Hearings to examine breaking the cycle of senior loneliness, focusing on strengthening family and community support.

1[Senate Hearing 119-58]2[From the U.S. Government Publishing Office]34                                                         S. Hrg. 119-5856                      BREAKING THE CYCLE OF SENIOR7                    LONELINESS: STRENGTHENING FAMILY8                         AND COMMUNITY SUPPORT910=======================================================================1112                                HEARING1314                               BEFORE THE1516                       SPECIAL COMMITTEE ON AGING1718                          UNITED STATES SENATE1920                    ONE HUNDRED NINETEENTH CONGRESS2122                             FIRST SESSION2324                               __________2526                             WASHINGTON, DC2728                               __________2930                             MARCH 12, 20253132                               __________3334                           Serial No. 119-053536         Printed for the use of the Special Committee on Aging3738 [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]3940        Available via the World Wide Web: http://www.govinfo.gov4142                                __________4344                   U.S. GOVERNMENT PUBLISHING OFFICE4560-186 PDF                  WASHINGTON : 20254647-----------------------------------------------------------------------------------4849                       SPECIAL COMMITTEE ON AGING5051                     RICK SCOTT, Florida, Chairman5253DAVE McCORMICK, Pennsylvania         KIRSTEN E. GILLIBRAND, New York54JIM JUSTICE, West Virginia           ELIZABETH WARREN, Massachusetts55TOMMY TUBERVILLE, Alabama            MARK KELLY, Arizona56RON JOHNSON, Wisconsin               RAPHAEL WARNOCK, Georgia57ASHLEY MOODY, Florida                ANDY KIM, New Jersey58JON HUSTED, Ohio                     ANGELA ALSOBROOKS, Maryland59                              ----------60                McKinley Lewis, Majority Staff Director61                Claire Descamps, Minority Staff Director6263                        C  O  N  T  E  N  T  S6465                              ----------6667                                                                   Page6869Opening Statement of Senator Rick Scott, Chairman................     170Opening Statement of Senator Kirsten E. Gillibrand, Ranking71  Member.........................................................     27273                           PANEL OF WITNESSES7475Andrew MacPherson, Founder and Executive Chair, Foundation for76  Social Connection Action Network, Washington, D.C..............     377James Balda, President and CEO, Argentum, Washington, D.C........     578Suzanne McCormick, President and CEO, YMCA of the USA, Tampa,79  Florida........................................................     780Tori Strawter-Tanks, Director, Clayton County Senior Services81  Department, Jonesboro, Georgia.................................    108283                                APPENDIX84                      Prepared Witness Statements8586Andrew MacPherson, Founder and Executive Chair, Foundation for87  Social Connection Action Network, Washington, D.C..............    3088James Balda, President and CEO, Argentum, Washington, D.C........    3689Suzanne McCormick, President and CEO, YMCA of the USA, Tampa,90  Florida........................................................    4191Tori Strawter-Tanks, Director, Clayton County Senior Services92  Department, Jonesboro, Georgia.................................    439394                        Questions for the Record9596Suzanne McCormick, President and CEO, YMCA of the USA, Tampa,97  Florida........................................................    4798Tori Strawter-Tanks, Director, Clayton County Senior Services99  Department, Jonesboro, Georgia.................................    49100101                       Statements for the Record102103The Alzheimer's Association and Alzheimer's Impact Movement (AIM)104  Statement......................................................    53105ASHA Statement...................................................    55106ASHA: Senior Living Communities Report...........................    59107ASHA: The Surpassing Price of Staying in a House Report..........    77108James Balda Statement............................................    91109NANASP Statement.................................................    98110Oshkosh Community YMCA Statement.................................    99111YMCA Statement...................................................   106112YMCA Florida Statistics..........................................   107113114                      BREAKING THE CYCLE OF SENIOR115                    LONELINESS: STRENGTHENING FAMILY116                         AND COMMUNITY SUPPORT117118                              ----------119120                       Wednesday, March 12, 2025121122                                        U.S. Senate123                                 Special Committee on Aging124                                                    Washington, DC.125    The Committee met, pursuant to notice, at 03:31 p.m., Room126106, Dirksen Senate Office Building, Hon. Rick Scott, Chairman127of the Committee, presiding.128    Present: Senator Scott, Justice, Johnson, Moody, Husted,129Gillibrand, and Warnock.130131                 OPENING STATEMENT OF SENATOR132                      RICK SCOTT, CHAIRMAN133134    The Chairman. [[added post: The U.S. Senate Special135Committee on Aging will now come to order.136    Today, I want to address the tragedy of rising social137isolation and]] loneliness among American seniors. Americans138have never had more opportunities for connection than we do139today, but studies are repeatedly warning that feelings of140isolation and loneliness are rising dramatically, especially141among elderly Americans. This is a problem.142    Here is why it should matter to everyone in this room and143the American people. The cycle of loneliness in seniors impacts144all of us, and if we don't figure it out now, we are doing145future generations to suffer the same negative impacts of146isolation. We can and must do better.147    Combating the feeling of isolation and loneliness for the148aging community has endless benefits, from better mental and149physical health, to stronger multi--generational relationships150for families and communities. Another benefit to reducing151isolation and loneliness is that this is critical in our fight152against scams.153    The internet and social media are great for many things,154but when isolated and lonely seniors turn to the internet for155companionship and social interaction. They are far more likely156to become victims of scams. It is heartbreaking because this157only fuels a cycle of negative outcomes for vulnerable older158Americans.159    That is why last week I was proud to be joined by Senator160Mark Kelly and several of our colleagues on the Aging Committee161to introduce and pass a resolution designating March 6th as162National Slam the Scam Day and working to raise awareness of163scams targeting older Americans. Seniors have lost so much to164scams, in many cases their identities or their life savings.165    Seniors are attacked with grandparent scams, financial166services scams, tech support scams, Government impersonation167scams, romance scams, among others. All of these scams are even168more effective with seniors who are struggling with loneliness,169isolation, and depression. In 2023, people over 60 lost a170combined 3.4 billion to fraud worldwide. We need to put an end171to this.172    This is something that every American should be worried173about. I know that every member of this Committee wants to put174an end to this critical issue. I am glad that Pam Bondi is our175Attorney General and Kash Patel is the Director of the FBI.176    I am confident they will fight for every senior in our177country and make sure that criminals are held accountable for178their despicable crimes. Beyond preventing scams, tackling the179issues associated with loneliness are key to my goal as180chairman of this Committee to improve the wellness of American181seniors.182    I know the ranking member has the same goal. In our first183meeting, I outlined four issues for this Committee to focus on184as we work to improve the wellness of American seniors. One of185these four issues was improving family and community support,186and that is so important because when seniors feel they have187purpose and are part of the community, they thrive.188    The sad reality we face today is that a growing number of189senior citizens are suffering from mental and physical issues190largely driven by an epidemic of loneliness. Despite public191health officials sounding the alarm, the issue has not yet been192addressed through any major legislation.193    That is why I introduced the Social Engagement and Network194Initiatives for Older Relief, or SENIOR Act, to address senior195loneliness. I am proud to have the support of Argentum, the196Foundation for Social Connection Action Network, and the YMCA,197who are all represented here today by our witnesses.198    The SENIOR Act has also been endorsed by Meals on Wheels.199Finally, I think it is incredibly important to recognize the200impact that COVID had on our seniors. Due to shutdowns and201restrictions in places like hospitals, assisted living202facilities, and nursing homes, many seniors weren't allowed to203be near their children, or grandchildren, or any of their loved204ones. In many cases, they were completely isolated to their own205rooms. That is horrible. This was heartbreaking to see.206    We all know the importance of community and social207interaction for our seniors and the great health benefits it208has. We had so many seniors that weren't even allowed to have209their loved ones next to them during their last time of need or210their last moments on this earth. We all know that seniors211contribute greatly when given opportunities to be active212members in their communities.213    I hope to make significant progress on this issue to end214loneliness and isolation among seniors, pass my SENIOR Act, and215work together to improve the wellness of older Americans. I216look forward to hearing your testimony and working with my217colleagues on next steps to fight this issue. I would now like218to recognize Ranking Member Gillibrand for her opening219statement.220221                  OPENING STATEMENT OF SENATOR222             KIRSTEN E. GILLIBRAND, RANKING MEMBER223224    Senator Gillibrand. Thank you, Chairman Scott, for calling225today's hearing. Imagine growing old by yourself with no226friends, no family, no loved ones around. I have seen it227before, and it is really lonely. It is the reality of many of228our seniors today.229    A heartbreaking one in four older Americans report being230socially isolated, and 43 percent report feeling lonely.231Loneliness and social isolation have detrimental consequences,232increasing risks of early death, chronic disease, and dementia.233This is not the kind of life that we want for our loved ones.234    It is not the kind of life we want for ourselves. The good235news is there are many things we can do to reduce and prevent236loneliness and social isolation. For example, home and237congregate meals deliver both life--sustaining nutrition and238social connection for older adults in their homes and239community.240    Transportation programs allow adults with limited mobility241to participate in community and social activities. There are242also various innovative programs, such as intergenerational243initiatives, that can help reduce social isolation. I look244forward to working with my colleagues to support and strengthen245programs that do reduce loneliness and social isolation for246older adults.247    This includes protecting and strengthening critical federal248funding for these programs, including in the Older Americans249Act. I am proud to lead and support efforts to increase funding250for the Older American Act programs, including the nutrition251programs.252    I look forward to hearing from our witnesses today, and to253hear all the ways that they can help--that we can help seniors254stay engaged, connected, and integrated in their communities.255    The Chairman. Thank you, Ranking Member Gillibrand. Now, to256welcome our witnesses here today. Before I introduce our first257witness, I would like to ask each of you to be mindful of our258limited time together today and keep opening statements to five259minutes. First, I would like to welcome Andrew MacPherson.260    Mr. MacPherson is the Founder and Board Chair of the261Foundation for Social Connection Action Network, an262organization representing some of the most influential consumer263groups, patient advocates, health plans, community-based264organizations, behavioral health groups, and private sector265innovators in the United States. Thank you for being here266today, and please begin with your testimony.267268          STATEMENT OF ANDREW MACPHERSON, FOUNDER AND269270             EXECUTIVE CHAIR, FOUNDATION FOR SOCIAL271272          CONNECTION ACTION NETWORK, WASHINGTON, D.C.273274    Mr. MacPherson. Chairman Scott, Ranking Member Gillibrand,275and distinguished members of the Aging Committee, thank you so276much for the opportunity to testify today on the critical issue277of loneliness among older adults.278    My name is Andrew MacPherson, and I am the Founder and279Executive Chair of the Foundation for Social Connection Action280Network. Established in 2018, we convened a diverse multi-281sector coalition of national organizations to develop and282advocate for federal policy solutions that address the epidemic283of social and loneliness in America.284    Since our establishment, the Action Network has been285honored to play an important role in supporting and advising286the policy efforts of Congress, on a bipartisan basis, as well287as the executive branch. Chairman Scott, thank you for your288leadership in authoring the bipartisan Social Engagement and289Network Initiatives for Older Relief, or SENIOR Act, which290underscores the role that the Older Americans Act plays in291addressing loneliness.292    While significant progress has been made here in Congress,293of course our work on this issue is far from over. As you know,294social isolation and loneliness among older adults has reached295epidemic proportions with devastating combined effects on296public health, healthcare costs, and individual well-being.297    According to the National Academies, 24 percent of298Americans aged 65 and older are considered to be socially299isolated. Forty percent of adults aged 60 and older report300feeling lonely, and chronic loneliness is linked to a 50301percent increased risk of dementia, 29 percent increased risk302of heart disease, and 32 percent risk of stroke.303    Beyond its impact on an individual's health, social304isolation and loneliness among older adults carries a305substantial economic burden to our country as well. AARP, a306member of our coalition, estimates that Medicare spends an307additional $6.7 billion annually on socially isolated older308adults due to increased hospitalizations, emergency room309visits, and over-reliance on long-term care services.310    Chairman Scott and Ranking Member Gillibrand, I have311included much more comprehensive analysis in my written312testimony submitted to the Committee. Fortunately, there are313ways, a number of ways, that Congress can ameliorate loneliness314and its deleterious impacts on older adults' health and well-315being.316    First, pass the SENIOR Act. Adding the term loneliness to317the Older Americans Act will allow and direct those funds to318ensure older adults are more socially connected. Second, and as319you know, the Older Americans Act serves as a vital cornerstone320for aging services but demands far out seed available321resources.322    By increasing funding for Older Americans Act nutrition323programs and community-based resources like senior centers,324older adults can access structured opportunities for325socialization, supporting their overall well-being.326Additionally, targeted funding for rural aging interventions is327essential to address isolation and loneliness in areas with328limited transportation resources.329    The Administration for Community Living's Commit to Connect330Program, which Congress created, is just one example of an331evidence-based model that can enhance and that should be332protected and expanded.333    Third, strengthening and expanding intergenerational334initiatives, such as shared housing programs, mentorship335opportunities, and community volunteer projects have proven to336significantly reduce loneliness across generations. To337strengthen these bonds, evidence-based strategies can be338implemented to include socially friendly environments,339expanding community programs that connect diverse age groups,340and investing in local institutions that serve341intergenerational hubs.342    Fourth, we must promote technology access in this country343for seniors. While technology holds significant potential to344mitigate loneliness, nearly 22 million senior--older adults345today lack broadband access.346    To bridge this gap, leveraging telehealth, assisted347devices, online support groups, and expanded broadband access348are truly necessary to address this issue, and finally, of349course, Medicare plays a critically important role here in the350growing crisis--to address the growing crisis of loneliness and351isolation as well.352    Medicare can, for example, ensure that the annual wellness353visit includes routine screenings for loneliness, expand354coverage for peer supports and hearing aids, support non-355emergency transportation opportunities through Medicare356Advantage, and other non-medical supports that can enhance357social connection and build social capital.358    In addition to recommendations, today I am proud to359announce the launch of our organization's federal policy360priorities for social connection, a comprehensive framework361comprising a full 130 policy recommendations designed to foster362social connection and end the public health crisis.363    Chairman Scott, Ranking Member Gillibrand, and members of364this Committee, the Aging Committee, addressing the epidemic of365loneliness among older adults is not only a moral imperative,366but it is a critical public health and economic necessity in367this country.368    Together, we can build a future where connection, not369loneliness, defines the American experience for seniors. Thank370you so much for the opportunity to testify today. I look371forward to your questions. Thank you.372    The Chairman. Thank you, Mr. MacPherson. Now, I would like373to welcome James Balda. Mr. Balda is the President and CEO of374Argentum, the leading national trade association serving375companies that own, operate, and support professionally managed376senior living communities.377    Under his leadership, they have focused on critical378advocacy and action to support seniors. Thanks for being here379today. Please begin with your testimony.380381              STATEMENT OF JAMES BALDA, PRESIDENT382              AND CEO, ARGENTUM, WASHINGTON, D.C.383384    Mr. Balda. [Technical problems]. Excuse me. Chairman Scott,385Ranking Member Gillibrand, and members of the Committee, thank386you for this opportunity. My name is James Balda, the President387and CEO of Argentum, the leading national