONTHLY MEETS AND 4574 03:03:20,160 --> 03:03:22,960 BECAME PART OF MY DESIGN. 4575 03:03:22,960 --> 03:03:24,760 THEY WANTED MONTHLY MEETINGS TO 4576 03:03:24,760 --> 03:03:26,360 LEARN ABOUT THE PROJECT AND MAKE 4577 03:03:26,360 --> 03:03:26,960 RECOMMENDATIONS AND HEAR ABOUT 4578 03:03:26,960 --> 03:03:30,960 THE RESULTS. 4579 03:03:30,960 --> 03:03:32,400 AND THIS IS AN EXAMPLE OF THE 4580 03:03:32,400 --> 03:03:32,720 FLYER. 4581 03:03:32,720 --> 03:03:34,840 THEY SAID NO, YOU NEED TO GO 4582 03:03:34,840 --> 03:03:35,040 BACK. 4583 03:03:35,040 --> 03:03:37,360 WE WANT OUR LOCALS ON FLYERS 4584 03:03:37,360 --> 03:03:39,120 BECAUSE IF WE PARTNER WITH YOU 4585 03:03:39,120 --> 03:03:41,400 AND WILL PASS THIS OUT AND HELP 4586 03:03:41,400 --> 03:03:43,440 RECRUIT, WE NEED TO SHOW WE ARE 4587 03:03:43,440 --> 03:03:45,200 PART OF THIS RESEARCH AND NEED 4588 03:03:45,200 --> 03:03:46,800 TO BE ON YOUR FLYER. 4589 03:03:46,800 --> 03:03:47,440 I WANTED TO SHARE THAT EXAMPLE 4590 03:03:47,440 --> 03:03:51,120 WITH YOU. 4591 03:03:51,120 --> 03:03:52,280 I THANK YOU FOR YOUR TIME. 4592 03:03:52,280 --> 03:03:54,120 FEEL FREE TO REACH OUT TO ME IF 4593 03:03:54,120 --> 03:03:57,360 YOU HAVE FURTHER QUESTIONS AND 4594 03:03:57,360 --> 03:03:59,280 YOU CAN FIND MORE INFORMATION 4595 03:03:59,280 --> 03:04:00,000 THROUGH FACEBOOK, TWITTER AND 4596 03:04:00,000 --> 03:04:03,280 INSTAGRAM. 4597 03:04:03,280 --> 03:04:13,440 THANK YOU. 4598 03:04:25,240 --> 03:04:27,640 >>AND NOW WE'LL GO THROUGH NEXT 4599 03:04:27,640 --> 03:04:30,160 STEPS AND WALKS YOU THROUGH THE 4600 03:04:30,160 --> 03:04:35,800 FACES OF RESEARCH OR BIG PIECES. 4601 03:04:35,800 --> 03:04:37,320 FIRST STARTING WITH NOMENCLATURE 4602 03:04:37,320 --> 03:04:43,280 AND DEFINING WHO OR WHAT IS A 4603 03:04:43,280 --> 03:04:44,920 CAREGIVER OR CARE PARTNER AMONG 4604 03:04:44,920 --> 03:04:45,880 DEMOGRAPHICALLY DIVERSE 4605 03:04:45,880 --> 03:04:49,200 COMMUNITIES BY CONCEPTUALIZING 4606 03:04:49,200 --> 03:04:53,040 AND SETTING TERMS NOT ONLY 4607 03:04:53,040 --> 03:04:55,480 CULTURALLY COMPETENT, ACCEPTABLE 4608 03:04:55,480 --> 03:04:57,360 AND INVITING. 4609 03:04:57,360 --> 03:05:00,320 IT HAS IMPLICATION FOR WHO IS 4610 03:05:00,320 --> 03:05:01,600 TAKING PART IN RESEARCH AND WHO 4611 03:05:01,600 --> 03:05:05,360 WE'RE TRYING TO REACH AND 4612 03:05:05,360 --> 03:05:08,160 SAMPLING, ENGAGEMENT AND 4613 03:05:08,160 --> 03:05:08,440 RECRUITMENT. 4614 03:05:08,440 --> 03:05:17,560 SECOND IS THE EXAM NATION OF 4615 03:05:17,560 --> 03:05:19,520 DESIGN AND HOW CAN WE MOVE 4616 03:05:19,520 --> 03:05:23,520 BEYOND QUALITATIVE AS THE GOLD 4617 03:05:23,520 --> 03:05:26,480 STANDARD AND EXAMINING 4618 03:05:26,480 --> 03:05:27,200 CAREGIVING AMONG DEMOGRAPHICALLY 4619 03:05:27,200 --> 03:05:29,520 DIVERSE GROUPS AND LOOKING AT 4620 03:05:29,520 --> 03:05:31,920 APPROACHES AND STRATEGIES FOR 4621 03:05:31,920 --> 03:05:35,280 EQUITABLE SAMPLING AND 4622 03:05:35,280 --> 03:05:36,320 RECRUITMENT AND RETENTION. 4623 03:05:36,320 --> 03:05:38,320 ALSO TO FOCUS ON NOT ONLY THE 4624 03:05:38,320 --> 03:05:39,560 UNDER REPRESENTED INCLUDES OR 4625 03:05:39,560 --> 03:05:41,640 UNDER INCLUDED GROUPS 4626 03:05:41,640 --> 03:05:43,400 HIGHLIGHTED BY JORDAN AND VAN 4627 03:05:43,400 --> 03:05:45,880 AND OTHERS BUT SIMULTANEOUSLY 4628 03:05:45,880 --> 03:05:51,080 EXPAND OUT TO WHAT WE TERM 4629 03:05:51,080 --> 03:05:54,080 PRIORITY POPULATIONS INCLUDING 4630 03:05:54,080 --> 03:06:01,800 CAREGIVERS WHO BELONG TO THE 4631 03:06:01,800 --> 03:06:02,720 LGBTQ PLUS POPULATIONS AND 4632 03:06:02,720 --> 03:06:06,480 LOOKING AT QUALITATIVE AND MIXED 4633 03:06:06,480 --> 03:06:08,640 DESIGN THINK AG APPROACHES AND 4634 03:06:08,640 --> 03:06:11,080 ADD TO OUR TOOL KIT OF RIGOROUS 4635 03:06:11,080 --> 03:06:12,080 STUDY DESIGNS TO UNDERSTAND CARE 4636 03:06:12,080 --> 03:06:22,600 PARTNER AND CAREGIVING RESEARCH. 4637 03:06:26,440 --> 03:06:27,760 AND LOOKING AT WHAT HAPPENS 4638 03:06:27,760 --> 03:06:30,640 AFTER THE LOVED ONE PASSES AND 4639 03:06:30,640 --> 03:06:31,960 WHAT DOES A CAREGIVERS LIFE 4640 03:06:31,960 --> 03:06:33,240 LOOKS LIKE ONCE THEY LOSE THE 4641 03:06:33,240 --> 03:06:38,320 INDIVIDUAL IN TERMS OF THEIR 4642 03:06:38,320 --> 03:06:43,240 HEALTH AND MENTAL HEALTH AND HOW 4643 03:06:43,240 --> 03:06:48,760 THEY RELATE TO THOSE IN THE 4644 03:06:48,760 --> 03:06:49,160 ENVIRONMENT. 4645 03:06:49,160 --> 03:06:54,960 WE'LL WELCOME THREE PANELISTS, 4646 03:06:54,960 --> 03:06:57,840 MARTHA WILLIAMS AND CHRISTINE 4647 03:06:57,840 --> 03:07:08,160 NGUYEN AND DR. REID. 4648 03:07:14,960 --> 03:07:17,640 >>WE'LL START WITH THE FIRST 4649 03:07:17,640 --> 03:07:23,000 QUESTION FOR OUR PANELISTS. 4650 03:07:23,000 --> 03:07:28,920 WHY DID YOU WHY DID YOU DECIDE 4651 03:07:28,920 --> 03:07:34,520 TO DO RESEARCH AND START WITH 4652 03:07:34,520 --> 03:07:38,200 MS. WILLIAMS. 4653 03:07:38,200 --> 03:07:40,960 >>IT'S SIMPLE. 4654 03:07:40,960 --> 03:07:42,080 I'M FROM AN INDIAN RESERVATION 4655 03:07:42,080 --> 03:07:49,080 AND THE NEEDS ARE GREAT. 4656 03:07:49,080 --> 03:07:52,240 MY DAD HAS PARKINSON'S AND MY 4657 03:07:52,240 --> 03:07:54,680 MOM HAS ALZHEIMER'S AND NOT 4658 03:07:54,680 --> 03:07:57,720 UNDERSTANDING IT MYSELF IT WAS 4659 03:07:57,720 --> 03:07:59,200 IMPORTANT TO BE PART OF 4660 03:07:59,200 --> 03:07:59,800 SOMETHING GREATER THAN WHAT I 4661 03:07:59,800 --> 03:08:07,440 WAS DOING. 4662 03:08:07,440 --> 03:08:09,040 >>THANK YOU, MARTHA. 4663 03:08:09,040 --> 03:08:11,440 CHRISTINE, YOUR THOUGHTS? 4664 03:08:11,440 --> 03:08:12,920 >>THREW. 4665 03:08:12,920 --> 03:08:14,080 THANKS FOR HAVING ME HERE. 4666 03:08:14,080 --> 03:08:17,360 I TRAINED AS A DOCTOR AND AS A 4667 03:08:17,360 --> 03:08:19,680 DOCTOR I THOUGHT OF RESEARCH AS 4668 03:08:19,680 --> 03:08:23,920 SOMETHING YOU CONDUCTED WITH 4669 03:08:23,920 --> 03:08:24,720 OTHER PEOPLE BUT A LOT OF US 4670 03:08:24,720 --> 03:08:26,600 WILL HAVE A FRIEND OR FAMILY 4671 03:08:26,600 --> 03:08:36,600 MEMBER WITH DEMENTIA AND I 4672 03:08:36,600 --> 03:08:38,280 WONDERED IF I WOULD DEVELOP 4673 03:08:38,280 --> 03:08:38,560 DEMENTIA. 4674 03:08:38,560 --> 03:08:41,440 I TALKED TO OTHER CAREGIVERS AND 4675 03:08:41,440 --> 03:08:44,480 PART OF A FACEBOOK GROUP FOR 4676 03:08:44,480 --> 03:08:47,080 PEOPLE WHO TAKE CARE OF PEOPLE 4677 03:08:47,080 --> 03:08:47,720 WITH ALZHEIMER'S OR DEMENTIA AND 4678 03:08:47,720 --> 03:08:56,720 I HEAR THE SAME THING. 4679 03:08:56,720 --> 03:08:58,920 WHEN YOU DEAL WITH IT YOU'RE 4680 03:08:58,920 --> 03:08:59,960 FIGURING IT OUT FOR THE FIRST 4681 03:08:59,960 --> 03:09:02,920 TIME ON YOUR OWN. 4682 03:09:02,920 --> 03:09:07,040 YOU DON'T KNOW WHAT TO EXPECT OR 4683 03:09:07,040 --> 03:09:08,320 WHAT'S THE TIME LINE OF WHAT'S 4684 03:09:08,320 --> 03:09:09,520 GOING TO HAPPEN TO YOUR LOVED 4685 03:09:09,520 --> 03:09:09,960 ONE. 4686 03:09:09,960 --> 03:09:12,720 YOU DON'T KNOW HOW TO HELP YOUR 4687 03:09:12,720 --> 03:09:14,280 LOVED ONE OR KNOW IF WHAT YOU'RE 4688 03:09:14,280 --> 03:09:20,440 DOING IS HELPFUL OR HARMFUL AND 4689 03:09:20,440 --> 03:09:22,640 THEN YOU EVEN WONDER HOW YOU'LL 4690 03:09:22,640 --> 03:09:24,880 KEEP GOING WHEN YOU DON'T REALLY 4691 03:09:24,880 --> 03:09:31,560 EXPECT THIS TO GET BETTER. 