association388representing senior living, including independent living,389assisted living, and memory care, where over two million390seniors are overwhelmingly satisfied with calling our391communities home.392    Argentum commends you, Senator, and Senator Smith, and393Senator Warnock on the introduction of the SENIOR Act and for394holding this important hearing. You all know, which is why we395are here today, that loneliness is an epidemic among our396Nation's elderly.397    As many as 50 percent experience it, and the physical,398mental, and cognitive consequences can be devastating and399overwhelming, particularly for those with some form of400dementia.401    The toll of loneliness impacts an individual's quality of402life and adds an ever--escalating cost to our healthcare403system. As has already been mentioned, this former Surgeon404General outlined the health consequences of loneliness, and the405Harvard, Stanford AARP study also recognized the costs of that406loneliness.407    The Alzheimer's Association has identified that loneliness408increases the risk of dementia by over 50 percent, which in409turn translates to over $230 billion in Medicare and Medicaid410expenses annually, which is projected to increase by over 200411percent by 2050.412    While these data points are staggering, the personal impact413is often tragic, reducing the quality of life for seniors and414putting a strain on caregivers and loved ones, but there is a415commonsense solution, offering seniors greater opportunities416for support and engagement. Socialization is a crucial aspect417of healthy aging.418    It promotes a sense of purpose and connection with others,419and significantly improves the mental, cognitive, and physical420health of seniors. We see this every day in senior living421communities, where residents become friends, and friends422ultimately become family.423    Our assisted living model, which is predominantly private424pay and supports all activities of daily living, was created to425allow seniors to thrive. It strives to recognize the importance426of dignity, choice, and community to keep them living as427independently--for as long as possible and providing them with428a sense of purpose and belonging and providing them with a wide429range of social and interactive activities, such as gardening,430educational programs, tours, exercise classes, book clubs, and431so much more.432    The social atmosphere of assisted living actually decreases433loneliness. A national survey of more than 130,000 assisted434living residents based on the UCLA loneliness score identified435that just 14 percent of seniors identify themselves as being436lonely living in an assisted living community compared to437nearly 30 percent in the broader community.438    Just yesterday, U.S. News reported that about two-thirds of439seniors said loneliness or isolation contributed to a decline440in their health before they moved into a senior living441community, but that 61 percent of residents say their feelings442of loneliness or isolation improved after moving in.443    Mr. Chairman, we believe our communities offer many444opportunities for seniors to combat loneliness, but we know445more can be done and more needs to be done outside of the four446walls of our buildings. That is why Argentum commends you on447taking the important step of introducing the SENIOR Act. This448bill will take critical steps to address the epidemic of senior449loneliness by promoting key programs specifically designed to450support seniors.451    Additionally, the requirement to direct the Secretary of452HHS to focus on the importance of multi-generational453relationships to mental health and loneliness is incredibly454significant. Argentum is also pleased to support House455Resolution 1812, the Care Across Generations Act, a bipartisan456bill that will create opportunities for intergenerational457connection through the establishment of a grant program for458assisted living and long-term care settings to co-locate a459childcare facility with the senior community.460    We believe the benefits to both seniors and children will461be invaluable, and I can speak firsthand to the value of462intergenerational programs, whether it is the experiences my463children have shared volunteering in a senior living community,464or through stories told to me by my wife about one of her first465jobs working in a preschool adjacent to an assisted living466community.467    Then there is the benefits of pet therapy, when Buttercup468and Sugarplum, two golden retrievers, visit a memory care469center in Maryland and bring the room and residence to life. Or470the impact of music therapy on Mary, a lifelong Beatles fan who471today is often non-verbal until "Let It Be" starts playing and472she is quickly leading the room in song.473    The World War II veteran who became isolated after losing474mobility, but after moving into a community, making friends,475and accessing physical therapy received a new lease on life.476While these are just a few stories I can share today, these477stories are commonplace in our communities.478    Mr. Chairman, thank you for the hearing and for taking the479first steps to break the cycle of loneliness, and we look480forward to working with you and the Committee on this and other481critical issues.482    The Chairman. Thank you, and thank you for what your483companies do for seniors. Now, I would like to welcome Suzanne484McCormick. She is the President and CEO of YMCA of the USA, the485National Resource Office for the Y.486    Everyone of course knows the YMCA, operating in 10,000487communities across all 50 states, D.C., and Puerto Rico. The488YMCA is a key community partner in combating senior loneliness.489Thanks for being here today and we look forward to your490testimony.491492           STATEMENT OF SUZANNE MCCORMICK, PRESIDENT493            AND CEO, YMCA OF THE USA, TAMPA, FLORIDA494495    Ms. McCormick. Chairman Scott, Ranking Member Gillibrand,496and other distinguished members of the Committee, I want to497thank you for inviting me today. I am here representing the4982,600 YMCAs, which serve 10,000 communities across our country.499I am grateful for the opportunity to share the story of how500they connect and support our older adults every day.501    At the Y, our mission is to strengthen communities by502connecting people of all ages, abilities, and backgrounds to503their potential, their purpose, and each other. This has been504at the core of who we are for 175 years, but today we know that505so many people are struggling to make these life-changing506connections, especially our seniors.507    Forty percent of adults say they feel lonely sometimes or508even more than that, and the mortality rate of being socially509disconnected is similar to the impact of smoking 15 cigarettes510a day, which is greater than the impact associated with obesity511and inactivity.512    The health risks for our older adults are heightened even513more because they are more likely to feel isolated and514disconnected than younger Americans. A bright spot, however, at515the Y, older adults find the support and meaningful516relationships they need to feel connected and healthy.517    YMCAs engage 17 million Americans every year, and nearly518four million are over age 55, and five million are over 65.519Seniors make up one-quarter of our members. A few years ago,520the Y partnered with NORC at the University of Chicago to find521out if older adults report better quality of life and social522connectedness when they visit our facilities and participate in523our programs. Results of this study showed significant524increases in overall well-being and social connectedness.525    They also showed a decrease in loneliness and improvements526in social well-being, spiritual well-being, physical health,527and mental health. The results were even better for older528adults who were able to engage more frequently in their Y.529    Our programs not only help participants build friendships530and connections that we all need to thrive, but they also help531prevent, delay, or control chronic disease. Thanks to a 20--532year partnership with CDC, the Y is the leading in-person533provider of evidence-based chronic disease prevention and534management programs, which address issues like diabetes,535hypertension, arthritis, falls, and cancer.536    These programs have been proven to improve health outcomes537and quality of life, and they often save health care dollars.538In fact, The Y is recognized for its work with the Centers for539Medicare and Medicaid Innovation.540    During a national study of 8,000 Medicare recipients, the541YMCA's Diabetes Prevention Program saved $2,650 per542participant, while preventing or delaying diabetes among the543majority of participants. The Y is also the leading provider of544Medicare Advantage fitness benefits, larger than the next seven545providers combined, but for as much as we are able to546accomplish on our own because of our national scale and547community level credibility, the Y is always looking to548maximize our impact through partnerships. In communities across549the country, YMCAs collaborate with partners like senior550centers, libraries, and places of worship to reach and engage551more seniors. The Y looks forward to also partnering with the552    Select Committee on Aging to improve both physical and553emotional well-being of our Nation's older adults.554    We urge Congress to continue supporting the highest level555of funding for the CDC, to help the Y innovate our evidence-556based chronic disease prevention and control programs, to557uphold Medicare Advantage's ability to offer supplemental558benefits like fitness and socialization opportunities and559enable Medicaid to help low-income seniors improve their560physical and mental health by helping them access the Y and our561evidence-based programs.562    Every dollar invested in community-based organizations like563YMCAs, organizations that are trusted and have on the ground564credibility, pays a dividend in the form of improved health and565wellness, especially for our older adults.566    There are a thousand stories I could share but I will leave567you with just a few. There is Pam from Palm Harbor, Florida.568Her husband passed away, she lost her home in a hurricane, and569she has become a caregiver for her adult son. She called it the570darkest period of her life and said she didn't even want to get571out of bed in the morning. At the Y, she found friendly people572and opportunities to engage and get active. She says it is the573best thing she has ever done for herself.574    In Phoenix, 86-year-old Gloria has a new bestie. That is575what she calls Lisa, a volunteer with the Y's Outreach Program576for Aging Seniors. Each week they go grocery shopping, they get577their hair done, and they have lunch together. Gloria says this578relationship helps her stay active and feel young.579    Lastly, serving so many older adults creates employment580opportunities for them as well. Althea and Oscar, both in their58180's, work part time at their Y. She works at the front desk.582He is a greeter who gives tours and manages the coffee bar.583These jobs, they say, help them find fulfillment and purpose in584their lives.585    On a personal note, I have had the great privilege of586meeting three Y members who bragged to me about celebrating587their 100th birthday with friends and family at their local Y,588their Y in Athens, Georgia, Kansas City, Missouri, and589Anchorage, Alaska.590    It still warms my heart to remember the joy on their faces591when they told me all their friends who turned out to celebrate592with them at their Y. This is the magic of creating places,593experiences, and opportunities for people to genuinely connect594with each other. This is the magic of the Y. This is the magic595our seniors need more than ever.596    In closing, there are YMCAs in every state represented by597the members of this Committee that are helping older adults598stay engaged and healthy every day. I would be happy to share599examples and submit them as part of the record today.600    Again, Y's across the country want to be your partner.601Thank you for the opportunity today and thank you for your602leadership.603    The Chairman. Thank you. We will take those and put them in604the record.605    Ms. McCormick. Thank you.606    The Chairman. Without objection, and thank you for being607here. Next, I would like to recognize Ranking Member Gillibrand608to introduce the next witness.609    Senator Gillibrand. I would like to give Senator Warnock610the privilege since she is from Georgia.611    Senator Warnock. Thank you, Ranking Member Gillibrand.612Thank you, Chair Scott, so grateful that we are hosting this613hearing today on such an important issue, this issue of614loneliness.615    I look forward to our continued partnership and work,616including by passing the SENIOR Act, to address this issue, but617while I am working in the Senate to improve access to these618programs, I am in awe of how Georgians back home are stepping619up every day to serve their communities.620    Grateful for the work that we get to do here, but it is621really the folks on the ground who are the tip of the spear, so622today I am so very proud to introduce a Georgian, Ms. Tori623Strawter-Tanks. Tori has served as Director of Clayton County624Senior Services for the past 12 years.625    As Director, Tori oversees five centers and manages the626Clayton County aging program, which provides essential services627to seniors, including home-delivered meals and transportation.628    Beyond her role in Clayton County, she is the President and629Founder of the Georgia Association of Senior Centers, so as630someone who has long been committed to this work, Tori thank631you for the work that you do every day for seniors all across632our state but particularly in Clayton County.633    We are all very, very grateful that you are here today to634share your experience and your perspective.635636          STATEMENT OF TORI STRAWTER-TANKS, DIRECTOR,637638                 CLAYTON COUNTY SENIOR SERVICES639640                 DEPARTMENT, JONESBORO, GEORGIA641642    Ms. Strawter-Tanks. Thank you so much for that643introduction. Thank you for the opportunity to speak before you644today. I am Tori Strawter-Tanks, and I have the privilege of645serving as Director of Senior Services in Clayton County,646Georgia, and as Senator Warnock said, I am the President of the647Georgia Association of Senior Centers.648    I am honored to be here today to discuss a critical issue649facing older adults across the country, social isolation and650the vital role senior centers and other aging programs play in651combating it.652    Senior centers are hubs of a high-impact exercise, cultural653engagement, physical wellness, and lifelong learning. The Older654Americans Act, it contributes funding to senior centers and655other important aging services.656    Protecting that funding is critical to ensuring that older657adults continue to have access to the services that I have658spent over half of my life carrying out. Across Georgia and659throughout the Nation, senior centers provide vital programs660that enhance the lives of older adults, keeping them socially661engaged and supporting their overall well-being.662    These programs include health, wellness, aquatic,663technology, fitness classes, lifelong learning, theatrical664productions, cultural arts programs, trips, and also evidence-665based programs.666    These programs play a vital role in improving seniors'667physical health, reducing fall risk, preventing chronic668disease, enhancing mental well-being, fostering creativity,669promoting social engagement, strengthening community670connections, and bridging the generational digital divide.671    At Frank Bailey Senior Center in Riverdale, Georgia, we saw672firsthand the extraordinary potential of older adults when Ms.673Dorothy Steele who started acting at the age of 80. Ms. Steel,674she took the stage, and she was a Hollywood sensation. She went675on to become a Hollywood sensation, starring as a tribal elder676in Marvel's Black Panther and Black Panther 2, Wakanda Forever,677proving that dreams do not have expiration dates.678    Ms. Steel has appeared in several other movies. You can679Google her to see her entire amazing body of work. Her story is680a testament to the power of senior centers to unlock potential681and rewrite the narrative of aging. Another essential service682that senior centers provide is congregate meals.683    For many older adults, these meals aren't just about food,684you see. They are about connection, dignity, and community.685Congregate meals ensure that seniors receive balanced,686nutritious food, reducing the risk of malnutrition and diet-687related illnesses. They combat isolation by providing688opportunities for older adults to gather, talk, and form689meaningful relationships.690    For some seniors, this may be the only hot meal they691receive in a day. Without adequate funding for congregate meal692programs, like these provided by the Older Americans Act, too693many older adults risk going hungry or becoming further694isolated. Along the same line, home-delivered meals also695provide nutritious food, social interaction, and wellness696checks for older adults who may not be able to leave their697homes.698    These services are especially critical for those who are699aging alone without family or other community support.700Additionally, transportation services provided through701assistance from federal funding help seniors to get to their702medical appointments, buy fresh and healthy foods at the703grocery store, and to see their friends, rather than being704isolated at home because they are not able to drive.705    Beyond their social and emotional benefits, senior centers706and other aging programs save our economy billions of dollars707annually. Research has shown that healthy, active seniors who708participate in community-based programs reduce healthcare costs709significantly, both for themselves and for taxpayers, and you710know what? We cannot begin to overlook the sandwich generation.711    These are those that are caring for aging parents while712supporting their children. As the senior population grows,713working caregivers face mounting financial, emotional, and714logistical challenges. When older adults stay active, healthy,715and engaged, it eases the burden on their families. Without716proper investment in senior centers and community-based717services, caregiving falls heavily on adult children already718juggling careers, finances, and family life.719    Access to social engagement, nutritious meals, health720programs, and transportation supports not just seniors, but721their families. It impacts workforce retention and the economy.722Yet despite their proven benefits, senior centers remain723underfunded, leaving many older adults struggling with barriers724like transportation, awareness, and the lack of investment.725    If we are really serious about combating senior isolation726and improving public health, we must, one, expand funding for727senior centers and other aging services. Improve transportation728access, especially to those in rural areas so older adults can729actively participate in community life.730    Strength in digital inclusion for seniors so they can stay731connected in a technology-driven world. Recognize senior732centers--I am going to say this one more time. Recognize senior733centers as essential infrastructures to support aging in place,734health, and well-being. Invest in meal programs to fight food735insecurity, combat isolation, and promote nutrition for older736adults.737    Support caregivers by ensuring seniors have access to738services that promote independence. Social isolation is not739just an individual problem. It is a public health crisis with740consequences as severe as smoking and obesity, but senior741centers and programs like congregate and home delivery meals742offer a proven solution, helping older adults not only stay743socially engaged but thrive in ways they never imagined.744    When we invest in senior centers, when we invest in senior745centers, we are not just enriching lives. We are saving money,746we are strengthening families, we are supporting working747caregivers and ensuring a better future for generations to748come. Thank you for your time and commitment to this issue. I749look forward to your questions and to working together to build750a stronger and more connected future for our Nation's seniors.751    The Chairman. Thank you, Ms. Strawter-Tanks, and thanks for752what you do.753    Senior centers down in Florida, and they are fun to go754visit, so there is a lot of action. Now, we will go to755questions. Let's start with Senator Moody.756    Senator Moody. Thank you Senator Scott and Ranking Member757Gillibrand. We appreciate you holding this hearing. I think758that the two of you in charge, I don't know that we have ever759seen so much activity on this Committee.760    I love it. It has been--protecting seniors within the State761of Florida, certainly while I was the Attorney General in the762State of Florida and growing up with a mother who dedicated her763entire career to helping seniors, low--income seniors. This is764an important committee, and this is an important hearing.765    I appreciate all of you taking time to be here. Certainly,766it is nice to see not only our sister state and neighbor state767people from Georgia, but from Florida as well. It was so nice768to see Ms. McCormick from Tampa Bay, which is my home.769    It is great to see a friendly face being here only a little770over a month. I crave folks from the Sunshine State coming up771here, and I remind them when I left and came up from the772Sunshine State, so much leadership came up here to Washington773that it snowed in Florida.774    It was crazy, but this is a great hearing, and certainly775the leadership of Senator Scott does not go unnoticed. He has776always been one to dig into the details of really complex777problems and I have always admired that about him, not only as778the Governor of Florida, but certainly as a Senator.779    What is remarkable to me is hearing from each of you--and780each of you pointed out very significant ways we could address781isolation of seniors, improve the health of seniors, and it782touched a lot on funding. Protecting funding, certainly783important. All of us on this Committee understand that, but784additional funding.785    I know that so many of us, whether you are on the786Republican side of the aisle or the Democratic side of the787aisle, so many of us I take very seriously this responsibility788we have to make sure that the fiscal health of this Nation789isn't driven right off a cliff.790    We have been seeing so much of that in the last few years791with pandemic spending never returning to normalcy. We ramped792it up during a time of emergency and was never backed off, and793so, many of us are struggling with, OK, we have got to face the794reality of we have very limited taxpayer funds to work with,795and as I am hearing from each of you, the answer is, in many796respects--one of your answers, I don't want to limit it to797that, is funding, and what I have been so interested in--and798yes, I understand that, and I am glad that you are here, and I799am glad you are advocating for that.800    What I have seen work so well throughout communities,801including with organizations like the Y and others, if they802have identified ways to combat problems that might not be803asking for more money.804    For example, I have seen--I heard about putting daycares,805and I know that is attached to a grant, but the idea of putting806a daycare within a senior living community and what that might807do just by being creative and thinking outside the box and808planning programs that put these two together in a way that809might benefit both.810    I have seen high school seniors around the Nation come up811with community service projects. Number one, to satisfy812graduation rates, but also it looks really good to colleges813when you are applying and showing what you do that are creating814programs to volunteer with seniors, and programs to help them815cleanup, or help take them places, or volunteer at senior816community centers.817    I think that not only helps the seniors and addresses818isolation among our seniors, but I think in a young person's819world where they are seeking validation, and inspiration, and820teachings, and modeling through an empty influence of social821media, I think it is so great that they are now spending time822with people who have lived a life and experienced the great823joys of life, and the tribulations and challenges of life, and824maybe have overcome them, or can warn about downfalls or risks.825    I think there is a mutually beneficial thing there too, and826I will start with you, Ms. McCormick. Are there any programs827like that, that the Y is fostering, that may not be asking for828large amounts of money, but that are facilitating the829communication or the creation of these outside the box programs830so that both age groups, young and old, benefit?831    Ms. McCormick. Without question. I do appreciate it, it832does feel often when any of us come to Washington, all we are833asking for is money. I think one of the things I would like to834highlight as an example is in our universe of Ys, one of our835strategies to increase services is through partnerships, and836often through public-private partnerships.837    We see many more YMCAs around the country finding private838partners, often their healthcare providers, to come into their839space and serve clients together, so leveraging resources that840exist in the community outside of Government funding.841    I think that is something that we have to continue to push842for, and we definitely see that in regards to serving seniors.843The other nugget I heard in your comments is community service,844and without question, we are an organization that is built on845volunteerism.846    The ability to bring volunteers in to deliver--but, you847know, it is a balance, and I think that is what we are all848striving for is how--what is the way that we can all contribute849something so that we can leverage our gifts and what we can850bring to achieve shared outcomes.851    Senator Moody. Thank you, Chairman.852    The Chairman. Thank you, Senator Moody. Now, I would like853to recognize Ranking Member Gillibrand.854    Senator Gillibrand. Thank you, Mr. Chairman. I really855appreciate everyone's testimony. Thank you so much for being856experts in this and caring so much about our older adults. I857really, really appreciate it.858    Ms. Strawter-Tanks, the goal--first of all, thank you so859much for being here and testifying. In your testimony, you860mentioned that you run various senior centers which are the861setting for the congregate meals.862    Can you describe the ways congregate meals have improved863the health of and reduced social isolation for older adults in864your centers? And where do you get your funding for congregate865meals, and are there any innovative ways to fund congregate866meals that you have thought of?867    Ms. Strawter-Tanks. Yes, so inside of our senior centers,868we offer congregate meals, and right now, our congregate meal869program is funded through the Older Americans Act funding, and870our seniors, they come--they also receive transportation to get871to our centers to get congregate meals.872    Right now we are exploring ways that we can come up with873better ideas to provide meals to them because we have faced874issues where funding has been cut. Our county is an amazing875county and our county supplements our congregate meal programs876whenever there are cuts or fluctuations with the budget.877    Right now we are just really exploring how we can be878prepared in case something happens where we can't provide those879congregate meals, but our congregate meal clients, they come to880our center, and they also receive some form of case management881where our staff is actually meeting with them, and talking to882them, and finding out what their needs are, because sometimes883it is a little bit more than just the meal, but we do know that884the meal is really important for our clients that come for885congregate meals.886    Senator Gillibrand. Can you--would you imagine if we asked887people who are on SNAP benefits if you could use your EBT card888to pay for congregate meals? Do you think that would be a889useful opportunity for settings that offer it?890    Ms. Strawter-Tanks. I think that would be an amazing891setting, especially in our side of our senior centers. Our892senior centers have full cafeterias where we have a contract893with, you know, local restaurants.894    I think that would be a really great benefit if we could895have that because some of our seniors do not qualify for896congregate meals, and so, they do have to pay for their meals,897but again, Clayton County does an amazing job with our senior898centers.899    Our senior centers are not underfunded. They are actually900funded very well. However, our meal program is kind of901underfunded because we need more funds to provide services to902those seniors who need meals.903    Senator Gillibrand. Then, you know, in New York, we have so904many good--in God's Love We Deliver, we have Meals on Wheels,905we have all these different types of organizations that are906willing to bring homebound seniors a cooked meal at least once907or twice a week.908    What we have heard is that that sometimes is the only909person who has visited them all week. It is the only person who910checks in on them to make sure they are okay, taking their911medicine, having heat on in the apartment. What is your912experience with home delivery of meals, and why is that913important for your constituencies?914    Ms. Strawter-Tanks. Home delivered meals are so important.915It is even greater than just that human contact. When the Meals916on Wheels driver comes to the door, all of our seniors who917receive home delivered meals also receive case management.918    Again, someone is actually talking to them, finding out919what their need is. Talking to them about are they having920issues with falling, do they need more than a meal, and just921connecting them with resources.922    It starts there. Once a Meals on Wheels driver is assigned923to that senior, that Meals on Wheels driver is actually924checking on them to make sure that everything is OK with the925senior as well, and then in our county, we also do things926around the holidays. We take Christmas food to them.927    We take turkeys to them. It is truly a collaboration of the928community and our county. We pull together to make sure that929those home delivered meal clients have everything that they930need socially and beyond the meal.931    Senator Gillibrand. Ms. McCormick, do you have a932perspective on either of those two questions?933    Ms. McCormick. I was just thinking as I was hearing you934talk, I was recalling a visit that I made to Buffalo, New York,935actually, and it was--it was on Halloween, and they did a936congregate meal lunch on the gym floor of one of the Y's there937in Buffalo in a historically underserved community, and it was938packed.939    In addition to the food, which I went and met with the940staff, and I heard it is--when I went to meet with the staff941and I heard the benefits are always two-fold. It is nutritional942you know, first and foremost, but it is also the ability to943bring seniors together in a setting where they can be with each944other, where they can make friends.945    In this particular forum, they had an opportunity to meet946with at least four of their public elected officials to talk947about what was going on in the city of Buffalo, so I think it948is always two-fold. It is always about nutrition and making949sure that that the health aspect, physical health is being met,950but as importantly, it is always about the social wellness that951congregate feeding--or it is not feeding, it is congregate952dining because it is usually a very festive atmosphere, so I953think, you know, we see that too in the Y.954    Senator Gillibrand. Thank you. Thank you both. Thank you955all.956    The Chairman. Senator Justice.957    Senator Justice. Thank you, Mr. Chairman. I haven't had the958opportunity to be here, you know, with different committees959that we had to go to and everything, and I didn't hear your960testimonies. I just caught the tail end of yours. It was great961and everything, but I would like to say just this.962    You know, I am one of the new kids on the block. You know,963I am a new kid that came here with white hair, and if you show964up with white and you are a new kid, you are here for a reason965other than just maybe some self-satisfying reason for yourself.966You see, I don't want anything. I don't want a thing, but I can967tell you what I really do want beyond anything for myself is I968want to do goodness.969    I want to do goodness absolutely for everybody that I can970possibly touch. I meet up with being a patriot, but I would971read just this, "breaking the cycle of senior loneliness,972strengthening family and community support." I am going to tell973you just this, in my State of West Virginia, you see plenty of974loneliness.975    I don't know how it gets any worse. That is all there is to976it. Let me just say just this and then I will ask a couple of977real quick questions. Again, to me, our seniors need so much978more than just contact with their seniors.979    You know, at the end of the day, they need kids involved.980They need animals involved--dogs. They absolutely need to be981able to give of their wisdom. You see, there is so many out982there that really want their wisdom, and they want to give it983so bad it is unbelievable because they want to feel worth,984worth in what they are doing.985    You know, we can have lots and lots of meetings, and we can986try to move the ball, but I am telling you just this from the987bottom of my heart, if you are speaking of loneliness and you988are speaking of our seniors, we have got to do a lot more. We989have got to do a lot more than we are doing.990    We can absolutely, and I hate to say this in any way, but991we can just call them seniors. You are a senior. You are a992senior. For God's sake the living, I am a senior, and before993you know it, we have become almost labeled or pigeonholed. I am994not a senior. I am Jim Justice.995    They are individuals, and they should be loved and996cherished in every single way, and we should be trying to help997in every way. For God's sake the living, they have given us998everything, everything, and they still stand ready to give us999more.1000    Again, I didn't hear your testimony. I can ask you a1001question like, you know, all the things we hear about, whether1002it be the phones, or the internet, and everything we hear1003negative about it, can we use that in a way to really help us1004do better? And the last thing I will tell you is just this, and1005I will open up to you and let any of you that wants to answer1006the question to answer it.1007    I would say to all of us, to all of us, to our Ranking1008Member, to this great Chairman, to all those that are on this1009Committee that have come and gone and everything, I would say,1010net--net, we better get at it doing more, because we are1011losing, we are losing our knowledge, and for crying out loud,1012our seniors, that I wish to goodness we didn't even use that1013name, but our seniors are really wanting to give to all of us.1014    They have already given so much. I say this in the military1015over and over, but our military of all, of all, they absolutely1016give so much and ask so little. They have done it, and done it,1017and done it. We have got to do something about it, so anyway,1018you don't have to answer my questions because I didn't hear1019your testimony, so anyway, but I love you for being here. Thank1020you so much.1021    The Chairman. Thank you, Senator Justice. Mr. MacPherson,1022we know that criminals prey on lonely seniors, making them more1023susceptible to fraud and scams. Can you speak to the connection1024between social isolation and the increased risk of being1025targeted or falling victim to scams?1026    Mr. MacPherson. Yes. Mr. Chairman, thank you for the1027question, and it is a significant issue in this country.1028Studies show that socially isolated seniors are twice as likely1029to fall victim to scams compared to those with more regular1030social connections, and that is why holding this hearing is so1031critically important here in the U.S. Senate.1032    Loneliness is linked to 40 percent increased risk of1033cognitive decline, as we know, which leads older adults to be1034more susceptible in this country. I do want to go back to the1035Older Americans Act. You know, a fraction of the federal1036budget. It adds a pretty--fairly small amount of money but1037high-impact dollars.1038    A critically important component of the Older Americans1039Act, of course, is focusing on elder abuse and protecting our1040seniors, so we want to make sure that we continue that funding.1041That we reauthorize the Older Americans Act. I also think, you1042know, the previous Surgeon General, Dr. Vivek Murthy, really1043took this issue on, and released a report in 2023 that our1044organization was very much involved with.1045    We sort of--he put an idea forward that we should have1046connection in all policies, right, so whether it be healthcare1047policy, whether it be labor, pick your poison, we need to1048infuse connection in everything that we are doing in this1049country, and Senator Justice, that is the only way that we are1050going to have a comprehensive solution to a very complex1051problem.1052    Thank you for the question, Mr. Chairman.1053    The Chairman. Thank you. Mr. Balda, sort of like our three1054states, has a huge senior population, so naturally, there are1055larger amounts of senior living communities. What is one clear1056link between senior living communities and healthy aging?1057    Mr. Balda. Thank you for that question, Mr. Chairman. When1058you think about what goes on in our buildings, at its heart, it1059is the social determinants of health. It is nutrition. It is1060physical activity. It is mental and cognitive activity. It is1061socialization.1062    It is all of those twenty-four hours a day, seven days a1063week, and that has enormous benefit to the health outcomes of1064the residents that live in our buildings. A study done by NORC,1065you had mentioned NORC earlier, took a look at the frailty of1066individuals right before they moved into our communities, and1067right after they moved into our communities, and then over a1068period of time.1069    What they found was right before they moved in, they were1070on a decline, and that persisted for a short period of time1071after they moved in, but then it leveled off and over the next1072several months it started to improve in terms of their frailty,1073and that is because of the activity