4692 03:09:31,560 --> 03:09:32,560 WE THINK IT'S GOING TO GET 4693 03:09:32,560 --> 03:09:39,200 BETTER AND YOU'LL BE DONE. 4694 03:09:39,200 --> 03:09:40,600 BUT HOW DOES IT GET BETTER AND 4695 03:09:40,600 --> 03:09:42,120 YOU WONDER THAT AND YOU WONDER 4696 03:09:42,120 --> 03:09:51,400 HOW TO HELP YOUR LOVED ONE. 4697 03:09:51,400 --> 03:09:53,360 FOR ME IT WAS ON TOP OF LANGUAGE 4698 03:09:53,360 --> 03:09:57,840 AND CULTURAL BARRIERS. 4699 03:09:57,840 --> 03:10:00,920 I WAS BORN IN VIETNAM AND MY 4700 03:10:00,920 --> 03:10:03,640 PARENTS WERE REFUGEES AND 4701 03:10:03,640 --> 03:10:06,320 THERE'S STIGMA. 4702 03:10:06,320 --> 03:10:08,440 MY PARENTS SPOKE GREAT ENGLISH 4703 03:10:08,440 --> 03:10:10,280 WHEN THEY DIDN'T HAVE DEMENTIA 4704 03:10:10,280 --> 03:10:12,160 BUT WHEN THEY DEVELOPED DEMENTIA 4705 03:10:12,160 --> 03:10:13,200 THEY STOPPED SPEAKING ENGLISH. 4706 03:10:13,200 --> 03:10:16,360 WHAT DO YOU DO THERE? 4707 03:10:16,360 --> 03:10:21,920 HOW DO YOU FIND CARE AND HELP? 4708 03:10:21,920 --> 03:10:24,400 SOMETIMES I LOOK THROUGH 4709 03:10:24,400 --> 03:10:28,640 PAMPHLETS AND I DON'T KNOW IF IT 4710 03:10:28,640 --> 03:10:31,600 APPLIES SO I WAS INTERESTED IN 4711 03:10:31,600 --> 03:10:32,720 WHAT DR. PARK SPOKE ABOUT 4712 03:10:32,720 --> 03:10:33,320 SPECIFICALLY LOOKING AT ASIAN 4713 03:10:33,320 --> 03:10:38,760 AMERICANS. 4714 03:10:38,760 --> 03:10:39,960 >>THANK YOU. 4715 03:10:39,960 --> 03:10:40,480 DEACON REID. 4716 03:10:40,480 --> 03:10:41,760 >>THANK YOU FOR ALLOWING ME TO 4717 03:10:41,760 --> 03:10:44,000 HAVE A LITTLE BIT OF TIME. 4718 03:10:44,000 --> 03:10:48,040 MY WHY IS MY WIFE. 4719 03:10:48,040 --> 03:10:52,400 MY WIFE WAS DIAGNOSED WITH EARLY 4720 03:10:52,400 --> 03:10:54,840 ONSET ALZHEIMER'S AT THE YOUNG 4721 03:10:54,840 --> 03:10:58,000 AGE OF 50 IN 2017. 4722 03:10:58,000 --> 03:10:59,880 AT THAT MOMENT WE RECOGNIZED WE 4723 03:10:59,880 --> 03:11:00,840 WANTED TO ADVOCATE FOR OUR 4724 03:11:00,840 --> 03:11:03,120 CHILDREN. 4725 03:11:03,120 --> 03:11:04,640 WE WANTED TO ADVOCATE FOR OUR 4726 03:11:04,640 --> 03:11:08,720 COMMUNITY BECAUSE AS WHAT'S BEEN 4727 03:11:08,720 --> 03:11:09,360 STATED AND PARTICULAR IN THE 4728 03:11:09,360 --> 03:11:10,960 BLACK COMMUNITY WE DON'T TALK 4729 03:11:10,960 --> 03:11:12,200 ABOUT ALZHEIMER'S. 4730 03:11:12,200 --> 03:11:14,400 WE DON'T TALK ABOUT DEMENTIA A 4731 03:11:14,400 --> 03:11:14,760 LOT. 4732 03:11:14,760 --> 03:11:19,280 SO BECAUSE OF THAT WE WANTED TO 4733 03:11:19,280 --> 03:11:21,800 CONTINUE TO ADVOCATE BOTH FOR 4734 03:11:21,800 --> 03:11:26,160 THOSE WITH ALZHEIMER'S AND 4735 03:11:26,160 --> 03:11:28,400 DEMENTIA AND THE CAREGIVERS 4736 03:11:28,400 --> 03:11:31,280 WHICH UNFORTUNATELY ARE 4737 03:11:31,280 --> 03:11:32,080 UNRECOGNIZED IN SO MANY WAYS 4738 03:11:32,080 --> 03:11:33,960 BECAUSE THE FOCUS IS TYPICALLY 4739 03:11:33,960 --> 03:11:37,600 ON THE PATIENT AND NOT 4740 03:11:37,600 --> 03:11:38,640 NECESSARILY THE CAREGIVER. 4741 03:11:38,640 --> 03:11:40,520 I USE THE TERM CARE PARTNER 4742 03:11:40,520 --> 03:11:43,360 SINCE I'M CARING FOR MY LOVELY 4743 03:11:43,360 --> 03:11:43,560 WIFE. 4744 03:11:43,560 --> 03:11:51,400 BUT THAT'S MY WHY. 4745 03:11:51,400 --> 03:11:52,600 >>NOW WOULD BE GREAT TIME TO 4746 03:11:52,600 --> 03:11:58,240 GET THE PANEL'S INPUT ON THE 4747 03:11:58,240 --> 03:12:01,840 GAPS AND OPPORTUNITIES WE SET 4748 03:12:01,840 --> 03:12:07,000 FOR FORTH SESSION EIGHT AND HOW 4749 03:12:07,000 --> 03:12:10,440 WE SPEAK ABOUT CAREGIVERS AND 4750 03:12:10,440 --> 03:12:13,160 DEACON REID REFERS HIMSELF AS A 4751 03:12:13,160 --> 03:12:15,160 CARE PARTNER AND IT'S IMPORTANT 4752 03:12:15,160 --> 03:12:17,880 TO LOOK AT WHO PROVIDE CARE WITH 4753 03:12:17,880 --> 03:12:22,560 THOSE LIVING WITH DISEASE, 4754 03:12:22,560 --> 03:12:22,960 DEMENTIA. 4755 03:12:22,960 --> 03:12:26,160 AND HOW WE MAY CAPTURE THE 4756 03:12:26,160 --> 03:12:27,400 SENSITIVE RICH BUT COMPLEX DATA 4757 03:12:27,400 --> 03:12:33,080 AND THE LAST IS EXTENDING OUT 4758 03:12:33,080 --> 03:12:37,480 CARE PHASES INTO WHEN THE PERSON 4759 03:12:37,480 --> 03:12:38,920 WITH DEMENTIA PASSES AWAY. 4760 03:12:38,920 --> 03:12:39,680 I'D LOVE TO HEAR THE GAPS AND 4761 03:12:39,680 --> 03:12:49,600 OPPORTUNITIES. 4762 03:12:49,600 --> 03:12:53,760 DR. NGUYEN CAN WE START WITH 4763 03:12:53,760 --> 03:12:56,800 YOU? 4764 03:12:56,800 --> 03:13:02,400 >>I HOPE WHEN WE TOOK ABOUT 4765 03:13:02,400 --> 03:13:05,480 CAREGIVING AND OUTREACH WE MOVE 4766 03:13:05,480 --> 03:13:07,600 AWAY FROM A LOT OF JARGON. 4767 03:13:07,600 --> 03:13:09,040 EVEN THE TITLE OF THE MEETING I 4768 03:13:09,040 --> 03:13:09,800 WROTE DOWN BECAUSE IT WAS A 4769 03:13:09,800 --> 03:13:14,520 MOUTHFUL FOR ME. 4770 03:13:14,520 --> 03:13:18,600 THE SUMMIT ON CARE, SERVICES AND 4771 03:13:18,600 --> 03:13:19,640 SUPPORT FOR THOSE LIVING WITH 4772 03:13:19,640 --> 03:13:21,400 CAREGIVERS AND SUPPORT AND I 4773 03:13:21,400 --> 03:13:22,240 CAN'T BREATHE. 4774 03:13:22,240 --> 03:13:24,960 I CAN BARELY USE ONE BREATH TO 4775 03:13:24,960 --> 03:13:25,560 SAY THAT. 4776 03:13:25,560 --> 03:13:33,520 WHEN YOU USE LANGUAGE SO SUPER 4777 03:13:33,520 --> 03:13:36,760 SCIENTIFIC AND SPECIFIC AS 4778 03:13:36,760 --> 03:13:40,280 SCHOLARS TEND TO DO IT'S A TURN 4779 03:13:40,280 --> 03:13:41,200 OFF TO LAY PEOPLE. 4780 03:13:41,200 --> 03:13:43,240 WE NEED TO THINK OF SPEAKING IN 4781 03:13:43,240 --> 03:13:43,800 A LANGUAGE THAT PEOPLE CAN 4782 03:13:43,800 --> 03:13:47,280 UNDERSTAND. 4783 03:13:47,280 --> 03:13:49,040 THAT'S ONE THING I REALLY I 4784 03:13:49,040 --> 03:13:50,760 THINK A LOT ABOUT IN ANY SORT OF 4785 03:13:50,760 --> 03:13:53,320 THING WHEN YOU DEAL WITH BEING 4786 03:13:53,320 --> 03:13:54,720 IN SOME SORT OF HEALTH CARE 4787 03:13:54,720 --> 03:13:55,800 VERSUS OTHER SITUATION TRYING TO 4788 03:13:55,800 --> 03:14:00,200 MOVE AWAY FROM THE JARGON. 4789 03:14:00,200 --> 03:14:05,480 >>THANK YOU, CHRISTINE, THAT'S 4790 03:14:05,480 --> 03:14:07,040 GREAT. 4791 03:14:07,040 --> 03:14:07,280 MARTHA? 4792 03:14:07,280 --> 03:14:08,400 MS. WILLIAMS ANY THOUGHTS? 4793 03:14:08,400 --> 03:14:11,560 >>I AGREE WITH WHAT SHE HAD 4794 03:14:11,560 --> 03:14:11,760 SAID. 4795 03:14:11,760 --> 03:14:13,480 MEETING PEOPLE WHERE THEY'RE AT. 4796 03:14:13,480 --> 03:14:16,280 WHEN WE DEAL WITH PEOPLE OF 4797 03:14:16,280 --> 03:14:17,760 DIFFERENT CULTURES AND DIFFERENT 4798 03:14:17,760 --> 03:14:19,320 EVERYTHING WE HAVE TO MEET THEM 4799 03:14:19,320 --> 03:14:22,840 WHERE THEY'RE AT. 4800 03:14:22,840 --> 03:14:26,080 FOR MYSELF, I DON'T SEE MYSELF 4801 03:14:26,080 --> 03:14:28,440 AS A CAREGIVER BUT FIRST BORN 4802 03:14:28,440 --> 03:14:29,880 DAUGHTER AND THAT'S MY 4803 03:14:29,880 --> 03:14:30,240 RESPONSIBILITY. 4804 03:14:30,240 --> 03:14:31,800 IT'S MY BLESSING TO TAKE CARE OF 4805 03:14:31,800 --> 03:14:32,840 MY PARENTS BECAUSE THEY WERE MY 4806 03:14:32,840 --> 03:14:38,800 BLESSING. 4807 03:14:38,800 --> 03:14:40,200 NOW IT'S MY TURN TO BE THEIR 4808 03:14:40,200 --> 03:14:41,560 BLESSING AND WHEN I GO TO THEIR 4809 03:14:41,560 --> 03:14:44,040 APPOINTMENTS AND DEAL WITH SO 4810 03:14:44,040 --> 03:14:49,440 MANY OTHER PEOPLE, DOCTORS, 4811 03:14:49,440 --> 03:14:50,640 INTERVENTIONISTS AND DON'T MEET 4812 03:14:50,640 --> 03:14:53,040 ME WHERE I'M AT AND LUCKILY 4813 03:14:53,040 --> 03:14:55,600 ENOUGH I HAVE ENOUGH EDUCATION 4814 03:14:55,600 --> 03:14:59,720 AND SOME CANNOT INTERACT WITH 4815 03:14:59,720 --> 03:15:01,120 THOSE WITH A LARGER VOCABULARY 4816 03:15:01,120 --> 03:15:03,000 OR SPEAK TO MY PARENTS THE WAY 4817 03:15:03,000 --> 03:15:03,400 THEY UNDERSTAND. 4818 03:15:03,400 --> 03:15:06,840 I TOTALLY AGREE. 4819 03:15:06,840 --> 03:15:08,040 MEETING PEOPLE WHERE THEY'RE AT 4820 03:15:08,040 --> 03:15:13,080 AND NOT TRYING TO SPEAK ABOVE 4821 03:15:13,080 --> 03:15:14,200 THEM OR USE HUGE MASSIVE WORDS. 4822 03:15:14,200 --> 03:15:21,040 THANK YOU. 4823 03:15:21,040 --> 03:15:23,240 THANK YOU 4824 03:15:23,240 --> 03:15:25,520 >>THANK YOU. 4825 03:15:25,520 --> 03:15:25,760 ROBERT. 4826 03:15:25,760 --> 03:15:26,760 >>THE SAME THING. 4827 03:15:26,760 --> 03:15:28,000 MEETING WHY YOU'RE AT. 4828 03:15:28,000 --> 03:15:32,120 IT GOES TO GATHERING THE DATA. 4829 03:15:32,120 --> 03:15:36,200 WHEN YOU GATHER DATA YOU DON'T 4830 03:15:36,200 --> 03:15:39,640 ALWAYS THINK ABOUT THOSE 4831 03:15:39,640 --> 03:15:40,840 SEGMENTS OF THE COMMUNITY THAT 4832 03:15:40,840 --> 03:15:43,280 ARE NOT IN THE MAJORITY. 4833 03:15:43,280 --> 03:15:45,040 WHEN YOU GATHER IN DATA A LOT OF 4834 03:15:45,040 --> 03:15:47,000 TIMES YOU ARE JUST TRYING TO GET 4835 03:15:47,000 --> 03:15:48,000 AS MUCH AS AS YOU CAN SO YOU GO 4836 03:15:48,000 --> 03:15:51,920 TO THE MAJORITY. 4837 03:15:51,920 --> 03:15:54,520 LIKE DR. EPPS IS DOING, REACHING 4838 03:15:54,520 --> 03:16:00,360 OUT TO WHERE THE ACTUAL DATA IS. 4839 03:16:00,360 --> 03:16:02,920 GOING TO THE CHURCHES AND I WAS 4840 03:16:02,920 --> 03:16:05,280 GLAD TO HEAR THAT WAS A 90% 4841 03:16:05,280 --> 03:16:07,080 SUCCESS RATE IN COMPLETING HER 4842 03:16:07,080 --> 03:16:07,560 SURVEY. 4843 03:16:07,560 --> 03:16:10,720 THAT'S GATHERING THE TRUE DATA 4844 03:16:10,720 --> 03:16:12,440 BECAUSE AS SHE ALSO MENTIONED 4845 03:16:12,440 --> 03:16:14,680 THAT'S WHERE YOU NEED TO GO IN 4846 03:16:14,680 --> 03:16:16,040 THE AFRICAN AMERICAN COMMUNITY. 4847 03:16:16,040 --> 03:16:17,800 YOU NEED TO GO WHERE THE PEOPLE 4848 03:16:17,800 --> 03:16:23,200 ARE IN ORDER TO GET THAT DATA. 4849 03:16:23,200 --> 03:16:27,240 WHEN YOU'RE TALKING ABOUT DOING 4850 03:16:27,240 --> 03:16:31,160 STUDIES AS WELL THERE SAY 4851 03:16:31,160 --> 03:16:33,600 DIFFERENCE BETWEEN A 24/7 4852 03:16:33,600 --> 03:16:35,920 PARTNER AND PAID CAREGIVER. 4853 03:16:35,920 --> 03:16:38,360 YOU NEED TO ALSO LOOK AT 4854 03:16:38,360 --> 03:16:40,120 GATHERING THE DATA FIRST FINDING 4855 03:16:40,120 --> 03:16:42,920 THE CARE PARTNERS BECAUSE A LOT 4856 03:16:42,920 --> 03:16:53,040 OF CARE PARTNERS ARE NOT KNOWN. 4857 03:16:53,040 --> 03:16:55,920 SOME ARE PART TIME OR DO CERTAIN 4858 03:16:55,920 --> 03:16:56,200 SEGMENTS. 4859 03:16:56,200 --> 03:16:57,640 BECAUSE OF THAT IT'S A LITTLE 4860 03:16:57,640 --> 03:17:01,440 MORE DIFFICULT TO GET GOOD DATA 4861 03:17:01,440 --> 03:17:02,360 FROM CARE PARTNERS BECAUSE YOU 4862 03:17:02,360 --> 03:17:04,120 FIRST HAVE TO IDENTIFY THE TRUE 4863 03:17:04,120 --> 03:17:06,280 CARE PARTNERS AND ALSO IDENTIFY 4864 03:17:06,280 --> 03:17:09,080 THE PERSONAL CARE PARTNERS 4865 03:17:09,080 --> 03:17:09,600 VERSUS THE CLINICAL CARE 4866 03:17:09,600 --> 03:17:14,960 PARTNERS. 4867 03:17:14,960 --> 03:17:17,040 >>EXCELLENT POINTS, THANK YOU. 4868 03:17:17,040 --> 03:17:19,400 I THINK NOW CERISE MAYBE WE'LL 4869 03:17:19,400 --> 03:17:20,760 OPEN IT UP TO THE Q&A. 4870 03:17:20,760 --> 03:17:31,280 SEE ABOUT SIX QUESTIONS HERE. 4871 03:17:32,440 --> 03:17:34,040 >>I WANT TO THANK THE PANEL FOR 4872 03:17:34,040 --> 03:17:36,240 JOINING US THIS AFTERNOON. 4873 03:17:36,240 --> 03:17:40,880 THE FIRST QUESTION I HAD WAS 4874 03:17:40,880 --> 03:17:42,040 FROM THE Q&A. 4875 03:17:42,040 --> 03:17:43,960 WE WOULD LIKE DR. LEWIS TO SPEAK 4876 03:17:43,960 --> 03:17:51,280 MORE ON THE HETEROGENEITY WITHIN 4877 03:17:51,280 --> 03:17:53,480 THE AMERICAN INDIAN AND ALASKAN 4878 03:17:53,480 --> 03:17:57,800 NATIVE POPULATION. 4879 03:17:57,800 --> 03:17:59,480 >>THANK YOU FOR THE QUESTION. 4880 03:17:59,480 --> 03:18:00,840 I WANT TO START BY SAYING THE 4881 03:18:00,840 --> 03:18:02,800 INFORMATION AND DATA WE HAVE 4882 03:18:02,800 --> 03:18:05,440 FROM CAREGIVERS AND PEOPLE WITH 4883 03:18:05,440 --> 03:18:06,400 DEMENTIA IS ONLY REPRESENTATIVE 4884 03:18:06,400 --> 03:18:07,760 OF THOSE STUDIES. 4885 03:18:07,760 --> 03:18:13,680 I WOULD SAY GIVEN VARIABLES THAT 4886 03:18:13,680 --> 03:18:16,360 DEMENTIA'S STILL FAIRLY NEW IN 4887 03:18:16,360 --> 03:18:18,520 INDIGENOUS IN COMMUNITIES AND 4888 03:18:18,520 --> 03:18:20,920 EXPERIENCING MORE COMORBIDITIES 4889 03:18:20,920 --> 03:18:22,120 THAT MORE WORK IS MORE NEEDED IN 4890 03:18:22,120 --> 03:18:29,080 THE COMMUNITIES TO FIND OUT 4891 03:18:29,080 --> 03:18:30,800 DIFFERENT UNDERSTANDING IN THE 4892 03:18:30,800 --> 03:18:32,240 CAREGIVING EXPERIENCES AS WELL 4893 03:18:32,240 --> 03:18:33,960 AS THOSE WITH DEMENTIA. 4894 03:18:33,960 --> 03:18:38,480 I WOULD ALSO HAD TO THAT DESPITE 4895 03:18:38,480 --> 03:18:43,080 THE FACT THAT AMERICAN INDIANS 4896 03:18:43,080 --> 03:18:45,880 AND OUT OF THE FEDERALLY 4897 03:18:45,880 --> 03:18:47,960 RECOGNIZED COMMUNITIES HALF ARE 4898 03:18:47,960 --> 03:18:50,480 IN ALASKA THEY HAVE DISTINCT 4899 03:18:50,480 --> 03:18:52,240 HISTORIES, CONNECTION TO THE 4900 03:18:52,240 --> 03:18:54,320 ENVIRONMENT, FAMILY SYSTEMS, 4901 03:18:54,320 --> 03:18:59,160 THERE'S UNIVERSAL CULTURAL 4902 03:18:59,160 --> 03:19:00,040 VALUES THAT OVERLAY COMMUNITY 4903 03:19:00,040 --> 03:19:01,560 SUPPORT AND ENGAGEMENT AND 4904 03:19:01,560 --> 03:19:04,600 CARING FOR YOUR ELDERS AND I 4905 03:19:04,600 --> 03:19:06,560 THINK WE'RE SEEING IN THE DATA 4906 03:19:06,560 --> 03:19:08,360 WE CAN SEE ACROSS A FEW STUDIES 4907 03:19:08,360 --> 03:19:10,320 DONE SUCH AS THE WORK HERE AT 4908 03:19:10,320 --> 03:19:17,440 MEMORY KEEPERS AND ALSO DR. NEIL 4909 03:19:17,440 --> 03:19:18,640 HENDERSON'S WORK AND WE'RE 4910 03:19:18,640 --> 03:19:20,400 SEEING SIMILARITIES AND 4911 03:19:20,400 --> 03:19:21,760 EXPERIENCES BUT I WANT TO BE 4912 03:19:21,760 --> 03:19:23,200 CAREFUL I'M NOT SAYING IT 4913 03:19:23,200 --> 03:19:26,120 APPLIES TO EVERYONE. 4914 03:19:26,120 --> 03:19:28,120 SO THERE IS A LOT OF 4915 03:19:28,120 --> 03:19:29,680 HETEROGENEITY WITH OVERLAYING 4916 03:19:29,680 --> 03:19:31,160 CULTURAL VALUES IMPACTING THE 4917 03:19:31,160 --> 03:19:34,200 EXPERIENCES WE'RE LEARNING. 4918 03:19:34,200 --> 03:19:36,760 >>THANK YOU, DR. LEWIS. 4919 03:19:36,760 --> 03:19:42,240 THE NEXT QUESTION I HAD FROM THE 4920 03:19:42,240 --> 03:19:46,200 Q&A IS FOR DR. PARK. 4921 03:19:46,200 --> 03:19:48,800 IN CENTERING YOUR STUDIES AROUND 4922 03:19:48,800 --> 03:19:50,600 VIETNAMESE AMERICANS AND KOREAN 4923 03:19:50,600 --> 03:19:54,040 AMERICANS, HOW WOULD YOU 4924 03:19:54,040 --> 03:19:55,080 ESTIMATE THAT DEMENTIA 4925 03:19:55,080 --> 03:19:55,920 CAREGIVING EXPERIENCES WOULD 4926 03:19:55,920 --> 03:19:57,240 DIFFER BETWEEN THOSE WHO LIVE IN 4927 03:19:57,240 --> 03:19:59,240 THE U.S. AND THOSE WHO ARE 4928 03:19:59,240 --> 03:20:05,160 CURRENTLY IN KOREA OR VIETNAM OR 4929 03:20:05,160 --> 03:20:15,120 BACK IN THEIR ORIGIN? 4930 03:20:15,120 --> 03:20:18,720 >>THERE'S SIMILARITIES AND 4931 03:20:18,720 --> 03:20:19,280 DIFFERENCES. 