and the engagements we do1074on a regular basis.1075    I think the issue we need to figure out, and there were1076questions earlier about, you know, funding and such, we are1077predominantly a private pay model, and I think as a country we1078need to figure out how to help more seniors access that model,1079whether it is in the four walls of our building or it is in1080their own private residence.1081    We think a lot about what we call sort of the forgotten1082middle of seniors in this country, the seniors that don't1083qualify for Medicaid and might not quite be able to pay for the1084current assisted living product, and we estimate that there is1085going to be more than 16 million of those in the coming1086decades.1087    How are they going to get the care and the services they1088need? How are they going to get access to the nutrition and the1089physical activity? And we think there is a lot that we can do1090to support that. We just need to be able to identify a model1091that is actually affordable for those individuals. There is1092also the concern that we have about the workforce in the long1093term and who is going to care for all of these seniors.1094    We have proven that our model works. It saves Medicare1095money. It saves Medicaid money, and I think there is much more1096that we can do to get those types of services and supports to1097more seniors in the country.1098    The Chairman. Thank you. Ms. McCormick, with your1099experience being President of YMCA, what real life instances of1100physical health linking to mental health and reducing1101loneliness among seniors have you seen?1102    Ms. McCormick. Well, I will share a Tampa example with you,1103because we have already had the Florida love today. You know,1104it is very hard not to see the connection when you go into a Y.1105The seniors that I encountered have such a vibrancy and energy1106to them.1107    One of the first people I met when I took this job, which1108was about three and a half years ago, he reached out to me on1109LinkedIn. His name is Danny Ferry. He is a retired Army1110veteran, and he has been--he had been actively participating in1111the Y in a swim program to rehabilitate a knee injury, and so,1112his initial engagement with the Y was around a health benefit.1113    He fell in love with the sense of belonging that it offered1114him. It gave him a place to go and feel like he could make1115friends. He has become an Uber volunteer with the Y. We held a1116large national fundraising conference down in Tampa about three1117years ago, and every day he was there dressed as a pirate with1118a parrot on his shoulder, serving as a greeter and giving1119directions.1120    He continues to reach out to me and tells me that the Y1121gave him a second chance after having just an incredible career1122in the Army and then transitioning out. He now has a sense of1123purpose.1124    What I see every time I go into a Y, we see seniors who1125come in potentially with the goal of working on their health or1126their physical activity, those are often the same thing, but1127the added benefit from their participation is that they are1128seen as people, and they make friends, and they have a joyful1129time, and those two things go hand in hand in almost every case1130I have seen.1131    I could tell you story after story of seniors. Walk into a1132Y. At around 10:30 a.m., they will either be in the pool1133exercising as a group, they will either be doing chair1134aerobics, or they will be socializing around the coffee clutch1135after they are done with their activities.1136    Sometimes it is hard to get them out of the Y just because1137they want to stay. We have our own version of a senior center1138some days.1139    The Chairman. Give me some--what are some of your important1140programs you think impact seniors?1141    Ms. McCormick. Some of our chronic disease prevention1142programs. We have programs that focus on arthritis mitigation.1143Diabetes prevention is one of our strongest signature programs.1144We have incredible results in that program. We have blood1145pressure self-monitoring program.1146    We have a cancer survivorship program, and we also have1147many wives who participate in falls prevention training with1148seniors, so it really covers the gamut of chronic disease--you1149know, the whole portfolio of chronic diseases many Ys are1150participating in, and I would say almost every Y in Florida is1151very engaged in that work.1152    The Chairman. Ms. Strawter-Tanks, can you give me some1153stories of how the seniors' activity in one of your centers is1154impacting--reduce the cost of Medicare and Medicaid?1155    Ms. Strawter-Tanks. Yes, so inside our senior centers, we1156have wonderful opportunities. The average age of our staff1157inside our senior centers is around 50 or 55, so seniors1158actually come to our centers looking for social engagement,1159looking for a meal, and some of them actually receive1160employment opportunities inside our senior centers. All of our1161exercise programs inside our seniors--are high impact, which1162actually improves their quality of life.1163    We do fall prevention classes. We do evidence-based1164classes. We do--it is a whole gambit of different activities1165and programs that we provide to keep seniors socially engaged1166and to improve the quality of life and their health.1167    The Chairman. Mr. MacPherson, what can we do to strengthen1168community ties and protect seniors from these bad actors?1169    Mr. MacPherson. There is a lot we can do. You know, the1170community-based interventions that we have heard some of them1171here today are just critically important. I think we need to1172take a settings approach, Mr. Chairman, to this issue, whether1173you are talking about health centers, community centers,1174housing, schools, workplaces, places of worship.1175    Our 130 policy recommendations that we have, that we just1176released today, addresses all of those settings, and ideas for1177the Federal Government, but also states, to invest in a--as I1178said, a comprehensive approach to a really challenging problem.1179Again, going back to the Older Americans Act.1180    It is just critically important that we protect that1181funding, expand that funding. It is a drop in the bucket in the1182federal budget that has an outsized impact on seniors across1183the country. The last thing I will say is that we have touched1184on intergenerational today, but I think it is worth emphasizing1185that.1186    Ranking Member Gillibrand, you have an extraordinary1187program in your state, DOROT, which is a member of our Steering1188Committee, that receives funding from the Older Americans Act1189and private sources as well, that has a whole range of1190intergenerational programming. That has been very successful in1191not just addressing social isolation and loneliness, but also1192addressing the well-being of the communities that they serve.1193    This is a complex issue, and there is a lot of different1194ways to address it. At the Foundation for Social Connection1195Action Network, again, we have got almost 70 national1196organizations involved in our work to come together to find a1197whole range of solutions, so thank you for the question.1198    The Chairman. If you have had 20 years of work in the1199healthcare policy space, what do you think is the most1200effective, or one of the most effective, I am sure there is a1201lot, of initiatives that combat loneliness among seniors?1202    Mr. MacPherson. I really appreciate that question. 201203years. Look----1204    The Chairman. Is that true?1205    Mr. MacPherson. It is true. Thank you for saying that. My1206hairline said it.1207    The Chairman. At least you have some.1208    Mr. MacPherson. You know, I will say raising the visibility1209of this issue is the most important aspect from my perspective,1210and this hearing is a critically important way to do that.1211Look, there is still a lot of stigma in this country around1212being socially isolated and, or lonely.1213    The way that we break down those barriers and allow people1214to be more connected at a very fundamental level is to talk1215about it, so, that is number one. Number two, as I said the1216former Surgeon General I think did an extraordinary job in1217raising the visibility of this issue and releasing a number of1218really thoughtful reports.1219    Went all over the country and talked about this. I will1220give you some more specifics though in health care policy, Mr.1221Chairman. Medicare Advantage--in 2018 Congress passed the1222Chronic Act, okay, and the Chronic Act was widely bipartisan,1223and what it did was allow Medicare Advantage plans in1224supplemental benefits to offer non-medical benefits.1225    Things like nutrition services, home-based palliative care,1226non-emergency transportation. If I think back over, you know,122720 years of doing this work, that was critically important--as1228Medicare Advantage was growing in the program, it was1229critically important that Congress gave them, and the Trump1230Administration at the time as well, gave the plans the1231opportunity to provide benefits that were non-medical in1232nature.1233    We would love to see that expanded. We would love to see1234hearing reimbursement, for example, for hearing devices and1235hearing moved into original Medicare, which would create more1236space in supplemental benefits for more non-medical approaches.1237    Those are just some samples--examples, Mr. Chairman, of1238things that I have seen over the years I think have been really1239impactful.1240    The Chairman. Do you think the SENIOR Acts would help1241groups that you work with fight loneliness?1242    Mr. MacPherson. I mean, look, absolutely, so the previous1243reauthorization of the Older Americans Act in 2020 included the1244word--added, I should say, the word social isolation. This is1245before the pandemic, by the way. Added the word social1246isolation to the Older Americans Act and attached about $2501247million for the--for ACL to implement programming.1248    That programming was wildly successful, and I would argue1249saved the Federal Government money. By adding loneliness, Mr.1250Chairman, that allows the resources in the Older Americans Act1251and senior centers, nutrition programs, etcetera, to direct1252funding at the public health epidemic crisis, so we are 1001253percent supportive. We are excited to advocate for it and get1254more co--sponsors, and we are eager to see it pass the1255Congress.1256    The Chairman. Ranking Member Gillibrand, do you have some1257questions?1258    Senator Gillibrand. Mr. Balda, can you talk a little bit1259about the role that insurance companies play in helping our1260seniors? Can you talk a little bit about what do you feel1261health care companies could do to help communities congregate1262care settings, ensure older adults are less isolated, and1263address maybe any of the issues we have been talking about from1264the insurance perspective?1265    Mr. Balda. Sure, absolutely, and thank you for the1266question, and unfortunately, over the last several years, we1267have seen the long-term care insurance market decline.1268    I think if there is a way for us to determine how to shore1269that market up so that more people can have access to long-term1270care insurance policies, that can help support the isolation1271issue in the long term in terms of giving them access to1272supports and services, whether it is in their private residence1273or whether it is in one of our communities.1274    I think programs like the YMCA have in terms of getting1275physical engagement for those that live outside of our settings1276and are supported through Medicare Advantage plans and things1277of that sort are incredibly helpful. Our communities already1278offer a lot of that just directly within their four walls in1279terms of activities in our pools, and activities in our gym1280centers, and yoga for seniors and such.1281    Anything insurance companies can do to offer supports and1282services, like the Silver Sneakers program is one example,1283would be incredibly helpful, but I really think figuring out a1284way to shore up the long-term care insurance market would be1285incredibly helpful so that people can access those supports and1286services in any setting.1287    Senator Gillibrand. Thank you. Mr. MacPherson, you touched1288upon intergenerational programs to reduce loneliness. Can you1289talk about which ones are most effective, what makes them1290effective, how they are funded, and what suggestions you have1291for this Committee?1292    Mr. MacPherson. They are funded from a whole range of1293sources, but as I said, the Older Americans Act is a critical1294source of funding.1295    You know, they really run the gamut. I would love to submit1296for the record some case studies, Senator Gillibrand, of some1297of the most effective programming and meet with your staff1298about that and kind of walk you through it.1299    I know that DOROT, for example, has the Genuine Connections1300Program, which is actually a virtual volunteer program for1301teens and adults over the age of 65, where they run workshops1302through Zoom and have social connectivity through that. Chess,1303art, etcetera. I am the son of a hospice volunteer.1304    I think that the hospice volunteer model could be a very1305effective way--that we have in communities across the country,1306could be a very effective way to address social isolation and1307loneliness, not just for seniors, but also for younger1308populations as well.1309    We have got an infrastructure out there. The question is,1310how do we leverage it in a thoughtful way?1311    Senator Gillibrand. Yes. Well, one of the ideas that my 16-1312year-old son had was--they have 10 hours of public service1313required every year at their school, so we came up with an idea1314that him and his friends would visit the local senior center1315and just spend hours upon hours getting to know different1316seniors and being part of their lives.1317    I also thought about this risk that our seniors fear and1318are subjected to all day long, which is the scams, the digital1319scams, the phone scams, the online scams, you know, clicking1320the wrong button. I think our young people would be so helpful1321in creating digital awareness, digital hygiene for our older1322people because they are so native, and they can explain--1323certainly my sons explain to my mother all the time what not to1324click on and why.1325    I think that could be the future of a great partnership,1326but I do hope you will keep exploring that and we would be1327delighted to receive your testimony and the studies because I1328think that intergenerational connection--a lot of our kids1329during COVID became deeply disconnected.1330    They missed two, three whole years of maturity and1331development, and I think our seniors could help our younger1332people learn how to be more connected and learn how to, you1333know, don't look at your phone, talk to your friend, you know,1334what are you missing in those social interactions.1335    I think the wisdom that our older generation has is1336extremely meaningful, so, I appreciate the work you do there,1337and then last, for Suzanne, I just wanted to ask you one more1338question about falls and social isolation. You know, every1339senior that I have talked to is worried about falling, so they1340buy the best sneakers. They try to take, you know, small steps,1341but they are very afraid to go out when the weathers bad. They1342are afraid--if they have had a fall, they don't want to go out1343at all.1344    I know a lot of older people who won't drive at night, a1345lot of older people who won't engage at all at night, because1346they are afraid of falling, and this is a question for anybody1347actually. If you have any ideas about how do we prevent falls,1348how do we prevent fear, and how do we build confidence and1349allow for social interactions so that they don't--not engage1350because of that fear.1351    Ms. McCormick. Excuse me, thank you for the question. I1352will start by building on something Mr. MacPherson said. I1353think part of the challenge and the opportunity before us is1354awareness about the opportunities to learn about falls1355prevention.1356    In New York State, I am happy to say that we--our YMCAs are1357engaged in a 4-year plan to enroll over 2,500 New Yorkers in1358fall prevention programs, so we have the capability, but we1359have to create greater awareness and reduce the stigma.1360    I think the Y wants to be a helpful partner in being that1361place where seniors feel like it is safe to come. In the summer1362months or the fall months to learn falls prevention so that1363they can continue to come. I do know, like the hard winters in1364the Northeast, but we are making progress in New York.1365    As I said, it is a four-year plan. We have 40 new1366instructors, and they are going to be taking the falls1367prevention program outside of the Y's where seniors are1368meeting, so into senior centers, churches, and other community1369locations.1370    We hope this will prove to be a good model, that we can1371meet seniors where they are. I think that is probably one of1372our great opportunities, not expecting them to come to us, and1373so we look forward to reporting back to you on the work that is1374happening in New York that hopefully can be scaled in--across1375the country.1376    I think it is when we get to seniors, when they participate1377in the program, when they can learn falls prevention, we can1378take that fear away, and then they can engage in ongoing social1379connection activities with other community members.1380    Senator Gillibrand. Thank you. Thank you, Mr. Chairman.1381    The Chairman. Senator Justice.1382    Senator Justice. Well, I will end, and I will end really1383quickly on my part, and Mr. Chairman, thank you, sir, and I1384will just say just this. In West Virginia, we value families1385like you can't imagine, and absolutely, the foundational part1386of our families and our culture is our families. There is no1387question whatsoever.1388    Now, let me just go back just a second and just say just1389this. You know, there was a few years ago that in West1390Virginia--I always called the voters Toby and Edith, and I1391would say just this, and this reflects on loneliness, but let's1392say Aunt Edith wants to have a picnic, and she wants all of her1393grandkids to be there.1394    We were in a situation in West Virginia a few years back1395where to be perfectly honest many, many, many folks left that1396had those kids because they had to go someplace else to find a1397job, and absolutely, if you haven't seen the ramifications of1398loneliness, then you have really missed something because it is1399sadness beyond belief.1400    I really think just this, that we are plenty smart enough1401to solve this riddle. We are not doing enough. We have got to1402go back to what I said just a little while ago. We have got to1403get kids involved. We have got to get dogs involved.1404    We have got to--I mean, for God's sake the living, you just1405think, and many of you probably don't know this, but if you1406know who Babydog is, honest to goodness, I can't tell you the1407number of places that I have gone to senior centers that1408absolutely--they don't care about me being there. They wanted1409Babydog to be there.1410    You know, absolutely, I tell you, we can solve this riddle,1411and all of us--and if we don't, shame on us. All of us should1412be willing