4932 03:20:19,280 --> 03:20:21,240 FOR EXAMPLE WITH KOREAN 4933 03:20:21,240 --> 03:20:28,720 AMERICANS OR COKOREANS OR KOREA 4934 03:20:28,720 --> 03:20:37,080 LIVING IN AMERICA THE SIMILARITY 4935 03:20:37,080 --> 03:20:37,560 SUCH 4936 03:20:37,560 --> 03:20:42,120 SUCH THE MAJORITY OF CAREGIVERS 4937 03:20:42,120 --> 03:20:46,080 ARE FEMALE OR WIFE OR EVEN 4938 03:20:46,080 --> 03:20:46,440 DAUGHTER-IN-LAW. 4939 03:20:46,440 --> 03:20:49,640 THAT'S VERY COMMON WHETHER YOU 4940 03:20:49,640 --> 03:20:55,360 LIVE IN THE U.S. OR KOREA. 4941 03:20:55,360 --> 03:20:56,720 ONE THING IS BECAUSE OF THE 4942 03:20:56,720 --> 03:21:00,680 LIMITED RESOURCES IN THE KOREAN 4943 03:21:00,680 --> 03:21:02,520 LANGUAGE HERE AS WELL AS THE 4944 03:21:02,520 --> 03:21:06,320 LACK OF KOREAN DEMENTIA 4945 03:21:06,320 --> 03:21:09,200 CAREGIVING PROGRAMS, MANY KO 4946 03:21:09,200 --> 03:21:10,720 KOREKOR 4947 03:21:10,720 --> 03:21:13,000 KOREANS ACTUALLY DO RESEARCH AND 4948 03:21:13,000 --> 03:21:15,560 LOOK UP RESOURCES IN KOREA. 4949 03:21:15,560 --> 03:21:21,160 AND IN KOREA THERE IS THE 4950 03:21:21,160 --> 03:21:22,520 GOVERNMENT SUBSIDIZED PROGRAM 4951 03:21:22,520 --> 03:21:25,200 FOR FAMILY MEMBERS TO CARE FOR 4952 03:21:25,200 --> 03:21:26,680 THEIR LOVED ONES. 4953 03:21:26,680 --> 03:21:31,000 AND IT'S MORE COMPREHENSIVE AND 4954 03:21:31,000 --> 03:21:33,200 THERE'S MORE INFORMATION, I 4955 03:21:33,200 --> 03:21:39,280 WOULD SAY VERSUS WHERE THE 4956 03:21:39,280 --> 03:21:41,200 PROGRAMS AND AVAILABLE FINANCIAL 4957 03:21:41,200 --> 03:21:43,000 RESOURCES EVEN FOR THE FAMILY 4958 03:21:43,000 --> 03:21:46,240 MEMBERS TO CARE FOR THE LOVED 4959 03:21:46,240 --> 03:21:51,400 ONES IS NOT CONSISTENT ACROSS 4960 03:21:51,400 --> 03:21:59,560 STATES AND LIMITED. 4961 03:21:59,560 --> 03:22:00,680 IN VIETNAM THERE'S MORE HELP 4962 03:22:00,680 --> 03:22:11,080 FROM EXTENDED FAMILY. 4963 03:22:12,720 --> 03:22:16,200 AND IN THE U.S. THERE'S LIMITED 4964 03:22:16,200 --> 03:22:17,760 DEMENTIA CAREGIVING RESOURCES 4965 03:22:17,760 --> 03:22:22,760 BECAUSE IT'S SO NEW OF A 4966 03:22:22,760 --> 03:22:23,040 CONCEPT. 4967 03:22:23,040 --> 03:22:24,440 THERE'S A LOT OF NORMALIZATION 4968 03:22:24,440 --> 03:22:35,000 OF MEMORY LOSS, FOR EXAMPLE AND 4969 03:22:35,320 --> 03:22:42,240 ALSO YOU CARE FOR YOUR LOVED 4970 03:22:42,240 --> 03:22:44,800 ONES BECAUSE IT'S NOT -- THE 4971 03:22:44,800 --> 03:22:52,120 TRADITIONAL CULTURAL NORM. 4972 03:22:52,120 --> 03:22:55,040 ONE THING I DIDN'T MENTION IN MY 4973 03:22:55,040 --> 03:22:57,040 PRESENTATION IS WE HAD AN 4974 03:22:57,040 --> 03:23:01,000 ABUNDANCE OF INTEREST IN OUR 4975 03:23:01,000 --> 03:23:01,520 STUDY. 4976 03:23:01,520 --> 03:23:03,880 SOME OF WHOM WHEN WE CONTACTED 4977 03:23:03,880 --> 03:23:06,640 IN THE INTEREST LIST HAD TO 4978 03:23:06,640 --> 03:23:07,840 UNFORTUNATELY DECLINE BECAUSE 4979 03:23:07,840 --> 03:23:09,240 ONCE THEY SHARED THE STUDY WITH 4980 03:23:09,240 --> 03:23:12,640 THEIR FAMILY MEMBERS THEY WERE 4981 03:23:12,640 --> 03:23:15,000 TOLD YOU CAN'T DO THAT BECAUSE 4982 03:23:15,000 --> 03:23:17,000 IT WILL MAKE IT SOUND LIKE IT'S 4983 03:23:17,000 --> 03:23:20,520 A BURDEN OR STRESSFUL AND YOU 4984 03:23:20,520 --> 03:23:22,920 CAN'T DO THAT BECAUSE WE HAVE TO 4985 03:23:22,920 --> 03:23:24,520 TAKE CARE OF OUR LOVED ONES. 4986 03:23:24,520 --> 03:23:25,480 THAT'S WHAT WE'RE SUPPOSED TO 4987 03:23:25,480 --> 03:23:26,320 DO. 4988 03:23:26,320 --> 03:23:27,280 YOU DON'T WANT TO LOSE FACE IN 4989 03:23:27,280 --> 03:23:31,440 THAT. 4990 03:23:31,440 --> 03:23:32,800 >>THANKS. 4991 03:23:32,800 --> 03:23:36,560 I'VE SEEN CHRISTINE HAD A 4992 03:23:36,560 --> 03:23:41,440 FOLLOW-UP FROM YOUR COMMENT. 4993 03:23:41,440 --> 03:23:44,080 >>SOMEONE WAS ASKING ABOUT THE 4994 03:23:44,080 --> 03:23:50,440 DIFFERENCES IN THE EX-PATRIOT 4995 03:23:50,440 --> 03:23:55,280 COMMUNITY AND FOR ME A FEW YEARS 4996 03:23:55,280 --> 03:23:57,760 AGO I LEARNED AMONG AMERICAN 4997 03:23:57,760 --> 03:23:59,280 MILITARY VETS PTSD WAS A BIG 4998 03:23:59,280 --> 03:24:01,280 FACTOR FOR DEMENTIA. 4999 03:24:01,280 --> 03:24:03,960 AT THE TIME I READ THIS I DIDN'T 5000 03:24:03,960 --> 03:24:06,800 REALLY HEAR ANYTHING ABOUT PTSD 5001 03:24:06,800 --> 03:24:08,360 AMONG THOSE WHO SURVIVED THE WAR 5002 03:24:08,360 --> 03:24:11,480 AND THE OPPRESSION AND THE 5003 03:24:11,480 --> 03:24:12,400 DISPLACEMENT THAT HAPPENED 5004 03:24:12,400 --> 03:24:12,920 AFTERWARDS. 5005 03:24:12,920 --> 03:24:17,840 I THOUGHT ABOUT MY PARENTS. 5006 03:24:17,840 --> 03:24:20,000 BOTH WERE CHILDREN OF 5007 03:24:20,000 --> 03:24:20,920 COLONIALISM AND THE FIGHT 5008 03:24:20,920 --> 03:24:22,640 AGAINST IT AND MY MOM WAS 5009 03:24:22,640 --> 03:24:26,080 DISPLACED AS A GIRL WHEN 5010 03:24:26,080 --> 03:24:27,240 VIETNAMESE CAME DOWN AND MY DAD 5011 03:24:27,240 --> 03:24:29,840 WAS AN ORPHAN AND MEMBERS OF HIS 5012 03:24:29,840 --> 03:24:32,320 FAMILY DISAPPEARED AND 5013 03:24:32,320 --> 03:24:34,360 EVENTUALLY HE BECAME A SOLDIER. 5014 03:24:34,360 --> 03:24:35,560 THE WAR AFFECTED EVERY PART OF 5015 03:24:35,560 --> 03:24:38,200 THEIR LIFE FOR THE MAJORITY OF 5016 03:24:38,200 --> 03:24:40,000 THEIR ADULT LIFE. 5017 03:24:40,000 --> 03:24:45,720 AFTER THE WAR ME AND MY WHOLE 5018 03:24:45,720 --> 03:24:51,720 FAMILY WERE INPRISONED IN A 5019 03:24:51,720 --> 03:24:53,160 REEDUCATION CAMP AND MY DAD WAS 5020 03:24:53,160 --> 03:24:55,600 THERE THE LONGEST AND WE WERE 5021 03:24:55,600 --> 03:24:57,400 BOAT PEOPLE AND ALMOST DIED AT 5022 03:24:57,400 --> 03:24:57,760 SEA. 5023 03:24:57,760 --> 03:24:59,480 ALL THEIR LIVES MY PARENTS 5024 03:24:59,480 --> 03:25:00,320 RETURNED TO THESE EVENTS AGAIN 5025 03:25:00,320 --> 03:25:05,480 AND AGAIN AND AGAIN. 5026 03:25:05,480 --> 03:25:08,760 THAT'S PTSD. 5027 03:25:08,760 --> 03:25:09,880 WHEN I THOUGHT ABOUT IT THOUGHT 5028 03:25:09,880 --> 03:25:12,040 THEY BOTH HAVE DEMENTIA AND 5029 03:25:12,040 --> 03:25:14,080 THEY'RE SO SHARP IN OTHER WAYS. 5030 03:25:14,080 --> 03:25:18,720 I DID WONDER DID PTSD AFFECT 5031 03:25:18,720 --> 03:25:21,240 THEIR ONSET OF DEMENTIA LIKE 5032 03:25:21,240 --> 03:25:23,560 DOCUMENTED AMONG WAR VETERANS OR 5033 03:25:23,560 --> 03:25:24,960 SOMETHING LIKE THAT. 5034 03:25:24,960 --> 03:25:26,160 AND FOR OTHER REASONS MY PARENTS 5035 03:25:26,160 --> 03:25:29,640 WERE SOCIALLY ISOLATED IN THE 5036 03:25:29,640 --> 03:25:31,160 UNITED STATES. 5037 03:25:31,160 --> 03:25:34,160 WE KNOW FROM RESEARCH SOCIAL 5038 03:25:34,160 --> 03:25:38,080 ISOLATION IS A RISK FACTOR OF 5039 03:25:38,080 --> 03:25:38,280 PTSD. 5040 03:25:38,280 --> 03:25:41,200 THERE ARE CERTAINLY SOME 5041 03:25:41,200 --> 03:25:44,360 DIFFERENCES IN EXPERIENCES THAT 5042 03:25:44,360 --> 03:25:45,520 MAYBE VIETNAMESE THAT CAME TO 5043 03:25:45,520 --> 03:25:48,440 THE UNITED STATES AS REFUGEES 5044 03:25:48,440 --> 03:25:50,200 VERSUS THOSE WHO MAY BE LIVING 5045 03:25:50,200 --> 03:25:52,120 THERE NOW AND THERE'S A 5046 03:25:52,120 --> 03:25:53,640 DIFFERENT CONTEXT FOR HOW THE 5047 03:25:53,640 --> 03:25:54,640 WAR IS PORTRAYED. 5048 03:25:54,640 --> 03:25:58,200 >>I THINK THAT BRINGS US TO OUR 5049 03:25:58,200 --> 03:26:03,400 GAP AND OPPORTUNITIES IN WHICH 5050 03:26:03,400 --> 03:26:07,800 WE REALLY WANTED TO GO INTO A 5051 03:26:07,800 --> 03:26:08,480 DIVERSE POPULATION YOU WANT 5052 03:26:08,480 --> 03:26:11,320 DIVERSE PERSPECTIVES YOU'LL HAVE 5053 03:26:11,320 --> 03:26:12,680 TO LEARN ABOUT A PERSON AND 5054 03:26:12,680 --> 03:26:14,000 INDIVIDUAL'S LIVED EXPERIENCE 5055 03:26:14,000 --> 03:26:18,600 FOR THEIR WHOLE KIND OF LIFE OF 5056 03:26:18,600 --> 03:26:19,920 HOW THEY INTERACT WITH THEIR 5057 03:26:19,920 --> 03:26:23,720 FAMILY AND SOCIETY AND HOW THEY 5058 03:26:23,720 --> 03:26:26,280 INTERACT WITH BEING WITH AMERICA 5059 03:26:26,280 --> 03:26:29,760 I FEEL THAT ALSO WOULD LEND A 5060 03:26:29,760 --> 03:26:31,360 LOT OF INFORMATION INTO THE 5061 03:26:31,360 --> 03:26:33,640 STUDY DESIGNS THAT WE MAKE AS WE 5062 03:26:33,640 --> 03:26:34,080 RECRUIT MORE DIVERSE 5063 03:26:34,080 --> 03:26:43,760 INDIVIDUALS. 5064 03:26:43,760 --> 03:26:46,400 AND THERE'S A QUESTION FOR 5065 03:26:46,400 --> 03:26:48,480 FAYRON AND I THINK IT GOES TO 5066 03:26:48,480 --> 03:26:52,000 UNDERSTANDING PEOPLE'S LIVED 5067 03:26:52,000 --> 03:26:53,600 EXPERIENCES AND ALSO RECOGNIZING 5068 03:26:53,600 --> 03:26:57,320 THE PLACE WHICH IS DOING THE 5069 03:26:57,320 --> 03:27:01,520 RESEARCH AND HOW THAT PLACE AND 5070 03:27:01,520 --> 03:27:03,880 THAT COMMUNITY RELATES IN THAT 5071 03:27:03,880 --> 03:27:08,320 THERE IS A COMMENT IN THE Q&A 5072 03:27:08,320 --> 03:27:10,600 ABOUT SOMETIMES THE INSTITUTION 5073 03:27:10,600 --> 03:27:12,800 AS YOU GO INTO A NEEDS TO 5074 03:27:12,800 --> 03:27:14,520 ACKNOWLEDGE THE PAST 5075 03:27:14,520 --> 03:27:16,520 RELATIONSHIPS BETWEEN DIFFERENT 5076 03:27:16,520 --> 03:27:16,960 COMMUNITIES. 5077 03:27:16,960 --> 03:27:21,240 COULD YOU KIND OF BRIEFLY TALK 5078 03:27:21,240 --> 03:27:22,880 ABOUT THAT AND YOUR TOP WAY TO 5079 03:27:22,880 --> 03:27:33,160 ALLEVIATE THAT? 5080 03:27:40,360 --> 03:27:43,680 >>THAT'S A GREAT POINT FOR ME 5081 03:27:43,680 --> 03:27:46,400 BEING EMPLOYED IN PREDOMINANTLY 5082 03:27:46,400 --> 03:27:48,760 WHITE INSTITUTION AND WORKING IN 5083 03:27:48,760 --> 03:27:51,920 A BLACK COMMUNITY I HAVE TO 5084 03:27:51,920 --> 03:27:54,920 RECOGNIZE THE ROLE THE PWI HAS 5085 03:27:54,920 --> 03:27:55,800 PLAYED AND THE NEGLECT OF 5086 03:27:55,800 --> 03:27:56,360 CERTAIN COMMUNITIES. 5087 03:27:56,360 --> 03:28:06,720 I ACKNOWLEDGE THAT. 5088 03:28:09,040 --> 03:28:12,360 I ALLOW THEM TO SPEAK ABOUT THAT 5089 03:28:12,360 --> 03:28:14,720 AND ENSURE THAT DOESN'T CONTINUE 5090 03:28:14,720 --> 03:28:25,280 AND TO HELP BRIDGE THAT GAP YOU 5091 03:28:28,320 --> 03:28:30,440 HAVE TO ACKNOWLEDGE IT AND WHEN 5092 03:28:30,440 --> 03:28:35,480 I TRAINING OTHERS IT'S ABOUT 5093 03:28:35,480 --> 03:28:37,000 KNOWING THE HISTORY OF THE 5094 03:28:37,000 --> 03:28:37,840 COMMUNITY AND ABOUT THE PAST 5095 03:28:37,840 --> 03:28:42,560 RELATIONSHIPS BEFORE YOU GO IN. 5096 03:28:42,560 --> 03:28:46,440 BECAUSE IF WE DON'T DO THAT 5097 03:28:46,440 --> 03:28:49,080 WE'LL BE FACED WITH -- WE'LL BE 5098 03:28:49,080 --> 03:28:50,680 FACED WITH NOT UNDERSTANDING WHY 5099 03:28:50,680 --> 03:28:51,800 CERTAIN THINGS ARE OCCURRING OR 5100 03:28:51,800 --> 03:28:53,520 WHY THEY DON'T WANT US TO COME 5101 03:28:53,520 --> 03:28:55,280 OR SPEAK OR SIGN UP FOR 5102 03:28:55,280 --> 03:28:55,520 ANYTHING. 5103 03:28:55,520 --> 03:28:59,560 >>I THINK ONE OF THE FINAL 5104 03:28:59,560 --> 03:29:02,800 QUESTIONS IS THAT THERE'S A 5105 03:29:02,800 --> 03:29:06,920 QUESTION HERE IN Q&A FROM SARAH 5106 03:29:06,920 --> 03:29:07,200 PATTERSON. 5107 03:29:07,200 --> 03:29:08,240 I'M GOING TO DIRECT THIS 5108 03:29:08,240 --> 03:29:09,680 QUESTION TO THE PANEL MEMBERS 5109 03:29:09,680 --> 03:29:15,240 BEING INCLUDED IN THE RESEARCH. 5110 03:29:15,240 --> 03:29:16,280 DO YOU HAVE COMMENTS OR THOUGHTS 5111 03:29:16,280 --> 03:29:19,440 ABOUT CONDUCTING RESEARCH IN 5112 03:29:19,440 --> 03:29:24,800 PERSON VERSUS ONLINE? 5113 03:29:24,800 --> 03:29:26,040 AND IS THERE A PRO OR CON TO 5114 03:29:26,040 --> 03:29:36,200 EACH TYPE? 5115 03:29:39,880 --> 03:29:42,880 >>I DO BOTH DATA COLLECTION 5116 03:29:42,880 --> 03:29:44,480 ONLINE AND BOTH WAYS HAVE BEEN 5117 03:29:44,480 --> 03:29:48,560 SUCCESSFUL BUT THE REASON I HAVE 5118 03:29:48,560 --> 03:29:51,240 TO SAY WHY THEY MAY HAVE BEEN 5119 03:29:51,240 --> 03:29:56,480 SUCCESSFUL IS BECAUSE OF THE 5120 03:29:56,480 --> 03:29:58,200 RECRUITMENT THAT OCCURRED AND I 5121 03:29:58,200 --> 03:29:59,920 SPEAK ONLINE AND DO FACE TO 5122 03:29:59,920 --> 03:30:00,120 FACE. 5123 03:30:00,120 --> 03:30:02,480 IT'S DEVELOPING THE 5124 03:30:02,480 --> 03:30:03,160 RELATIONSHIPS WITH THE 5125 03:30:03,160 --> 03:30:05,200 INDIVIDUALS THAT I'M RECRUITING. 5126 03:30:05,200 --> 03:30:10,320 BEING PERSONABLE I THINK THAT'S 5127 03:30:10,320 --> 03:30:14,400 CONTRIBUTED TO MY SUCCESS WITH 5128 03:30:14,400 --> 03:30:16,360 THE RECRUITMENT WHICH WHETHER WE 5129 03:30:16,360 --> 03:30:18,640 DO THE RESEARCH ONLINE OR IN 5130 03:30:18,640 --> 03:30:19,160 PERSON IT WILL STILL BE 5131 03:30:19,160 --> 03:30:21,960 SUCCESSFUL. 5132 03:30:21,960 --> 03:30:27,280 >>DO THE PANELISTS HAVE -- HAVE 5133 03:30:27,280 --> 03:30:29,600 YOU BEEN PARTICIPATING IN PERSON 5134 03:30:29,600 --> 03:30:30,920 AND DURING THE PANDEMIC DID YOU 5135 03:30:30,920 --> 03:30:38,080 DO ANY KIND OF ONLINE SERVICES? 5136 03:30:38,080 --> 03:30:40,400 DID YOU HEARD IN THE ONLINE KIND 5137 03:30:40,400 --> 03:30:41,640 OF WAY? 5138 03:30:41,640 --> 03:30:47,960 >>IF I CAN SPEAK ON THAT. 5139 03:30:47,960 --> 03:30:51,720 THE PANDEMIC HELPED IN SOME WAYS 5140 03:30:51,720 --> 03:30:54,440 VIA ZOOM OF COURSE IN ALL AREAS. 5141 03:30:54,440 --> 03:30:57,760 BUT AT THE SAME TIME I HAVE TO 5142 03:30:57,760 --> 03:30:59,480 AGREE THAT DOING ANYTHING IN 5143 03:30:59,480 --> 03:31:01,080 PERSON GOES A LONG WAY. 5144 03:31:01,080 --> 03:31:03,280 SO IF I'M SPEAKING PERSONALLY, I 5145 03:31:03,280 --> 03:31:08,160 WOULD RATHER HAVE THAT 5146 03:31:08,160 --> 03:31:12,200 CONNECTION PERSONALLY THREE 5147 03:31:12,200 --> 03:31:12,400 ZOOM. 5148 03:31:12,400 --> 03:31:14,160 ZOOM IS GOOD BUT AT THE SAME 5149 03:31:14,160 --> 03:31:16,160 TIME YOU CAN STILL GET LOST ON 5150 03:31:16,160 --> 03:31:18,320 THE ZOOM MEETING IF WE PUT ALL 5151 03:31:18,320 --> 03:31:22,240 200 PARTICIPANTS UP, SOMEBODY'S 5152 03:31:22,240 --> 03:31:24,400 LOST OFF YOUR SCREEN. 5153 03:31:24,400 --> 03:31:27,360 SO YOU'RE TAKING AWAY THE 5154 03:31:27,360 --> 03:31:29,160 PERSONAL ASPECT. 5155 03:31:29,160 --> 03:31:30,000 PERSONALLY I PREFER THE PERSONAL 5156 03:31:30,000 --> 03:31:38,560 ASPECT OF IT. 5157 03:31:38,560 --> 03:31:40,320 >>WE HAVE ONE COMMENT FROM 5158 03:31:40,320 --> 03:31:44,560 MICHELLE MICHAELS. 5159 03:31:44,560 --> 03:31:49,000 SHE WAS SHARING SHE WORKS IN A 5160 03:31:49,000 --> 03:31:51,040 STATE THE STATE OF ARIZONA 5161 03:31:51,040 --> 03:31:54,120 COMMISSION FOR THE DEAF AND HARD 5162 03:31:54,120 --> 03:31:55,600 OF HEARING. 5163 03:31:55,600 --> 03:31:58,640 THERE'S OLDER COMMUNITY 5164 03:31:58,640 --> 03:32:04,320 CULTURALLY DEAF AND NEED ACL TO 5165 03:32:04,320 --> 03:32:05,200 COMMUNICATE AND THERE ARE 5166 03:32:05,200 --> 03:32:07,320 LIMITED RESOURCES IN WHICH TO 5167 03:32:07,320 --> 03:32:09,880 COMMUNICATE WITH THAT COMMUNITY. 5168 03:32:09,880 --> 03:32:11,480 I THINK THAT MICHELLE IS 5169 03:32:11,480 --> 03:32:18,360 BRINGING OUT AN ISSUE IN WHICH 5170 03:32:18,360 --> 03:32:20,440 THERE'S AN OPPORTUNITY TO 5171 03:32:20,440 --> 03:32:22,760 INCLUDE AND BUILD RESOURCES TO 5172 03:32:22,760 --> 03:32:26,040 RECRUIT AND RETAIN INDIVIDUALS 5173 03:32:26,040 --> 03:32:27,320 SUCH AS THE INDIVIDUALS YOU ARE 5174 03:32:27,320 --> 03:32:32,360 DESCRIBING IN YOUR COMMENTS. 