to take a blood oath that we are going to fix it. We1413are going to fix this. I mean, there is so much that can be1414done, and absolutely, again, if you have not seen and felt and1415touched loneliness, then absolutely you have been very, very,1416very lucky because it is sadness like you can't imagine, so all1417I would say is just this. My question would be, what can we do?1418What can we do beyond--I mean, I know your answer is going to1419be--you know, it is almost like you go in a restaurant and1420say--you know, the waitress comes over and says, sir, how do1421you like your eggs? Do you like your eggs scrambled or fried?1422And you say, yes, absolutely.1423    In this situation, we have got to say yes to all these1424ways, all these ways to make things better. These people have1425given so much, it is off the chart, and so, I want to listen1426real quickly if anybody on the panel wants to take the1427question.1428    My question would be just centered around, you know, in1429West Virginia, those values are unbelievable. Tell me anything1430and everything you can possibly tell me in a matter of just a1431few seconds that will make it better. Please, any of you.1432    Mr. Balda. Thank you, Senator, for that question and those1433sentiments, and love the idea of pets and just so you know,1434almost all of our communities allow pets. In most cases, either1435the residents have pets or the communities themselves have1436pets, which then become pets for everybody else in the1437building.1438    Senator Justice. Babydoll is not a pet.1439    Mr. Balda. Well, exactly. Fantastic point.1440    Senator Justice. I mean, Babydoll is one of us.1441    Mr. Balda. They bring any, any animal, right. It brings1442life to the entire community, and it is things like that, and1443it is things like music therapy, and it is the1444intergenerational, you know, connections that we have been1445talking about, and I think there is not a single solution to1446this crisis.1447    I think there is elements of a solution among all of us1448here, all serving sort of different parts of the community, and1449learning from each other on what works and what doesn't, I1450think is a tremendous opportunity, and even before we started,1451we were sort of sharing ways to potentially partner with each1452other on some things.1453    Senator Gillibrand, back to your question about falls, you1454know, I think that is a terrible concern for seniors and I see1455it in my loved ones, and I can only tell you, in our1456communities, you know, one of the first things that happens1457when somebody comes in, they go through an assessment.1458    Oftentimes we identify that it has been lack of nutrition,1459lack of exercise. Needs some physical therapy. Oftentimes it is1460medication, on too many medications, and having to adjust that1461regimen, but it goes beyond that. It is also the setting in1462which they live, and does it have the right flooring? Does it1463have the appropriate lighting?1464    There is a whole host of those, regardless of whether they1465live in our buildings or others, but I think technology is also1466a crucial role in that as well, in terms of being able to1467identify when somebody has fallen if they live on their own.1468    I can tell you personally, my mom was an hour away from me,1469and she fell, and she sat there until I could come and pick her1470up because she was too proud to call for help, and so, it is a1471terrible need that we need to fill, and we are part of the1472solution, and I think all of us here are part of the solution.1473    I commend you for this hearing and bringing us all together1474to work on it together, so, thank you.1475    Ms. McCormick. Senator, I would respond and say, I think1476that you have heard today--you have heard a lot of tactical1477activities, things that we can do to provide, but I think what1478you have said that has touched me is this is about cultural1479recommitment to a belief in our responsibility to seniors.1480    At the Y, we have four core values. They are caring,1481honesty, respect, and responsibility, and I think this1482Committee is--has a huge opportunity to continue to elevate the1483responsibility that every American has to every American person1484who happens to be over the age of 55 or 60. I won't say older1485adult or seniors.1486    I think it is an opportunity, again, for us to raise1487awareness and recommit to the responsibility that we have for1488those who have lived wonderful lives and still are living1489wonderful lives that we can all learn from.1490    Senator Justice. Well, thank you so much for all you do1491every day. Let's just do more.1492    The Chairman. All right, I want to thank Ranking Member1493Gillibrand for being here. I want to thank my fellow Senators1494for being here. I thank our witnesses and the audience.1495    Yes, I think all of us can picture somebody in our lives1496that, you know, has gone through loneliness, whether it is a1497family member or somebody you have seen along the trail or1498something, and it is tough.1499    It is important that we figure out how to recommit to1500figure out how to get this done. There is some things that the1501private sector can do, or families can do, our friends can do,1502and there is some things Government can do. We have got to1503figure out how to do all those things in a manner that has an1504impact.1505    Thanks everybody for being here. I look forward to1506continuing to work with members across the aisle and down the1507dais on this very important topic. If any Senators have1508additional questions for the witnesses or statements to be1509added, the hearing record will be open until next Wednesday at15105.00 p.m..1511    I want to thank everybody for being here.1512    [Whereupon, at 11:57 a.m., the hearing was adjourned.]15131514=======================================================================15151516                                APPENDIX15171518=======================================================================15191520                      Prepared Witness Statements15211522=======================================================================15231524                 U.S. Senate Special Committee on Aging15251526  "Breaking the Cycle of Senior Loneliness: Strengthening Family and1527                           Community Support"15281529                             March 12, 202515301531                      Prepared Witness Statements15321533                           Andrew MacPherson15341535    Chairman Scott, Ranking Member Gillibrand, and1536distinguished members of the Aging Committee, thank you for the1537opportunity to testify today on the pressing issue of social1538isolation and loneliness among older adults. My name is Andrew1539MacPherson, and I am the Founder and Chairman of the Foundation1540for Social Connection Action Network (F4SC-AN). Since our1541establishment in 2018, our mission has been to create a diverse1542coalition of national organizations, including consumer groups,1543health plans, health care providers, technology innovators, and1544patient advocates, with the goal of developing and advocating1545for federal policy solutions that address the epidemic of1546social isolation and loneliness. Our efforts encompass a wide1547range of activities, from legislative and programmatic advocacy1548to public awareness campaigns that integrate research and1549evidence.1550    The Action Network is honored to have played a role in1551supporting and advising a range of federal policy efforts to1552address the public health crisis of social isolation and1553loneliness, including working directly with members of Congress1554on a bipartisan basis, former U.S. Surgeon General Dr. Vivek1555Murthy, the White House Domestic Policy Council, and leading1556agencies such as the Administration for Community Living as1557well as leading advocates in the field such as the1558Gerontological Society of America and AARP. Over the past seven1559years, we have worked diligently alongside these and other1560influential voices to address loneliness and social isolation,1561striving to make meaningful progress in addressing one of the1562most pressing public health challenges of our time.1563    As this Committee knows, this issue is critical. Before1564sharing key statistics and the reasons behind our work, I want1565to acknowledge and thank you for the tremendous efforts and1566progress in the Senate and House to support older Americans.1567    We strongly support Chairman Scott and Senator Tina Smith1568in their introduction of the Social Engagement and Network1569Initiatives for Older Relief (SENIOR) Act, which aims to reduce1570loneliness by expanding access to community-based initiatives1571that foster social connection. A key element of this1572legislation is the inclusion of the word "loneliness" in the1573definition of "disease prevention and health promotion1574services" under the Older Americans Act. This inclusion1575underscores the critical role social connection plays in1576helping older adults live healthy, independent lives.1577Additionally, this change would increase funding for vital1578gathering places, like senior centers and libraries, where1579older adults can participate in structured social activities1580that build connections. It also supports transportation1581solutions through subsidized ridesharing and shuttle services1582that help older adults stay active in their communities. It1583expands volunteer and peer-support networks, providing older1584adults with meaningful opportunities for mutual aid,1585mentorship, and community engagement. Importantly, the1586legislation mandates a federal report on the impact of1587loneliness, examining how multigenerational family structures1588influence social connectedness in older adults. We thank the1589Chairman and Senator Smith for their leadership on this1590important legislation.1591    In the House, Congressmen Flood and Bera introduced the1592Improving Measurements for Loneliness and Isolation Act. Even1593with increasing recognition of loneliness as a public health1594crisis, the U.S. health care system currently has no1595standardized method for measuring social disconnection,1596loneliness, or social isolation. This bill addresses the gap by1597establishing a federal Working Group composed of experts,1598researchers, and agency representatives to develop uniform1599metrics for assessing loneliness and isolation. These1600standardized tools could be integrated into Medicare wellness1601visits, electronic health records, and public health surveys,1602to ensure early identification of at-risk seniors.1603Additionally, this legislation would provide critical data to1604inform policy decisions, including potential insurance coverage1605for community-based interventions like home-visit programs,1606which have been shown to reduce loneliness and improve overall1607well-being.1608    In addition to these two pieces of bipartisan legislation,1609we are pleased to note that a number of other bills that have1610been introduced on this issue in the past several years. We1611commend these members for their bipartisan leadership and their1612commitment to this critical issue.1613    Although significant progress has been made, the work is1614far from complete. We must continue to build on these efforts,1615ensuring that we address the full scope of loneliness and1616social isolation with the urgency and dedication it requires.1617This demographic, already dealing with challenges related to1618aging, health, and accessibility, is disproportionately1619impacted by isolation, with consequences extending beyond1620emotional well-being to physical health, cognitive decline, and1621even mortality. The impact of loneliness on older adults is not1622merely a matter of individual suffering but a societal concern1623with costs that merit our collective attention.16241625The Crisis of Loneliness Among Older Adults16261627    Social isolation and loneliness among older adults have1628reached epidemic proportions, with devastating effects on1629public health, health care costs, and overall well-being.1630According to the National Academies of Sciences, Engineering,1631and Medicine (NASEM), nearly one in four adults aged 65 and1632older is considered socially isolated.\1\ The consequences are1633severe: chronic loneliness is linked to a 50% increased risk of1634dementia, a 29% increased risk of heart disease, and a 32%1635increased risk of1636stroke.\2\,\3\,\4\1637Research has also found that prolonged loneliness is as harmful1638to health as smoking 15 cigarettes per day,\5\ making it a1639significant public health crisis that demands urgent action.1640---------------------------------------------------------------------------1641    \1\ National Academies of Sciences, Engineering, and Medicine1642(2020) Social Isolation and Loneliness in Older Adults: Opportunities1643for the Health Care System, The National Academies Press, Washington,1644DC. 10.17226/25663.1645    \2\ National Academies of Sciences, Engineering, and Medicine1646(2020) Social Isolation and Loneliness in Older Adults: Opportunities1647for the Health Care System, The National Academies Press, Washington,1648DC. 10.17226/25663.1649    \3\ Valtorta NK, Kanaan M, Gilbody S, Ronzi S, Hanratty B.1650Loneliness and social isolation as risk factors for coronary heart1651disease and stroke: systematic review and meta-analysis of longitudinal1652observational studies. Heart. 2016;102(13):1009-1016.1653    \4\ Kuiper JS, Zuidersma M, Oude Voshaar RC. Social relationships1654and risk of dementia: a systematic review and meta-analysis of1655longitudinal cohort studies. Ageing Res Rev. 2015;22:39-57. doi:165610.1016/j.arr.2015.04.006.1657    \5\ Our Epidemic of Loneliness and Isolation (2023). Office of the1658U.S. Surgeon General. Department of Health and Human Services. https://1659www.hhs.gov/sites/default/files/surgeon-general-social-connection-1660advisory.pdf.1661---------------------------------------------------------------------------1662    Beyond its impact on health, social isolation among older1663adults carries a substantial economic burden. Estimates show1664that Medicare spends an additional $6.7 billion annually on1665socially isolated older adults due to increased1666hospitalizations, emergency room visits, and nursing home1667admissions.\6\ Loneliness is also associated with higher rates1668of depression and anxiety,\7\ leading to increased prescription1669medication use and mental health service costs. Furthermore,1670socially disconnected older adults are more likely to1671experience functional decline,\8\ increasing reliance on costly1672long-term care services.1673---------------------------------------------------------------------------1674    \6\ Flowers, L., Houser, A., Noel-Miller, C., Shaw, J.,1675Bhattacharya, J., Schoemaker, L. & Farid, M. (2017). Medicare Spends1676More on Socially Isolated Older Adults. AARP. https://www.aarp.org/pri/1677topics/health/coverage-access/medicare-spends-more-on-socially-1678isolated-older-adults/.1679    \7\ Our Epidemic of Loneliness and Isolation (2023). Office of the1680U.S. Surgeon General. Department of Health and Human Services. https://1681www.hhs.gov/sites/default/files/surgeon-general-social-connection-1682advisory.pdf.1683    \8\ National Academies of Sciences, Engineering, and Medicine1684(2020) Social Isolation and Loneliness in Older Adults: Opportunities1685for the Health Care System, The National Academies Press, Washington,1686DC. 10.17226/25663.1687---------------------------------------------------------------------------1688    The economic impact extends beyond health care1689expenditures. Social isolation reduces workforce participation1690among older adults who might otherwise engage in part-time1691employment, mentorship, or volunteer activities, all of which1692contribute to economic productivity.\9\ It also places a1693financial strain on family caregivers, many of whom must reduce1694their working hours or leave the workforce entirely to provide1695care for an isolated loved one.\10\ Addressing this crisis is1696not just a moral imperative, it is an economic necessity.1697---------------------------------------------------------------------------1698    \9\ National Academies of Sciences, Engineering, and Medicine.1699(2020). Social Isolation and Loneliness in Older Adults: Opportunities1700for the Health Care System. https://www.nap.edu/catalog/25663/social-1701isolation-and-loneliness-in-older-adults-opportunities-for-the-health-1702care-system1703    \10\ Committee on Family Caregiving for Older Adults; Board on1704Health Care Services; Health and Medicine Division; National Academies1705of Sciences, Engineering, and Medicine; Schulz R, Eden J, editors.1706Families Caring for an Aging America. Washington (DC): National1707Academies Press (US); 2016 Nov 8. 4, Economic Impact of Family1708Caregiving. https://www.ncbi.nlm.nih.gov/books/NBK396402/.1709---------------------------------------------------------------------------1710    Several structural and societal factors contribute to this1711crisis of social isolation and loneliness among older adults.1712The decline of multi-generational living - a trend driven by1713economic pressures and shifting cultural norms - has reduced1714the built-in support systems that once naturally fostered1715intergenerational connections. According to the Pew Research1716Center, while 57% of older adults worldwide lived in extended1717family houses in 1960, that figure has steadily declined,1718particularly in high-income nations like the United States,1719where only 20% of older adults now reside in such1720arrangements.\11\1721---------------------------------------------------------------------------1722    \11\ Pew Research Center (2010). The Return of the Multi-1723Generational Family Household. https://www.pewresearch.org/social-1724trends/2010/03/18/the-return-of-the-multi-generational-family-1725household/.1726---------------------------------------------------------------------------1727    Simultaneously, shrinking social circles and declining1728participation in community and civic life have further1729exacerbated the problem. Robert Putnam's seminal work Bowling1730Alone (2000) details how social capital has diminished over1731recent decades, with fewer individuals engaging in clubs,1732religious institutions, and volunteerism-key avenues through1733which older adults have historically built and maintained1734relationships.\12\1735---------------------------------------------------------------------------1736    \12\ Putnam, R. (2000). Bowling Alone: The Collapse and Revival of1737American Community. Simon & Schuster.1738---------------------------------------------------------------------------1739    Barriers to mobility-both physical and financial-compound1740these issues. Many older adults face challenges such as1741inaccessible public transportation, unaffordable housing, and1742declining physical health, which can prevent them from engaging1743in the social activities they once enjoyed. Mobility1744limitations have been reported to affect about 35% of adults1745aged 70 and older, and the majority of adults over 85 years,1746making it difficult to visit friends, attend social gatherings,1747or participate in community life.\13\1748---------------------------------------------------------------------------1749    \13\ Freiberger E, Sieber CC, Kob R. Mobility in Older Community-1750Dwelling Persons: A Narrative Review. Front Physiol. 