5175 03:32:32,360 --> 03:32:41,960 THANK YOU FOR YOUR COMMENT. 5176 03:32:41,960 --> 03:32:44,280 CRYSTAL, DID YOU WANT TO USE OUR 5177 03:32:44,280 --> 03:32:45,440 LAST FIVE MINUTES? 5178 03:32:45,440 --> 03:32:47,400 >>THERE'S AN INTERESTING ONE IN 5179 03:32:47,400 --> 03:32:49,120 THE CHAT I WOULDN'T MIND 5180 03:32:49,120 --> 03:32:50,080 HIGHLIGHTING TO ANY OF THE 5181 03:32:50,080 --> 03:32:51,840 PANELISTS THAT WOULD LIKE TO HOP 5182 03:32:51,840 --> 03:32:54,400 ON, I THINK THAT'D BE GREAT. 5183 03:32:54,400 --> 03:32:57,760 IT'S FROM LESLIE BAUN. 5184 03:32:57,760 --> 03:33:00,160 HOW DO YOU BALANCE PRIVACY AND 5185 03:33:00,160 --> 03:33:02,000 ENGAGEMENT IN 5186 03:33:02,000 --> 03:33:02,600 PARTICIPATORY-BASED COMMUNITY 5187 03:33:02,600 --> 03:33:08,320 RESEARCH IN THE CHURCH. 5188 03:33:08,320 --> 03:33:13,880 I SEE FAYRON'S FACE. 5189 03:33:13,880 --> 03:33:19,040 >>SO I THINK IT IS I LEAVE IT 5190 03:33:19,040 --> 03:33:23,320 TO MY RESEARCH PARTICIPANTS IF 5191 03:33:23,320 --> 03:33:24,800 THEY WANT TO SHARE. 5192 03:33:24,800 --> 03:33:25,880 THEY'RE PARTICIPATING IN THE 5193 03:33:25,880 --> 03:33:28,000 RESEARCH AND THEY'RE PART OF 5194 03:33:28,000 --> 03:33:33,720 THIS IT WOULD NOT COME FROM ME. 5195 03:33:33,720 --> 03:33:37,200 I HAVE DIFFERENT STUDIES AND ONE 5196 03:33:37,200 --> 03:33:39,600 STUDY I FOLLOWED FAMILIES TO 5197 03:33:39,600 --> 03:33:42,400 CHURCHES BUT I DIDN'T LET ANYONE 5198 03:33:42,400 --> 03:33:43,120 KNOW. 5199 03:33:43,120 --> 03:33:45,440 BISHOP JUST GAVE ME PERMISSION 5200 03:33:45,440 --> 03:33:46,560 TO BE THERE BUT HE DIDN'T EVEN 5201 03:33:46,560 --> 03:33:50,760 KNOW WHO THE FAMILIES WERE. 5202 03:33:50,760 --> 03:33:51,480 ULTIMATELY IT'S UP TO THE FAMILY 5203 03:33:51,480 --> 03:33:53,320 TO MAKE IT KNOWN IF THEY CHOOSE 5204 03:33:53,320 --> 03:33:55,920 TO AND THAT'S HOW IT'S BEEN EVEN 5205 03:33:55,920 --> 03:33:58,400 WHEN WE GO OUT AND DOING THE 5206 03:33:58,400 --> 03:33:59,840 EVENTS WE HAVE SOME FAMILIES 5207 03:33:59,840 --> 03:34:02,400 THAT WOULD NOT SAY ANYTHING AND 5208 03:34:02,400 --> 03:34:04,720 WE HAVE SOME FAMILIES THAT WOULD 5209 03:34:04,720 --> 03:34:06,600 GET UP AND SAY SOMETHING. 5210 03:34:06,600 --> 03:34:10,120 I HAD ONE PERSON WHO GOT UP AND 5211 03:34:10,120 --> 03:34:11,760 SPOKE AND SAID I AM THE PERSON 5212 03:34:11,760 --> 03:34:12,640 I'M SPEAKING ABOUT AND DO WANT 5213 03:34:12,640 --> 03:34:23,000 TO BE PART OF THIS. 5214 03:34:30,760 --> 03:34:32,480 USUALLY THE PARTICIPANTS SHARE 5215 03:34:32,480 --> 03:34:33,000 THEIR EXPERIENCE. 5216 03:34:33,000 --> 03:34:34,360 >>THANK YOU, FAYRON. 5217 03:34:34,360 --> 03:34:36,720 WE'LL WRAP UP WITH A FINAL 5218 03:34:36,720 --> 03:34:38,600 QUESTION FOR THE FINALISTS. 5219 03:34:38,600 --> 03:34:46,080 HOW CAN RESEARCHERS BE MORE 5220 03:34:46,080 --> 03:34:47,960 CONSIDERATE AND MINDFUL IN 5221 03:34:47,960 --> 03:34:53,520 RECRUITING THEM FOR RESEARCH 5222 03:34:53,520 --> 03:35:02,200 STUDIES? 5223 03:35:02,200 --> 03:35:04,520 >>I'VE BEEN BLESSED WITH THE 5224 03:35:04,520 --> 03:35:05,720 TEAM APPROACHING WITH KINDNESS, 5225 03:35:05,720 --> 03:35:11,440 CARE AND UNDERSTANDING. 5226 03:35:11,440 --> 03:35:13,000 IT GOES BACK TO MEETING THE 5227 03:35:13,000 --> 03:35:15,560 PERSON WHERE I'M AT. 5228 03:35:15,560 --> 03:35:17,000 I'M SURE I'M DEER IN HEADLIGHT 5229 03:35:17,000 --> 03:35:19,240 BECAUSE I DIDN'T KNOW ANYTHING. 5230 03:35:19,240 --> 03:35:21,280 I SHOULDN'T SAY I DIDN'T KNOW 5231 03:35:21,280 --> 03:35:21,520 NOTHING. 5232 03:35:21,520 --> 03:35:25,440 I DIDN'T KNOW WHAT TO ASK. 5233 03:35:25,440 --> 03:35:28,480 THERE'S SO MANY UNKNOWNS AND 5234 03:35:28,480 --> 03:35:39,040 THEY DIDN'T INUNDATE ME WITH THE 5235 03:35:39,360 --> 03:35:41,960 PERSON YOU'RE WORKING WITH AND 5236 03:35:41,960 --> 03:35:43,040 TAKING TIME TO DO THAT BEFORE 5237 03:35:43,040 --> 03:35:44,000 YOU MOVE FORWARD IS IMPORTANT IN 5238 03:35:44,000 --> 03:35:52,640 MY OPINION. 5239 03:35:52,640 --> 03:35:54,160 >>THERE'S SO MANY KEY PARTS 5240 03:35:54,160 --> 03:35:56,560 THROUGHOUT THE SESSION THAT 5241 03:35:56,560 --> 03:35:59,080 RECRUITMENT AND THE SUBSEQUENT 5242 03:35:59,080 --> 03:36:01,960 RETENTION DOESN'T START WHEN WE 5243 03:36:01,960 --> 03:36:04,320 SIMPLY START OUR STUDY. 5244 03:36:04,320 --> 03:36:09,520 IT BEGINS YEARS IN ADVANCE AND 5245 03:36:09,520 --> 03:36:11,880 DEVELOPING MEANINGFUL 5246 03:36:11,880 --> 03:36:14,160 BI-DIRECTIONAL RELATIONSHIPS 5247 03:36:14,160 --> 03:36:15,360 WITH COMMUNITIES AND MOVING 5248 03:36:15,360 --> 03:36:18,440 FORWARD WITH RESEARCH IN A 5249 03:36:18,440 --> 03:36:23,600 CULTURALLY COMPETENT WAY. 5250 03:36:23,600 --> 03:36:28,240 DEACON REID, DR. NGUYEN, 5251 03:36:28,240 --> 03:36:30,000 ANYTHING ELSE BEFORE WE MOVE ON 5252 03:36:30,000 --> 03:36:31,080 WITH THE QUESTION? 5253 03:36:31,080 --> 03:36:36,080 >>MAKE IT EASY ON THE 5254 03:36:36,080 --> 03:36:36,400 PARTICIPANTS. 5255 03:36:36,400 --> 03:36:37,720 MANY CAREGIVERS ARE UNDER STRESS 5256 03:36:37,720 --> 03:36:39,920 SO ANYTHING YOU CAN DO TO MAKE 5257 03:36:39,920 --> 03:36:45,480 PARTICIPATING EASIER IS GOOD. 5258 03:36:45,480 --> 03:36:47,960 >>THANK YOU, CHRISTINE. 5259 03:36:47,960 --> 03:36:51,320 DEACON REID YOU WANT TO CLOSE US 5260 03:36:51,320 --> 03:36:51,640 OUT? 5261 03:36:51,640 --> 03:36:55,560 >>I AGREE WITH THE EMPATHETIC 5262 03:36:55,560 --> 03:37:01,640 PART OF IT AND UNDERSTANDING THE 5263 03:37:01,640 --> 03:37:03,840 CARE PARTNER IS INVOLVED IN IT 5264 03:37:03,840 --> 03:37:05,520 24/7 AND WITH THAT THEY HAVE THE 5265 03:37:05,520 --> 03:37:07,120 MOST KNOWLEDGE OF WHAT'S GOING 5266 03:37:07,120 --> 03:37:07,360 ON. 5267 03:37:07,360 --> 03:37:11,240 A LOT OF TIMES WHEN WE GO TO THE 5268 03:37:11,240 --> 03:37:13,840 DOCTOR THE DOCTOR'S TRYING TO BE 5269 03:37:13,840 --> 03:37:16,680 NICE AND SPEAK TO MY WIFE BUT 5270 03:37:16,680 --> 03:37:18,760 REALLY SHE STILL HAS TO TURN 5271 03:37:18,760 --> 03:37:21,240 AROUND AND COME TO ME TO GET THE 5272 03:37:21,240 --> 03:37:24,600 ACTUAL FACTS AS TO WHAT'S GOING 5273 03:37:24,600 --> 03:37:24,760 ON. 5274 03:37:24,760 --> 03:37:27,320 BEING EMPATHETIC IN THAT WAY 5275 03:37:27,320 --> 03:37:28,600 MAKES A BIG DIFFERENCE AND I 5276 03:37:28,600 --> 03:37:33,040 HAVE TO ADMIT WE'VE BEEN VERY 5277 03:37:33,040 --> 03:37:34,280 BLESSED WITH A CARE TEAM THAT 5278 03:37:34,280 --> 03:37:38,320 HAS NOT ONLY CARED FOR MY WIFE 5279 03:37:38,320 --> 03:37:44,080 AND EVEN THE -- TOOK THE 5280 03:37:44,080 --> 03:37:46,680 OPPORTUNITY TO ASK ME HOW I'M 5281 03:37:46,680 --> 03:37:48,120 DOING AND IT'S NOT MY 5282 03:37:48,120 --> 03:37:49,320 APPOINTMENT SO THAT GOES A LONG 5283 03:37:49,320 --> 03:37:50,560 WAY AS WELL. 5284 03:37:50,560 --> 03:37:52,440 >>THANK YOU, DEACON REID AND 5285 03:37:52,440 --> 03:37:54,440 FOR THE SPEAKERS AND PANELISTS 5286 03:37:54,440 --> 03:37:57,360 AND THANK YOU TO CERISE. 5287 03:37:57,360 --> 03:37:58,480 I THINK THAT'S THE END OF 5288 03:37:58,480 --> 03:37:58,800 SESSION EIGHT. 5289 03:37:58,800 --> 03:38:06,160 THANK YOU. 5290 03:38:06,160 --> 03:38:07,720 >>THANK YOU SO MUCH, EVERYONE. 5291 03:38:07,720 --> 03:38:08,960 WHAT A TREMENDOUS SESSION. 5292 03:38:08,960 --> 03:38:10,080 THANK YOU EVERYONE FOR JOINING 5293 03:38:10,080 --> 03:38:13,280 US FOR THE THIRD AND LAST DAY OF 5294 03:38:13,280 --> 03:38:15,560 THE DEMENTIA CARE SUMMIT. 5295 03:38:15,560 --> 03:38:16,880 WE'LL NOW TRANSITION TO A 5296 03:38:16,880 --> 03:38:18,640 REFLECTION AND SUMMARY OF DAY 5297 03:38:18,640 --> 03:38:20,520 THREE OF THE SUMMIT FOLLOWED BY 5298 03:38:20,520 --> 03:38:25,000 SOME CLOSING REMARKS THAT JULIE 5299 03:38:25,000 --> 03:38:25,360 WILL PROVIDE. 5300 03:38:25,360 --> 03:38:26,880 A REVIEW OF WHAT THE GREAT 5301 03:38:26,880 --> 03:38:28,280 SESSIONS AND DISCUSSIONS WE HAD 5302 03:38:28,280 --> 03:38:30,760 TODAY WE BEGAN OUR DAY BY 5303 03:38:30,760 --> 03:38:33,080 HEARING FROM MEMBERS OF THE 5304 03:38:33,080 --> 03:38:34,400 LIVED EXPERIENCE AND STAKEHOLDER 5305 03:38:34,400 --> 03:38:37,440 ENGAGEMENT PANELS WITH REMARKS 5306 03:38:37,440 --> 03:38:41,320 FROM DAVE ARNOLD AND PETRA NILES 5307 03:38:41,320 --> 03:38:43,840 AND IT HIGHLIGHTED THE VALUES 5308 03:38:43,840 --> 03:38:45,760 AND IMPORTANCE OF PLANNING FOR 5309 03:38:45,760 --> 03:38:47,840 THE FUTURE AND MAINTAINING 5310 03:38:47,840 --> 03:38:49,040 INDEPENDENCE AS WELL AS THE 5311 03:38:49,040 --> 03:38:53,440 SIGNIFICANT FINANCIAL SEQUENCES 5312 03:38:53,440 --> 03:38:57,320 OF BEING AS BE UNPREPARED AND 5313 03:38:57,320 --> 03:38:58,840 UNINFORMED IN THE FACE OF 5314 03:38:58,840 --> 03:39:00,120 DEMENTIA WHICH IS NO RESPECTER 5315 03:39:00,120 --> 03:39:01,520 OF AGE, ZIP CODE OR SOCIO 5316 03:39:01,520 --> 03:39:08,440 ECONOMIC STATUS. 5317 03:39:08,440 --> 03:39:10,200 AFTER THAT WE HEARD WITH THE 5318 03:39:10,200 --> 03:39:11,320 DEMENTIA CARE CONFERENCE. 5319 03:39:11,320 --> 03:39:13,600 THE SESSION HIGHLIGHTS FOR US 5320 03:39:13,600 --> 03:39:15,920 WAYS THE DEMENTIA CARE WORKFORCE 5321 03:39:15,920 --> 03:39:19,440 MIRRORS THE COMPLEX AND OFTEN 5322 03:39:19,440 --> 03:39:21,360 FRAGMENTED CARE CONTINUUM THAT 5323 03:39:21,360 --> 03:39:24,680 INDIVIDUALS AND THEIR CARE 5324 03:39:24,680 --> 03:39:26,280 PARTNERS OR CAREGIVERS MUST 5325 03:39:26,280 --> 03:39:27,160 NAVIGATE. 5326 03:39:27,160 --> 03:39:30,480 WE HEARD THE DATA SURROUNDING 5327 03:39:30,480 --> 03:39:32,840 THE WORKFORCE IS EQUALLY 5328 03:39:32,840 --> 03:39:34,200 FRAGMENTED AND OFTEN INCOMPLETE. 5329 03:39:34,200 --> 03:39:36,640 IT WAS NOTED IN PARTICULAR 5330 03:39:36,640 --> 03:39:38,960 ALMOST NO DATA ABOUT THE 5331 03:39:38,960 --> 03:39:40,720 ASSISTED LIVING WORKFORCE IS 5332 03:39:40,720 --> 03:39:42,280 AVAILABLE AND THAT THE LEVEL OF 5333 03:39:42,280 --> 03:39:43,600 DETAIL WITH WHAT WE KNOW ABOUT 5334 03:39:43,600 --> 03:39:47,240 WHO'S IN THE WORKFORCE AND 5335 03:39:47,240 --> 03:39:49,600 THEY'RE CHARACTERISTICS AND 5336 03:39:49,600 --> 03:39:55,280 THEIR ROLES IS SIGNIFICANTLY 5337 03:39:55,280 --> 03:40:00,040 LACK AND THE NASEM REPORT 5338 03:40:00,040 --> 03:40:05,200 NARRATIVE TO IMPROVE QUALITY AND 5339 03:40:05,200 --> 03:40:07,120 CONTINUES THE LOW PAY AND 5340 03:40:07,120 --> 03:40:08,480 ADEQUATE WORKINGS CAN BE AND THE 5341 03:40:08,480 --> 03:40:11,280 ENVIRONMENTS IN THE NURSING HOME 5342 03:40:11,280 --> 03:40:12,080 SECTOR IN PARTICULAR AND GREAT 5343 03:40:12,080 --> 03:40:13,200 NEED AND OPPORTUNITY FOR THERE 5344 03:40:13,200 --> 03:40:15,440 TO BE ACTIONS ON THE 5345 03:40:15,440 --> 03:40:16,360 RECOMMENDATIONS IN THAT REPORT 5346 03:40:16,360 --> 03:40:18,560 WITH THE GOAL OF I AM PROVING 5347 03:40:18,560 --> 03:40:19,840 AND STRENGTHENING THE WORKFORCE 5348 03:40:19,840 --> 03:40:22,960 AND ULTIMATELY DEMENTIA CARE 5349 03:40:22,960 --> 03:40:25,640 QUALITY AS WELL. 5350 03:40:25,640 --> 03:40:27,080 FOR SESSION 7 WE HEARD ABOUT 5351 03:40:27,080 --> 03:40:28,400 ECONOMIC IMPACT AND 5352 03:40:28,400 --> 03:40:28,720 IMPLICATIONS. 5353 03:40:28,720 --> 03:40:32,880 THE SESSION HIGHLIGHTS FOR US 5354 03:40:32,880 --> 03:40:34,480 VIA PRESENTATION BY DR. DUKE HAN 5355 03:40:34,480 --> 03:40:36,320 ABOUT THE ROLE OF FINANCIAL 5356 03:40:36,320 --> 03:40:38,760 DECISION MAKING IN AGE-RELATED 5357 03:40:38,760 --> 03:40:39,800 COGNITIVE DECLINE AND EARLY 5358 03:40:39,800 --> 03:40:43,520 STAGES OF DEMENTIA AND THE NEED 5359 03:40:43,520 --> 03:40:45,680 FOR GREATER CLARITY ABOUT THOSE 5360 03:40:45,680 --> 03:40:48,720 DIFFERENCES AND SOME OF THOSE 5361 03:40:48,720 --> 03:40:48,920 LINKS. 5362 03:40:48,920 --> 03:40:50,200 AS WELL AS THE NEED TO INFORM 5363 03:40:50,200 --> 03:40:50,800 SUPPORTS FOR EARLY FINANCIAL 5364 03:40:50,800 --> 03:40:53,400 PLANNING. 5365 03:40:53,400 --> 03:40:55,120 THE SESSION ALSO HIGHLIGHTED FOR 5366 03:40:55,120 --> 03:40:56,960 US AGAIN SIMILAR TO THINGS WE 5367 03:40:56,960 --> 03:40:59,280 HEARD IN EARLIER DAYS OF THE 5368 03:40:59,280 --> 03:41:01,640 SUMMIT THAT PATHWAYS TO 5369 03:41:01,640 --> 03:41:03,880 DIAGNOSIS ARE OFTEN PROCEEDED 5370 03:41:03,880 --> 03:41:06,080 AND FOLLOWED BY CRISIS EVENTS. 5371 03:41:06,080 --> 03:41:08,120 WE SEE THIS FROM HIGHER EXPOSURE 5372 03:41:08,120 --> 03:41:11,960 TO ACUTE ILLNESS CARE SUCH AS 5373 03:41:11,960 --> 03:41:13,440 HOSPITALIZATION. 5374 03:41:13,440 --> 03:41:15,560 WE KNOW THIS CARRIES SIGNIFICANT 5375 03:41:15,560 --> 03:41:17,480 CLINICAL CONSEQUENCES AND ALSO 5376 03:41:17,480 --> 03:41:23,640 HAS I MPLICATIONS FOR PAYERS AN 5377 03:41:23,640 --> 03:41:24,440 COSTS. 5378 03:41:24,440 --> 03:41:25,760 THERE'S IMPORTANT DIFFERENCES IN 5379 03:41:25,760 --> 03:41:28,640 SOME OF THOSE PATTERNS BASED ON 5380 03:41:28,640 --> 03:41:29,800 WHETHER OR NOT SOMEONE IS 5381 03:41:29,800 --> 03:41:31,280 RECEIVING TRADITIONAL MEDICARE 5382 03:41:31,280 --> 03:41:33,080 OR MEDICARE ADVANTAGE AND THAT 5383 03:41:33,080 --> 03:41:33,680 WE NEED TO BETTER UNDERSTAND 5384 03:41:33,680 --> 03:41:37,880 THOSE DIFFERENCES. 5385 03:41:37,880 --> 03:41:38,960 COMMENTS AND DISCUSSION AMONG 5386 03:41:38,960 --> 03:41:41,120 PRESENTERS AND THE AUDIENCE IN 5387 03:41:41,120 --> 03:41:43,280 THIS SESSION ALSO HIGHLIGHTED 5388 03:41:43,280 --> 03:41:47,240 AND POINTED TO THE NEED TO MORE 5389 03:41:47,240 --> 03:41:49,120 PRECISELY QUANTIFY THE COST TO 5390 03:41:49,120 --> 03:41:49,880 FAMILY MEMBERS AND TRYING TO 5391 03:41:49,880 --> 03:41:51,560 FIND WAYS TO DO THAT BEYOND THE 5392 03:41:51,560 --> 03:41:54,800 IMMEDIATE FAMILY AS WELL. 5393 03:41:54,800 --> 03:41:57,760 AND CRITICALLY WE HEARD FROM HEL 5394 03:41:57,760 --> 03:41:59,560 EN LAMONT ABOUT THE DATA NEEDED 5395 03:41:59,560 --> 03:42:01,880 TO INFORM POLICY DECISIONS 5396 03:42:01,880 --> 03:42:02,720 INCLUDING BEING SPECIFIC ABOUT 5397 03:42:02,720 --> 03:42:07,280 THE DIFFERENTIAL IMPACTS OF 5398 03:42:07,280 --> 03:42:08,360 INTERVENTIONS, IDEALLY THINK OF 5399 03:42:08,360 --> 03:42:15,280 WAYS RESEARCHERS CAN BREAK DOWN 5400 03:42:15,280 --> 03:42:18,760 THE DIFFERENTIAL CHARACTERISTIC 5401 03:42:18,760 --> 03:42:21,280 AND DUAL ELIGIBILITY AND 5402 03:42:21,280 --> 03:42:22,120 ENSURING SUFFICIENT DETAILS 5403 03:42:22,120 --> 03:42:24,280 SHARED TO PROVIDE AN 5404 03:42:24,280 --> 03:42:25,240 UNDERSTANDING OF 5405 03:42:25,240 --> 03:42:25,760 GENERALIZABILITY. 5406 03:42:25,760 --> 03:42:27,240 LASTLY WE CLOSED WITH THE 5407 03:42:27,240 --> 03:42:28,640 TREMENDOUS SESSION THAT JUST 5408 03:42:28,640 --> 03:42:30,800 WRAPPED UP FOCUSSED ON 5409 03:42:30,800 --> 03:42:32,080 APPROACHES TO PARTICIPATORY 5410 03:42:32,080 --> 03:42:33,400 RESEARCH AND DIVERSE RECRUITMENT 5411 03:42:33,400 --> 03:42:34,840 AND RETENTION. 