2020 Sep175115;11:881. doi: 10.3389/fphys.2020.00881. PMID: 33041836; PMCID:1752PMC7522521.1753---------------------------------------------------------------------------1754    At the same time, the increasing reliance on digital1755communication as a primary means of connection has created new1756barriers. While technology has expanded opportunities for1757social engagement, many older adults struggle with digital1758literacy and lack access to high-speed internet, particularly1759in rural and underserved communities.1760    Finally, ageism in society discourages many older adults1761from seeking social engagement, exacerbating their isolation.1762Negative stereotypes about aging can lead to self-imposed1763withdrawal, as older adults may feel undervalued or unwelcome1764in spaces dominated by younger generations. Research from the1765World Health Organization (WHO) suggests that ageism is linked1766to poorer physical and mental health outcomes, increased social1767isolation, and even reduced life expectancy.\14\1768---------------------------------------------------------------------------1769    \14\ World Health Organization (2021). Ageism is a global1770challenge: UN. https://www.who.int/news/item/18-03-2021-ageism-is-a-1771global-challenge-un17721773---------------------------------------------------------------------------1774Evidence-Based Policy Solutions to Address Loneliness17751776    In light of these statistics, I would like to highlight1777five key areas where public policy can play a transformative1778role in addressing and mitigating this crisis. These areas1779present tangible opportunities for a response rooted in1780collaboration and innovation to ensure our most vulnerable1781populations receive support and connection. I want to express1782my gratitude once again for the committee's focus on this1783critical matter, and I look forward to exploring these1784solutions together.17851786Strengthen Federal Programs to Address Loneliness Among Older1787Adults17881789    The Older Americans Act (OAA) serves as a vital cornerstone1790for aging services, but current demand far exceeds available1791resources. While an increase in funding is needed, it can1792result in cost savings in other areas. By enhancing funding for1793OAA nutrition programs, we can ensure that congregate meal1794sites not only provide nourishment to maintain physical health1795but also serve as vital social hubs that promote engagement and1796connection among older adults. In alignment with the1797committee's jurisdiction, addressing issues of health1798maintenance, securing adequate income, and engaging in1799productive activities, further investments in senior centers,1800libraries, and multi-use community spaces will offer structured1801opportunities for socialization, supporting overall well-being.1802    Additionally, targeted funding for rural aging1803interventions is essential to address isolation in areas with1804limited transportation and resources. The Administration for1805Community Living (ACL) has taken an important leadership role1806in developing evidence-based models to integrate social1807engagement into health policy. Expanding funding for ACL's1808Commit to Connect initiative would enable a more comprehensive1809evaluation of interventions that address loneliness, including1810technological solutions, intergenerational programming, and1811cognitive health initiatives. We also recommend that1812policymakers prioritize funding for peer support programs,1813volunteer-based companionship models, and faith-based1814mentorship initiatives, which are instrumental in strengthening1815community-driven approaches to social connection. This broader1816approach will not only enhance quality of life but also ensure1817that older adults receive the full spectrum of support they1818need to thrive in all areas of life.18191820    Expand Intergenerational Programs18211822    Intergenerational initiatives-such as shared housing1823programs, mentorship opportunities, and community volunteer1824projects-have proven to significantly reduce loneliness among1825both older and younger generations. A recent study by1826Generations United found that 92% of Americans believe that1827participation in intergenerational programs improves feelings1828of loneliness across age groups.\15\ Fortunately, many1829evidence-based strategies can be implemented to strengthen1830these bonds, including designing built environments that1831encourage social interaction,\16\ establishing and scaling1832community connection programs that unite diverse age groups,1833and strategically investing in local institutions that serve as1834intergenerational community hubs.1835---------------------------------------------------------------------------1836    \15\ Generations United and The Eisner Foundation (2018). All in1837together: Creating places where young and old thrive. https://1838www.gu.org/app/uploads/2018/06/SignatureReport-Eisner-All-In-1839Together.pdf.1840    \16\ Jennings, Viniece & Browning, Matthew & Rigolon, Alessandro.1841(2019). Planning Urban Green Spaces in Their Communities:1842Intersectional Approaches for Health Equity and Sustainability.184310.1007/978-3-030-10469-6--5.1844---------------------------------------------------------------------------1845    Increasing funding for these programs is essential to1846deepen community cohesion and enhance mental well-being,1847aligning with the Committee's focus on promoting health, income1848security, and access to productive activity for older adults.1849Furthermore, the development of intergenerational and age-1850friendly communities creates opportunities for social1851engagement, reduces feelings of loneliness, and fosters empathy1852across generations. Such initiatives not only strengthen1853individual well-being but also contribute to a more inclusive1854and supportive society.18551856Promote Digital Inclusion and Technology Access18571858    While technology holds significant potential to mitigate1859social isolation, its adoption among older adults remains1860limited. Pew Research Center data indicates that 55% of1861Americans aged 65 and older do not use social media,\17\ and1862nearly 22 million older adults lack broadband access.\18\ To1863address these challenges, prioritizing digital literacy1864training and ensuring affordable broadband access, particularly1865in rural and underserved communities, is crucial. Despite the1866overall increase in technology adoption, digital disparities1867persist, especially among individuals with disabilities, lower-1868income adults, and rural residents. A Gallup study highlights1869that older adults who use technology for support are more1870likely to seek in-person assistance, underscoring the1871complementary relationship between digital and physical1872connection.1873---------------------------------------------------------------------------1874    \17\ Faverio, M. (2022). Share of those 65 and older who are tech1875users has grown in the past decade. Pew Research Center. https://1876www.pewresearch.org/short-reads/2022/01/13/share-of-those-65-and-older-1877who-are-tech-users-has-grown-in-the-past-decade/.1878    \18\ Older Adults Technology Services (OATS) (2021). Report: 221879Million U.S. Seniors Lack Broadband Internet Access; First Time Study1880Quantifies Digital Isolation of Older Americans as Pandemic Continues1881to Ravage Nation [Press Release]. AARP. https://oats.org/aging-1882connected-press-release/.1883---------------------------------------------------------------------------1884    To bridge this gap, leveraging telehealth, assistive1885devices, online support groups, and expanded broadband access1886can significantly enhance social connectivity among older1887Americans. These interventions not only increase access to1888social support beyond in-person interactions but also improve1889patient-doctor relationships and foster community cohesion.1890    In addition, updating the 2010 National Broadband Plan to1891focus on low-income, rural, underrepresented, and socially1892isolated populations will ensure a more inclusive digital1893landscape. Federal digital literacy programs should also be1894expanded to include cybersecurity education, specifically1895targeting older adults to ensure they can navigate online1896spaces safely. By addressing digital literacy, expanding1897broadband access, and continuing to innovate in the development1898and implementation of technology, we can effectively combat1899social isolation and foster meaningful connections across1900generations.19011902Enhance Medicare's Role in Addressing Loneliness19031904    Medicare plays a crucial role in supporting the health and1905well-being of older adults, and it is poised to do more to1906address the growing crisis of loneliness and social isolation.1907One effective strategy would be to require Medicare Annual1908Wellness Visits to include routine screenings for social1909isolation and loneliness, enabling providers to identify at-1910risk individuals and connect them with appropriate1911interventions. It is also important to ensure that Medicare1912Advantage plans maintain access to sufficient rebate dollars to1913offer and tailor supplemental benefits that directly address1914these issues, such as social engagement programs and1915transportation assistance. Expanding Medicare's coverage to1916include interventions for loneliness, such as counseling and1917peer support services, would provide this at-risk population1918with a critical avenue for emotional and social care.1919Furthermore, expanding coverage for hearing aids-through1920improved private insurance and Medicare benefits-would remove a1921significant barrier to communication and socialization for1922older adults, helping to reduce the isolation often caused by1923hearing loss. These steps would strengthen Medicare as a more1924comprehensive solution for addressing loneliness, ensuring that1925older adults receive not just physical care but also the social1926and emotional support they need to thrive.19271928Improve Transportation Access19291930    Reliable transportation acts as a crucial bridge to social1931connection, directly combating feelings of loneliness. Access1932to transportation enables individuals, especially those with1933mobility limitations or living in rural or isolated areas, to1934engage in social life by connecting them to parks, green1935spaces, community activities, cultural institutions, social1936events, and visits with loved ones. For individuals with lower1937socioeconomic status, access to affordable transportation can1938alleviate the psychological burden of prioritizing basic needs1939over social activities. Overall, access to transportation is1940vital for reducing social isolation and loneliness in these1941vulnerable populations who may otherwise find themselves cut1942off from essential support networks.1943    Studies consistently demonstrate that increased use of1944public transportation, especially among seniors, correlates1945with a reduction in feelings of loneliness and1946depression.\19\,\20\ Increasing access to1947affordable, reliable public transportation can improve1948opportunities for social connection and recreation, build1949social capital, and increase social ties. Therefore, we urge1950transportation planners and decision-makers to adopt a "people1951first" mentality by prioritizing movability through walking and1952bicycling networks, accessible and affordable transit services,1953lower traffic speeds, and better air quality control.1954---------------------------------------------------------------------------1955    \19\ Henning-Smith, C., Evenson, A., Kozhimannil, K. B., &1956Moscovice, I. (2018). Geographic variation in transportation concerns1957and adaptations to travel-limiting health conditions in the United1958States. Journal of Transport & Health (Print), 8, 137-145. doi.org/195910.1016/j.jth.2017.11.146.1960    \20\ Mattson, J. W., & Peterson, D. (2021). Measuring benefits of1961rural and small urban transit in Greater Minnesota. Transportation1962Research Record, 036119812199001. https://doi.org/10.1177/196303611981219900141964---------------------------------------------------------------------------1965    Additionally, policymakers should develop a Senior Mobility1966Program under the Federal Transit Administration (FTA) to1967incentivize cities to improve public transportation options,1968such as subsidized ride-sharing services and accessible bus1969routes for older adults. Addressing transportation insecurity1970by improving access to non-emergency medical transportation and1971non-medical transportation programs also provides social1972interaction opportunities, connects individuals to healthcare1973services, and improves quality of life. Ultimately,1974transportation transcends its function as a means of travel and1975is a fundamental tool for fostering social inclusion and1976bolstering overall well-being.19771978A Bold Agenda for the Future: F4SC-AN's Policy Priorities19791980    Today, I am honored to announce the launch of the1981Foundation for Social Connection Action Network's Policy1982Priorities for Social Connection, which includes these and1983other focus areas. It is a groundbreaking framework comprised1984of over 130 strategic policy solutions designed to foster1985genuine social connection. Based on a thorough review of1986existing research, including leading scientist Dr. Julianne1987Holt-Lunstad's SOCIAL Framework (Systems Approach of Cross-1988Sector Integration and Action Across the Lifespan),\21\ our1989framework prioritizes seven key areas for action: Health;1990Education; Work, Employment & Labor; Built Environment; Arts,1991Culture, and Leisure; Food & Nutrition; and Research and1992Measurement, most of which I've discussed with you today.1993---------------------------------------------------------------------------1994    \21\ Holt-Lunstad J. Social Connection as a Public Health Issue:1995The Evidence and a Systemic Framework for Prioritizing the "Social" in1996Social Determinants of Health. Annu Rev Public Health. 2022 Apr19975;43:193-213. doi: 10.1146/annurev-publhealth-052020-110732. Epub 20221998Jan 12. PMID: 35021021.1999---------------------------------------------------------------------------2000    This ambitious agenda calls for a united effort across all2001levels of government while also recognizing the crucial role2002communities play in strengthening social bonds. At its core,2003our policy agenda aims to create sustainable, inclusive2004solutions that promote meaningful connections for individuals2005at every stage of life. Grounded in rigorous scientific2006evidence highlighting the devastating effects of social2007isolation and loneliness, this agenda aligns promising policies2008with the transformative potential to enhance public health,2009drive economic prosperity, uplift community well-being, and2010elevate the overall quality of life for all Americans.2011Together, we can build a future where connection, not2012isolation, defines the American experience.20132014Conclusion: A Call to Action20152016    Chairman Scott, Ranking Member Gillibrand, and esteemed2017members of the Committee, as this hearing instructs us,2018addressing the epidemic of loneliness among older adults is not2019only a moral imperative but also a critical public health2020necessity. The time for decisive action is now. We urge2021Congress to increase funding for proven programs, advocate for2022innovative legislative solutions, and prioritize social2023connection as a national objective.2024    Tackling this issue offers us an opportunity to unite in a2025time of increasing polarization. By fostering social2026connection, we can bridge divides, rebuild trust, and2027strengthen the fabric of our communities. This issue transcends2028political affiliation and speaks to our shared humanity.2029Together, we can build a future where connection, not2030isolation, defines the American experience. Thank you for the2031opportunity to testify today.20322033                 U.S. Senate Special Committee on Aging20342035  "Breaking the Cycle of Senior Loneliness: Strengthening Family and2036                           Community Support"20372038                             March 12, 202520392040                      Prepared Witness Statements20412042                              James Balda20432044    Chairman Scott, Ranking Member Gillibrand, and members of2045the committee, thank you for this opportunity. I am James2046Balda, President and CEO of Argentum, the leading national2047association serving senior living communities, including2048independent living, assisted living and memory care communities2049across the nation. More than 2 million seniors call our2050communities home. Argentum commends you, Senator Smith (D-MN)2051and Senator Warnock (D-GA) on the introduction of the SENIOR2052Act and for holding this important hearing.2053    Socialization is a crucial aspect of healthy aging.2054Socialization promotes a sense of purpose and connection with2055others. It significantly improves the mental health, cognitive2056function, and physical health of seniors.2057    We see this firsthand every day in our communities. Our2058assisted living model of care was created to allow seniors to2059thrive - to provide seniors with a sense of dignity,2060independence and community - to keep seniors living as2061independently as possible, to prolong the quality of life, and2062delay for as long as possible the need for costlier care. The2063structure of our communities' social activities specifically2064fosters a sense of community and belonging while simultaneously2065providing 24-hour care -- assisting our residents with a2066multitude of ADLs, or activities of daily living, such as2067bathing, dressing, toileting, eating and mobility. Our care2068also includes medication management, providing nutritious meals2069and crucial socialization.2070    I believe we do our job well. According to multiple2071national surveys, our residents are thriving. Ninety-four2072percent of senior residents said they were happy with their2073choice of community and had made friends; 99% said they felt2074safe; 75% responded that their quality of life improved; and2075according to a poll of more than 130,000 assisted living2076residents, loneliness levels were reduced dramatically when2077residents, who formerly lived alone, moved into our2078communities.2079    Lillian, an 85-year-old assisted living resident in2080California, lived alone and suffered mobility issues and2081depression. Shortly after she moved into an assisted living2082community, Lillian filled her day with art classes, exercise2083classes, and prayer groups and stated she now has a "wonderful2084group of friends, many who are lifelong."2085    An assisted living community provides a wide range of2086social and interactive activities tailored to different2087abilities and interests. Seniors can enjoy gardening, dancing,2088educational seminars, exercise classes, concerts, book clubs,2089religious services, arts and crafts, and game nights, to name2090just a few. Regardless of the activity, each is designed to2091create a sense of purpose and community, and to combat2092isolation, depression and loneliness. Equally importantly,2093because assisted living communities are the homes of seniors,2094pets are welcome at most communities, and pet therapy is often2095available for those who are not capable of caring for a pet.20962097The Health Impact of Social Isolation20982099    Loneliness and social isolation in older adults are serious2100public health risks, affecting millions of