5412 03:42:34,840 --> 03:42:36,440 THIS SESSION WAS TREMENDOUS AS 5413 03:42:36,440 --> 03:42:39,640 THEY ALL WERE AND HIGHLIGHTED 5414 03:42:39,640 --> 03:42:41,560 FOR US GREAT EXAMPLES AND 5415 03:42:41,560 --> 03:42:43,600 CONSIDERATIONS FOR HOW WE 5416 03:42:43,600 --> 03:42:44,920 APPROACH, PARTICIPATORY RESEARCH 5417 03:42:44,920 --> 03:42:48,960 AND WHAT THIS CAN LOOK LIKE IN 5418 03:42:48,960 --> 03:42:50,240 COMMUNITIES THAT AS DR. EPPS 5419 03:42:50,240 --> 03:42:54,320 REMINDS US ARE NOT INDEED HARD 5420 03:42:54,320 --> 03:42:55,560 TO REACH BUT WHERE THERE'S 5421 03:42:55,560 --> 03:42:56,760 SPECIFIC CONSIDERATIONS HOW WE 5422 03:42:56,760 --> 03:42:58,440 UNDERSTAND THE COMPETING NEEDS 5423 03:42:58,440 --> 03:43:01,400 AND PRIORITIES OF COMMUNITIES, 5424 03:43:01,400 --> 03:43:03,640 THE HISTORICAL AND PRESENT-DAY 5425 03:43:03,640 --> 03:43:06,400 CONCERNS THAT EXIST ABOUT TRUST 5426 03:43:06,400 --> 03:43:08,200 AND CONFIDENTIALITY AND HOW THE 5427 03:43:08,200 --> 03:43:10,240 APPROACHES THAT WE AS 5428 03:43:10,240 --> 03:43:13,560 RESEARCHERS MAY USE TO TALK 5429 03:43:13,560 --> 03:43:14,760 ABOUT CAREGIVING AND EXPERIENCES 5430 03:43:14,760 --> 03:43:17,000 WITH DEMENTIA CAN BE 5431 03:43:17,000 --> 03:43:17,880 INCONSISTENT WITH THE LIVED 5432 03:43:17,880 --> 03:43:19,600 EXPERIENCE AND VALUES IN SOME 5433 03:43:19,600 --> 03:43:19,920 COMMUNITIES. 5434 03:43:19,920 --> 03:43:22,520 THAT'S SOMETHING WE NEED TO 5435 03:43:22,520 --> 03:43:23,000 BETTER UNDERSTAND. 5436 03:43:23,000 --> 03:43:29,040 WE HEARD REMARKS FROM PANELISTS 5437 03:43:29,040 --> 03:43:31,760 MARTHA WILLIAMS AND DR. NGUYEN 5438 03:43:31,760 --> 03:43:36,600 AND DEACON REID ABOUT THEIR WHY 5439 03:43:36,600 --> 03:43:38,440 THEY'RE PARTICIPATING IN 5440 03:43:38,440 --> 03:43:40,640 RESEARCH AND A FEW THINGS I 5441 03:43:40,640 --> 03:43:45,080 NOTED IS REMOVING JARGON, 5442 03:43:45,080 --> 03:43:47,080 MEETING PEOPLE WHERE THEY'RE AT 5443 03:43:47,080 --> 03:43:50,480 AND REMEMBERING HOW WE IDENTIFY 5444 03:43:50,480 --> 03:43:51,760 OURSELVES IN DIVERSE COMMUNITIES 5445 03:43:51,760 --> 03:43:54,320 AND WITH OUR DIVERSE BACKGROUNDS 5446 03:43:54,320 --> 03:43:55,520 MAY BE VERY DISTINCT AND 5447 03:43:55,520 --> 03:43:57,600 INDIVIDUALIZED AND THAT WE HAVE 5448 03:43:57,600 --> 03:43:59,680 TO UNDERSTAND IT AND NEED TO 5449 03:43:59,680 --> 03:44:01,920 RESPOND TO THAT IN OUR 5450 03:44:01,920 --> 03:44:03,520 APPROACHES TO REACHING OUT TO 5451 03:44:03,520 --> 03:44:05,720 AND ENGAGING WITH DIVERSE 5452 03:44:05,720 --> 03:44:06,000 COMMUNITIES. 5453 03:44:06,000 --> 03:44:08,280 AND I WILL PERHAPS CLOSE BY 5454 03:44:08,280 --> 03:44:12,080 LIFTING UP THE WORDS FROM DEACON 5455 03:44:12,080 --> 03:44:16,320 REID OF WHICH THE EASE WHERE WE 5456 03:44:16,320 --> 03:44:17,440 CAN OBTAIN MAJORITY DATA AND 5457 03:44:17,440 --> 03:44:19,080 NEED TO GO WHERE PEOPLE ARE TO 5458 03:44:19,080 --> 03:44:21,120 GET THE TRUE DATA. 5459 03:44:21,120 --> 03:44:24,200 I APPRECIATED THOSE REMARKS AND 5460 03:44:24,200 --> 03:44:26,000 WANT TO THANK EVERYONE WHO 5461 03:44:26,000 --> 03:44:26,720 CONTRIBUTED TO THE SESSIONS 5462 03:44:26,720 --> 03:44:28,880 TODAY AND FOR JOINING US FOR AN 5463 03:44:28,880 --> 03:44:29,680 OUTSTANDING SUMMIT. 5464 03:44:29,680 --> 03:44:31,200 I'M GOING TO HAND IT OVER TO 5465 03:44:31,200 --> 03:44:36,880 JULIE TO CLOSE US OUT. 5466 03:44:36,880 --> 03:44:38,600 >>THANK YOU FOR THE THOUGHTFUL 5467 03:44:38,600 --> 03:44:40,000 COMMENTS ABOUT OUR DAY. 5468 03:44:40,000 --> 03:44:43,080 FOR THE FINAL FEW MINUTES IT'S 5469 03:44:43,080 --> 03:44:43,760 MY PRIVILEGE TO MAKE BRIEF 5470 03:44:43,760 --> 03:44:45,040 CLOSING REMARKS AND TELL YOU 5471 03:44:45,040 --> 03:44:47,200 WHAT TO EXPECT GOING FORWARD. 5472 03:44:47,200 --> 03:44:48,760 FOR THE LAST THREE DAYS OF THE 5473 03:44:48,760 --> 03:44:51,920 SUMMIT WE HEARD PRESENTATIONS 5474 03:44:51,920 --> 03:44:53,320 AND DISCUSSIONS THAT SUMMARIZED 5475 03:44:53,320 --> 03:44:55,520 AND HIGHLIGHTED THE EXCITING 5476 03:44:55,520 --> 03:44:56,280 SCIENTIFIC PROGRESS SINCE THE 5477 03:44:56,280 --> 03:44:58,960 2020 SUMMIT. 5478 03:44:58,960 --> 03:45:00,880 THE PRESENTATIONS IDENTIFIED 5479 03:45:00,880 --> 03:45:03,000 HIGH PRIORITY RESEARCH GAPS AND 5480 03:45:03,000 --> 03:45:11,280 OPPORTUNITIES AND THESE EM PLIFY 5481 03:45:11,280 --> 03:45:17,760 WHY -- EXEMPLIFY WHY WE NEED 5482 03:45:17,760 --> 03:45:19,200 SUPPORT FOR CAREGIVERS AND 5483 03:45:19,200 --> 03:45:24,600 RESEARCH IS NEEDED TO INFORM THE 5484 03:45:24,600 --> 03:45:28,760 SOLUTIONS AND ADVANCE HEALTH 5485 03:45:28,760 --> 03:45:30,480 EQUITY AND WE NEED ADVOCACY 5486 03:45:30,480 --> 03:45:31,880 SECTORS AND IMPORTANTLY THE 5487 03:45:31,880 --> 03:45:33,760 PERSPECTIVES AND INSIGHT FROM 5488 03:45:33,760 --> 03:45:39,760 PERSONS LIVING WITH DEMENTIA AND 5489 03:45:39,760 --> 03:45:41,280 CAREGIVERS AND PARTNERS AND 5490 03:45:41,280 --> 03:45:42,280 GRATEFUL FOR THOSE WHO SHARED 5491 03:45:42,280 --> 03:45:44,760 THEIR TIME AND EXPERIENCES WITH 5492 03:45:44,760 --> 03:45:45,320 US. 5493 03:45:45,320 --> 03:45:47,560 I'M INSPIRED FROM ALL I HEARD 5494 03:45:47,560 --> 03:45:48,600 AND LEARNED. 5495 03:45:48,600 --> 03:45:50,320 WE HOPE THIS SERVES AS A CALL TO 5496 03:45:50,320 --> 03:45:52,520 ALL RESEARCHERS AND EARLY STAGE 5497 03:45:52,520 --> 03:45:52,840 INVESTIGATORS. 5498 03:45:52,840 --> 03:45:54,640 RESEARCH MOMENTUM IS BUILDING 5499 03:45:54,640 --> 03:45:56,720 AND THE URGENCY HAS NOT 5500 03:45:56,720 --> 03:45:57,040 DIMINISHED. 5501 03:45:57,040 --> 03:45:59,520 WITH THE WIDE RANGE OF RESEARCH 5502 03:45:59,520 --> 03:46:00,360 NEEDS IDENTIFIED AND DISCUSSED 5503 03:46:00,360 --> 03:46:04,000 NOW IS THE TIME TO BE FEARLESS 5504 03:46:04,000 --> 03:46:04,600 IN THE SCIENTIFIC PURSUIT OF 5505 03:46:04,600 --> 03:46:07,920 PROGRESS. 5506 03:46:07,920 --> 03:46:12,760 NOT TO WORRY IF YOU DID NOT TAKE 5507 03:46:12,760 --> 03:46:13,240 COPIOUS NOTES. 5508 03:46:13,240 --> 03:46:15,280 YOU MAY VISIT THE SUMMIT WEBSITE 5509 03:46:15,280 --> 03:46:18,400 TO ACCESS RECORD INGS AND THE 5510 03:46:18,400 --> 03:46:20,120 WEBSITE IS HERE FOR YOUR 5511 03:46:20,120 --> 03:46:21,480 REMINDER AND CHECK BACK IN 5512 03:46:21,480 --> 03:46:24,240 MONTHS FOR THE SUMMIT REPORT AND 5513 03:46:24,240 --> 03:46:29,560 FINAL RESEARCH GAPS AND 5514 03:46:29,560 --> 03:46:30,040 OPPORTUNITIES. 5515 03:46:30,040 --> 03:46:30,560 ON BEHALF OF 5516 03:46:30,560 --> 03:46:32,040 DR. GILMORE-BYKOVSKYI AND 5517 03:46:32,040 --> 03:46:33,520 MYSELF, I'LL WRAP UP THE SUMMIT 5518 03:46:33,520 --> 03:46:34,960 WITH A SECOND THANK YOU TO ALL 5519 03:46:34,960 --> 03:46:37,480 THE DEDICATED PEOPLE THAT 5520 03:46:37,480 --> 03:46:39,120 CONTRIBUTED TO THIS EFFORT. 5521 03:46:39,120 --> 03:46:41,040 WE THANK OUR COLLEAGUES AT ROSE 5522 03:46:41,040 --> 03:46:46,040 LEE AND ASSOCIATES AND SOPHIA 5523 03:46:46,040 --> 03:46:49,520 JONES AND TEAMS FOR THE BEHIND 5524 03:46:49,520 --> 03:46:51,760 THE SCENES EFFORTS AND EXPRESS 5525 03:46:51,760 --> 03:46:53,720 GRATITUDE TO OUR COLLEAGUES ON 5526 03:46:53,720 --> 03:46:55,800 THE NATIONAL INSTITUTE ON AGING. 5527 03:46:55,800 --> 03:46:59,240 ELENA FAZIO AND JESSICA BOATEN 5528 03:46:59,240 --> 03:47:01,720 AND OTHERS INSTRUMENTAL TO THE 5529 03:47:01,720 --> 03:47:02,320 SUCCESS OF THE SUMMIT. 5530 03:47:02,320 --> 03:47:03,760 PLEASE ENJOY THE REST OF YOUR 5531 03:47:03,760 --> 03:47:04,320 DAY AND THANK YOU AGAIN FOR 5532 03:47:04,320 --> 00:00:00,000 JOINING US.