seniors. According2101to a study in JAMA Internal Medicine, up to 50% of those 60 and2102older are at risk of social isolation, and nearly one-fourth of2103adults aged 65 and older are socially isolated. Factors such as2104living alone, the loss of family or friends, chronic illness,2105and hearing loss are all contributing factors to social2106isolation and loneliness.2107    The consequences of social isolation cannot be overstated.2108The former U.S. Surgeon General, Dr. Vivek Murthy, called2109loneliness "America's invisible epidemic," noting that "The2110physical health consequences of poor or insufficient connection2111include a 29% increased risk of heart disease, a 32% increased2112risk of stroke, a 50% increased risk of developing dementia for2113older adults, and a 60% increased risk of premature death." An2114AARP report estimates that the adverse health effects of2115loneliness equal that of smoking 15 cigarettes per day.2116    The Alzheimer's Association reports that social isolation2117increases dementia risk by more than 50%. What's more, it found2118that a strong connection exists between high social contact2119later in life and memory and thinking skills.21202121The Cost of Social Isolation21222123    The costs of loneliness are significant. According to a2124Harvard-Stanford-AARP study measuring the impact of social2125isolation on the healthcare system, Medicare spent an estimated2126$1,608 annually for each socially-isolated older adult than it2127did for those who had more social contacts, concluding that "a2128lack of social contacts among older adults is associated with2129an estimated $6.7 billion in additional federal spending each2130year." Additionally, a recent study in JAMA Internal Medicine2131determined that social isolation among seniors can increase the2132chances of admission to nursing homes and recommended that2133programs to increase their socialization could reduce2134healthcare spending.2135    As this committee well knows, the prevalence and cost of2136dementias is escalating, with some projections stating the2137number of people living with dementia is projected to roughly2138double every twenty years. The health care costs of Alzheimer's2139and other dementias to Medicare and Medicaid are approximately2140$231 billion annually, and is projected increase of over 200%2141by 2050.21422143The Benefits of Communal Living21442145    Assisted living communities strengthen social connections2146for our residents and therefore play an important role in2147reducing social isolation and supporting the overall health and2148well-being of seniors. A national study by the University of2149Michigan found that adults aged 50 to 80 who live alone report2150higher rates of social isolation than those who live with2151others. The social and communal atmosphere of assisted living2152changes that dynamic. As stated above, a national survey of2153more than 130,000 assisted living residents by Activated2154Insights, found that just 14.3% of senior living residents2155reported being lonely, compared to 29.9% of seniors who live2156alone. Many of our communities have reported even lower2157loneliness scores.2158    The communal yet home-like nature of assisted living2159fosters independence and socialization to help seniors thrive2160while preventing mental and physical decline. "A community is a2161group of people who care about one another, and that's what we2162are here," said Eilean of her community in upstate New York.2163Resident satisfaction in assisted living remains extremely high2164because communities are able to not only offer high quality of2165personal care but also improve the quality of life of2166residents. National surveys have found that 90% of assisted2167living residents report high satisfaction with their care and2168communities.2169    When 95-year-old James' wife died and it wasn't safe for2170him to remain at home alone, he reluctantly moved into an2171assisted living community. His granddaughter said that the move2172"literally saved his life" and that her grandfather "blossomed2173due to his many new friendships." His caregivers managed his2174chronic conditions, medications and psychosocial needs. She2175stated, "I am a firm believer that without assisted living we2176would have lost my grandpa quickly after the death of my2177grandmother. To see a light in his eyes again and to hear that2178he feels he has purpose has been the greatest gift."2179    A 2024 U.S. News & World Report survey of older Americans2180and their families found that nearly all the respondents (99%)2181said they felt safe at their senior living community, further,2182nearly all respondents (98%) said they trusted the staff at2183their senior living community to care for their well-being.2184Social connections made in assisted living communities are2185important -- 93% of residents reported that they are pleased2186with the social opportunities within their communities, and 75%2187say assisted living has demonstrably improved their quality of2188life. According to the 2024 J.D. Power Senior Living2189Satisfaction Survey, assisted living communities received a2190satisfaction score of 855 (on a 1,000-point scale), up 182191points from the prior year, and higher than industries like2192travel and hospitality.2193    "A laugh a day keeps the doctor away, and that's what we do2194here," said Bob, an 84-year-old resident, in a Florida2195community. Perhaps Bob is on to something. In a review of2196Medicare claims of residents from more than 14,000 senior2197living communities, and using the Harvard Claims-Based Frailty2198Index to assess vulnerability, researchers found that residents2199experienced a 10% decline in frailty levels one year after2200moving in. Through care coordination and managing chronic2201conditions, assisted living communities improve the health and2202wellbeing of their residents while decreasing the financial2203strain on the healthcare system. A 2018 Washington University2204study found that living in a senior community can lead to lower2205levels of hospitalization for vulnerable seniors-including2206those with chronic health conditions. Utilizing data from a2207decade-long study, the report concludes that the services2208offered by many senior living communities encourage residents2209to seek treatment sooner for pressing issues, leading to fewer2210trips to the hospital. The "findings suggest that the positive2211effects from the various support services available in the2212senior housing environment accrue over time in helping2213vulnerable elders better manage their health conditions."22142215Two Testimonials:22162217    "About three years ago my neighbor started to decline in2218his physical abilities. He was a veteran and would go to the VA2219regularly for help with different issues he was experiencing.2220He loved walking and tried as hard as he could to keep moving2221so he would not lose his ability to walk. Despite his efforts2222he continued to decline. In the winter, my friend could not2223walk safely outside. He had a hard time with some stairs in his2224house and the sloped driveway and in the winter, he lost much2225leg strength. He cooked for himself and did not always want to2226take the time to eat properly. He became very skinny and frail.2227He was a very social person, but he continued to become more2228isolated. Family and neighbors tried to keep him company as2229best as they could, but no one could provide him with the2230social aspects of his life as he needed.2231    I used to pick him up every Sunday for church services, but2232it became harder and harder for him to get himself ready.2233Sometimes it would take him three hours to get ready. It became2234hard for him to shower and to dress. Eventually he finally gave2235up on trying to come to church with us, which was a big part of2236his life -- not just spiritually but also socially. As time2237went on, the decision was made to move him into an assisted2238living community. Immediately he loved it! It met his needs in2239so many ways. He could walk the building without fear of what2240he used to worry about. He could use the fitness room every2241day, which he loved to do. He ate three meals daily in the2242dining room and started to put back the weight he had lost.2243Socially he integrated very quickly, and he told me recently2244that he considers the people living there to be a part of his2245family. He truly loves it, and it made such a difference in his2246quality of life.2247    I had spoken to his daughter about her dad many times on2248the phone. She lived in a different city and didn't get to see2249him too often. One day after he moved into the community, his2250daughter gave me a big hug and thanked me for all the talks and2251discussions that helped to lead her dad to moving into an2252assisted living community. She said the people that work there2253are her heroes. She then said that her dad was happier than he2254had ever been in his entire life. She said her entire family2255was grateful for the community that gave her dad renewed hope2256and happiness and a better life than he had in a very long2257time."22582259-Holladay, Utah, January 202422602261    Meet Zelma Bennett, one of our newest residents at2262Commonwealth Senior Living at Stratford House. Zelma moved into2263our community on January 29th, after spending the past year2264living with a friend. Zelma, who had previously run a group2265home for adults, enjoyed maintaining a vibrant social life with2266assistance, but her memory loss prompted her to seek a2267community where she could continue engaging socially while2268receiving the support she needed. From the moment she arrived,2269Zelma embraced every opportunity for socialization,2270participating in nearly every activity offered. She uses her2271calendar so frequently to keep track of events that she wears2272it out and needs to replace it before the month's end! Her2273enthusiasm has been contagious, and she has made many new2274friends in a short time. Zelma's story is just one example of2275how socialization in our communities has dramatically improved2276the quality of life for seniors. The friendships and activities2277she's engaged in have helped alleviate her feelings of2278loneliness and have given her a renewed sense of purpose and2279joy. We are so grateful she chose to join our community.22802281-Resident Program Director, Danville, Virginia, March 202522822283    As we look back five years from the start of the pandemic,2284it is important to note how our residents faired during those2285times of intense isolation. A 2022 joint report from the ATI2286Advisory and the American Senior Housing Association found that2287senior living communities improved quality of life during the2288pandemic through cohesive social environments and encouragement2289of residents to participate in social activities. Residents,2290the study found, were more likely to have greater social,2291physical and intellectual wellness than their counterparts2292living in the greater community.22932294The Benefits of Pet Therapy22952296    The powerful bond between humans and animals has been2297proven to benefit physical, mental, and emotional well-being.2298For this reason, most assisted living communities allow pets.2299Pets can provide unconditional love and support, encourage2300socialization, reduce stress levels, and foster a sense of2301belonging - all of which can curb loneliness and bring about2302physical and mental healing.2303    Pets have an incredible capacity to bring joy and2304companionship into our lives. Joanie and her rescued black cat,2305"Baby Boy," often serve as the "greeters" to visitors of their2306assisted living community. And Jean, a resident of a community2307in Florida, has Gretta Garbo, a 9-year-old Miniature Poodle, as2308her steadfast companion. Gretta Garbo is every bit the starlet2309of the community as her namesake suggests -- the poodle dresses2310for all types of occasions and provides the normally2311introverted Jean with the motivation to socialize and2312participate in communal activities.2313    For those who are unable to have their own pet, many2314communities utilize pet therapy which can play a crucial role2315in curbing negative behaviors associated with dementia and2316other cognitive impairments. By providing companionship and2317emotional support, pet therapy can help seniors feel more2318connected and less isolated, leading to a reduction in negative2319behaviors. Furthermore, the soothing presence of therapy2320animals can help calm seniors with cognitive impairments,2321promoting a more stable emotional state and overall well-being.2322    Buttercup and Sugarplum, two Golden Retrievers, are regular2323visitors to a memory care community in Maryland. When they2324arrive during circle time, there isn't a resident who doesn't2325want to see an affectionate tail wag and maybe receive a2326friendly lick on their hands. A room, once quiet, can transform2327into laughter and perhaps even unlock precious memories of2328long-forgotten childhood pets or spark the recollection of the2329name of their children's first puppy.23302331Directed Socialization Critical in Caring for Seniors with2332Dementia23332334    Research links dementia-associated apathy to accelerated2335decline in all physical and mental areas. When cognitive2336changes start, withdrawal and isolation are common. Memory care2337communities often have programs to encourage residents to2338consistently socialize and participate in therapeutic2339activities to reduce apathy and build cognitive reserve.2340    A national senior living provider headquartered in Texas2341recently evaluated its memory care socialization program known2342as the Circle of Friends program and compared two cognitively2343similar groups of their assisted living residents. One group2344was enrolled in Circle of Friends. The second group was not,2345but chose from a similar menu of activities to attend on their2346own. The participation standard for both groups was four hours2347a day. What was learned was that approximately 75% of the2348residents in the Circle of Friends group spent a minimum of2349four hours per day engaged in purposeful activities, with less2350than one-fourth exhibiting apathy. However, less than a third2351of the group of self-directed participants met the study's2352minimum participation standard and nearly two-thirds exhibited2353apathy. For residents who are beginning to experience cognitive2354decline, the benefits of a guided program can be significant in2355helping to maintain engagement and function.23562357Whisper Words of Wisdom - Music Therapy and Cognitive Decline23582359    Directed socialization with music therapy is also effective2360when dementia residents become socially withdrawn and can2361encourage engagement and improve verbal abilities. Mary, a 73-2362year-old memory care resident suffering from vascular dementia,2363can become non-verbal and withdrawn as her disease progresses.2364To help abate this, a record player in her apartment becomes an2365important tool. For Mary, a lifelong Beatles fan (she has a2366framed $5 ticket stub from a 1965 Beatles concert she attended2367in Portland, Oregon in 1965), directed music therapy is2368effective. Let it Be is often the song of choice. Mary remains2369silent at the beginning of the song but soon is swaying to the2370music and when the phrase "whisper words of wisdom" is sung,2371Mary is inevitably singing along. It's common for fellow2372residents to join in for an impromptu sing-a long.23732374The Aging Crisis and Long-Term Care Solutions23752376    By 2030, all baby boomers will be at least age 65, and in2377that same year for the first time in our nation's history,2378there will be more individuals over the age of 65 than under2379the age of 18. The most rapidly growing segment of the2380population are those 85 and older. As this Committee continues2381to provide guidance to Congress on how to prepare for the2382nation's aging crisis, is it important to note that assisted2383living is the most cost-effective form of long-term care.2384    To stretch limited federal long-term care dollars, "right-2385sizing" long-term care needs is critical. A 2021 report by the2386U.S. Department of Veterans Affairs found that if veterans did2387not need the high level of care of skilled nursing, the federal2388government could save an average of $69,000 per year per2389veteran by providing care in assisted living communities.2390Ensuring that veterans and seniors are in their appropriate2391level of care can provide significant financial savings, both2392to the individual and to taxpayer-funded public programs.2393    Additionally, the need for investment in our nation's long-2394term care is long overdue, with a rapidly aging population and2395need for long-term care projected to explode in the coming2396years. Every day, more than 10,000 Americans turn 65, and the239785 and older population (average age of an assisted living2398resident) is projected to more than double from 6.6 million in23992019 to 14.4 million in 2040 (a 118% increase). By 2030, all2400baby boomers will have reached 65 years old and for the first2401time in history, older adults will outnumber children in the2402United States. Federal data shows that someone turning age 652403today has a 70% chance of needing some type of long-term care2404in their lifetime, 50% will need more extensive care in a2405skilled nursing facility or assisted living community, and 20%2406will need it for five years or more.2407    Despite this projected explosion in demand, there is not2408nearly enough supply of senior housing to meet these care2409needs. The National Investment Center for Seniors Housing and2410Care (NIC) estimates that approximately 881,000 additional2411units of assisted living inventory will be needed to serve2412seniors by 2030. Estimates suggest that the development cost2413associated with needed production of assisted living will2414exceed $1 trillion by 2050. Insufficient investment will2415dramatically limit housing access and options for seniors.24162417The Importance of the SENIOR Act and the Care Across2418Generations Act24192420    Mr. Chairman, we believe our communities offer many2421opportunities for seniors to combat loneliness, but we know2422more can be done and believe seniors should be able to choose2423where and how they live. That is why Argentum commends you on2424taking the important step of introducing the SENIOR Act. The2425important bill will take critical steps to address the epidemic2426of senior loneliness by promoting key programs specifically2427designed to reduce loneliness for all seniors in the broader2428community. Additionally, the requirement to direct the2429Secretary of HHS to report to Congress on the importance of2430multigeneration relationships to mental health and loneliness2431is significant.2432    According to studies by the National Institute of Health,2433both older and younger people experience a significant2434reduction in loneliness through interactions with individuals2435from different generations. Therefore, Argentum is also pleased2436to support H.R. 1812, the Care Across Generations Act, a2437bipartisan bill which will create opportunities for2438intergenerational connection through the establishment of a2439grant program for assisted living and all long-term care2440settings to co-locate a childcare facility near or within a2441long-term care community. We believe the benefits to both the2442seniors and the children will be enormous.2443    Mr. Chairman, thank you again for holding this important2444hearing. Argentum looks forward to working with you and the2445Committee on this and other critical issues impacting our2446nation's seniors.24472448                 U.S. Senate Special Committee on Aging24492450  "Breaking the Cycle of Senior Loneliness: Strengthening Family and2451                           Community Support"24522453                             March 12, 202524542455                      Prepared Witness Statements24562457                           Suzanne McCormick24582459    Chairman Scott and Ranking Member Gillibrand: I want to2460thank you for inviting me today.2461    I am here representing the nation's 2,600 YMCAs, which2462serve 10,000 communities across our country. I am grateful for2463the opportunity to share the story of how they connect and2464support our older adults every day.2465    At the Y, we are committed to strengthening communities by2466connecting people of all ages, abilities and backgrounds to2467their potential, their purpose and each other.2468    This has been at the core of who we are for 175 years in2469the U.S. But today, we know that people are struggling to make2470these connections.2471    Forty percent of adults say they feel lonely sometimes or2472even more often than that.2473    The mortality rate of being socially disconnected is2474similar to the impact of smoking 15 cigarettes a day, and2475greater than the impact associated with obesity and inactivity.2476    The health risks for our older adults are heightened,2477because they are more likely to feel isolated and disconnected2478than younger Americans.2479    But at the Y, older adults find the support and meaningful2480relationships they need to feel connected and be healthy.2481    YMCAs engage 17 million Americans annually, and nearly 42482million are over age 55. Almost 2.5 million are over 65.2483Seniors make up nearly one-quarter of our members.2484    A few years ago, the Y partnered with NORC at the2485University of Chicago to find out whether older adults report2486better quality of life and social connectedness when they visit2487our facilities or participate in our programs.2488    Results of this study showed significant increases in2489overall well-being and social connectedness, a decrease in2490loneliness, and observed improvements in social well-being,2491spiritual well-being, physical health and mental health.2492    The results were even better for older adults who were able2493to engage more frequently with their YMCA.2494    Our programs not only help participants build friendships2495and connections that we all need to thrive, but they also can2496help prevent, delay or control chronic disease.2497    Thanks to a 20-year partnership with CDC, the Y is the2498leading in-person provider of evidence-based chronic disease2499prevention and management programs, which address issues like2500diabetes, hypertension, arthritis, falls and cancer.2501    These programs have been proven to improve health outcomes2502and quality of life, and they often save health care dollars.2503    In fact, the Y is recognized for its work with the Centers2504for Medicare and Medicaid Innovation. During a national study2505of 8,000 Medicare recipients, the YMCA's Diabetes Prevention2506Program saved $2,650 per participant while preventing or2507delaying diabetes among the majority of recipients.2508    The Y is also the leading provider of the Medicare2509Advantage fitness benefit -- larger than the next seven2510providers combined.2511    But for as much as we are able to accomplish on our own due2512to our national scale and community-level credibility, the Y is2513always looking to maximize our impact through partnerships.2514    So, in communities across the country, YMCAs collaborate2515with partners like senior centers, libraries and places of2516worship to reach and engage more older adults.2517    The Y looks forward to also partnering with the Select2518Committee on Aging to improve both the physical and emotional2519health of our nation's older adults.2520    We urge Congress to continue supporting the highest level2521of funding for the CDC to help the Y innovate our evidence-2522based chronic disease prevention and control programs, uphold2523Medicare Advantage's ability to offer supplemental benefits2524like fitness and socialization opportunities, and enable2525Medicaid to help low-income seniors improve their physical and2526mental health.2527    Every dollar invested in community-based organizations like2528YMCAs - organizations with trusted relationships and on-the-2529ground credibility - pays a dividend in the form of improved2530health and wellness, especially for our older adults.2531    Again, thank you for this opportunity today, and thank you2532for your leadership.25332534                 U.S. Senate Special Committee on Aging25352536  "Breaking the Cycle of Senior Loneliness: Strengthening Family and2537                           Community Support"25382539                             March 12, 202525402541                      Prepared Witness Statements25422543                          Tori Strawter-Tanks25442545    Thank you for the opportunity to speak before you today. My2546name is Tori Strawter-Tanks, and I have the privilege of2547serving as the Director of Senior Services in Clayton County,2548Georgia, and the President and Founder of the Georgia2549Association of Senior Centers (GASC). I am honored to be here2550today to discuss a critical issue facing older adults across2551the country-social isolation and the vital role senior centers2552and other aging programs play in combatting it.2553    Senior centers are hubs of high-impact exercise, cultural2554engagement, physical wellness, and lifelong learning. The Older2555Americans Act contributes to funding senior centers and other2556important aging services, and protecting that funding is2557critical to ensuring older adults continue to have access to2558the services I have spent my life carrying out.2559    Across Georgia, and throughout the nation, senior centers2560provide vital programs that enhance the lives of older adults,2561keep them socially engaged, and support their overall well-2562being. These include:2563      Health, wellness, aquatic, technology, and fitness2564classes, theatrical productions, cultural arts programs, trips,2565and evidence-based programs. This programming plays a vital2566role in improving seniors' physical health, reducing fall2567risks, preventing chronic disease, enhancing mental well-being,2568fostering creativity, promoting social engagement,2569strengthening community connections, and bridging the2570generational digital divide.2571    At Frank Bailey Senior Center in Riverdale, Georgia, we saw2572firsthand the extraordinary potential of older adults when Ms.2573Dorothy Steel, who started her acting career at age 80, took2574her first acting class at our center. She went on to become a2575Hollywood sensation, starring as a tribal elder in Marvel's2576Black Panther and Black Panther: Wakanda Forever, proving that2577dreams don't have expiration dates.2578    Ms. Steel's appeared in several other films. Her story is a2579testament to the power of senior centers to unlock potential2580and rewrite the narrative of aging.2581    Another essential service that senior centers provide is2582congregate meals. For many older adults, these meals aren't2583just about food; they are about connection, dignity, and2584community.25852586       Congregate meals ensure that seniors receive balanced,2587nutritious food, reducing the risk of malnutrition and diet-2588related illnesses.2589      They combat isolation by providing opportunities for2590older adults to gather, talk, and form meaningful2591relationships.2592      For some seniors, this may be the only hot meal they2593receive in a day.25942595    Without adequate funding for congregate meal programs, like2596those provided through the Older Americans Act, too many older2597adults risk going hungry or becoming further isolated.2598    Along the same line, home-delivered meals also provide2599nutritious food, social interaction, and wellness checks for2600older adults who may not be able to leave their homes. These2601services are especially critical for those who are aging alone,2602without family or other community support.2603    Additionally, transportation services provided through2604assistance from federal funding help seniors get to their2605medical appointments, buy fresh and healthy food at the grocery2606store, and see their friends-rather than being isolated at home2607because they are not able to drive.2608    Beyond their social and emotional benefits, senior centers2609and other aging programs save our economy billions of dollars2610annually. Research has shown that healthy, active seniors who2611participate in community-based programs reduce healthcare costs2612significantly-both for themselves and for taxpayers.2613    We cannot overlook the sandwich generation, those caring2614for aging parents while supporting their children. As the2615senior population grows, working caregivers face mounting2616financial, emotional, and logistical challenges.2617    When older adults stay active, healthy, and engaged, it2618eases the burden on their families. Without proper investment2619in senior centers and community-based services, caregiving2620falls heavily on adult children already juggling careers,2621finances, and family life.2622    Access to social engagement, nutritious meals, health2623programs, and transportation supports not just seniors, but2624their families, workforce retention, and the economy. Yet,2625despite their proven benefits, senior centers remain2626underfunded, leaving many older adults struggling with barriers2627like transportation, awareness, and lack of investment.2628    If we are serious about combatting senior isolation and2629improving public health, we must:26302631      1. Expand funding for senior centers and other aging2632services2633      2. Improve transportation access, especially in rural2634areas so that older adults can actively participate in2635community life2636      3. Strengthen digital inclusion for seniors so they can2637stay connected in a technology-driven world2638      4. Recognize senior centers as essential infrastructure2639to support aging in place, health, and well-being2640      5. Invest in meal programs to fight food insecurity,2641combat isolation, and promote nutrition for older adults2642      6. Support caregivers by ensuring seniors have access to2643services that promote independence.26442645    Social isolation is not just an individual problem, it's a2646public health crisis with consequences as severe as smoking or2647obesity. But, senior centers and programs like congregate and2648home-delivered meals offer a proven solution, helping older2649adults not only stay socially engaged but thrive in ways they2650never imagined.2651    When we invest in senior centers, we are not just enriching2652lives, we are saving money, strengthening families, supporting2653working caregivers, and ensuring a better future for2654generations to come.2655    Thank you for your time and commitment to this issue. I2656look forward to your questions and to working together to build2657a stronger, more connected future for our nation's seniors.26582659=======================================================================26602661                        Questions for the Record26622663=======================================================================26642665                 U.S. Senate Special Committee on Aging26662667  "Breaking the Cycle of Senior Loneliness: Strengthening Family and2668                           Community Support"26692670                             March 12, 202526712672                        Questions for the Record26732674                           Suzanne McCormick26752676                        Senator Raphael Warnock26772678    Question:26792680    The Centers for Disease Control and Prevention (CDC)2681maintains key community partnerships to address complex public2682health issues, including chronic disease. For example, the2683Diabetes Prevention Program, in partnership with the YMCA and2684CDC, supports evidence-based lifestyle change programs to2685prevent type 2 diabetes.\1\2686---------------------------------------------------------------------------2687    \1\ What is the National DPP?, Centers for Disease Control and2688Prevention (May 15, 2024), https://www.cdc.gov/diabetes-prevention/2689programs/what-is-the-national-dpp.html.2690---------------------------------------------------------------------------2691    Why are strong investments in federal health agencies,2692including the CDC, important for maintaining community2693partnerships and support programs that address chronic disease2694prevention?26952696    Response:26972698    CDC is the nation's leading science-based, data-driven2699organization that protects public health through health2700promotion and disease prevention. CDC's National Center on2701Chronic Disease Prevention and Health Promotion and National2702Center on Injury Prevention and Control have invested in the Y2703to pilot and scale evidence-based programs that prevent and2704control chronic diseases and prevent childhood drownings.2705    Health care costs in the United States are among the2706highest in the world, but Americans often face worse health2707outcomes than their peers in other high-income countries.2708According to CDC:27092710      An estimated 129 million people in the U.S. have at2711least one major chronic disease (heart disease, cancer,2712diabetes, obesity, hypertension, etc.).2713      Over the past two decades, the prevalence of chronic2714diseases has increased steadily, and this trend is expected to2715continue.2716    Strong federal investments in the CDC will:27172718      Help our Ys scale proven programs and strategies that2719address the nation's leading causes of death and disability,2720which include heart disease, cancer, obesity, stroke,2721arthritis, and diabetes.2722      Address chronic diseases, which impact 6 in 102723Americans.2724      Help the nation save money-90% of health care spending2725goes to treating chronic disease as opposed to preventing these2726conditions.2727    The public health programs and prevention activities2728conducted by the CDC-in partnerships with organizations like2729the Y-have been proven to be effective. They are crucial to2730reducing health care costs and improving health outcomes. The Y2731offers a variety of evidence-based programs to address chronic2732disease and prevent drownings and, with modest funding from CDC2733and the help of private philanthropy, has scaled these programs2734in communities across the country (see below for examples).2735    CDC's National Diabetes Prevention Program (NDPP) helps2736some of the 98 million adults living with prediabetes reduce2737their risk for developing the disease by taking steps that will2738improve their overall health and well-being. Consider that2739Research has shown that programs like the National Diabetes2740Prevention Program can reduce the number of new cases of type 22741diabetes by 58%, and by 71% for adults over the age of 60.e2742YMCA's Diabetes Prevention Program (DPP) has helped the average2743participant lose 5% of their body weight and helped Medicare2744save $2,650 per participant over 15 months. In April 2018,2745Medicare began covering DPP. The Y is delivering the NDPP in 412746states and has served 80,842 participants at 1,159 sites.2747    CDC's Arthritis Program helps helps the Y expand it's2748EnhancerFitness program to more people. EnhancerFitness is a2749proven community-based senior fitness and arthritis management2750program that helps some of the 54 million adults living with2751arthritis become more active, energized, and independent. Were2752you aware that EnhancerFitness program participants were found2753to have fewer hospitalizations and spend $945 less in health2754care per year than non-participants. Now offered at 258 Ys in2755634 sites in 45 states, the program has reached 42,5842756individuals living with arthritis.2757    CDC's Heart Disease and Stroke Program supports the Y's2758Blood Pressure Self-Monitoring Program, which helps some of the2759116 million Americans living with hypertension prevent heart2760disease and stroke by getting their condition under control2761through tracking their blood pressure and receiving nutrition2762education. Importantly, today, three in four people living with2763hypertension do not have their condition under control. As of27642024, there were 13,718 participants across 41 states who2765experienced an average reduction of 8.6% in systolic blood2766pressure and 4.8% in diastolic blood pressure through the Y's2767program.2768    CDC's Comprehensive Cancer Program supports the LIVESTRONGr2769at the YMCA program, which helps some of the 18 million2770Americans who are living with, though, or beyond cancer to2771strengthen their spirit, mind, and body with physical activity2772programs. Recent clinical trials from the Yale Cancer Center2773and Dana-Farber/Harvard Cancer Institute confirmed that2774LIVESTRONGr at the YMCA participants experienced improved2775fitness and quality of life as well as significant decreases in2776cancer-related fatigue. Ys have served more than 85,477 cancer2777survivors in 42 states.2778    CDC's Nutrition, Physical Activity and Obesity Programs2779help evaluate and scale Family-based weight management programs2780like the Y's Healthy Weight and Your Child, an evidence-based2781program that equips 7- to 13-year-olds and their families with2782the knowledge and skills to live a healthier lifestyle.2783Research showed a statistically significant reduction in body2784mass index, sedentary activities and improvements in physical2785activity and self-esteem at 6 and 12 months. The program is2786being delivered in 31 states across the country. Strategies2787that increase community access to safe places to walk and bike.2788    In closing, the Y supports the highest level of funding2789possible for the CDC's programs that prevent and control2790chronic disease in order to scale programs that work in2791partnership with states and community-based organizations.2792Thank you.27932794                 U.S. Senate Special Committee on Aging27952796  "Breaking the Cycle of Senior Loneliness: Strengthening Family and2797                           Community Support"27982799                             March 12, 202528002801                        Questions for the Record28022803                          Tori Strawter-Tanks28042805                        Senator Raphael Warnock28062807    Question:28082809    As Director of Clayton County Senior Services, you have2810witnessed firsthand how senior and intergenerational centers2811positively affect the lives of older adults, families, and2812entire communities across the state of Georgia.2813    Can you share specific challenges that older adults and2814families across Georgia might face should federal funding for2815senior programs be reduced or limited?28162817    Response:28182819    1. Service Reductions or Eliminations2820      Fewer people served: Programs may have to prioritize the2821most at-risk clients, leaving many without services.2822      Waitlists would grow: Individuals who previously2823received help may be put on indefinite waitlists.2824      Program closures: Some services (like congregate meals2825at senior centers) might be shut down entirely in some areas.2826    2. Increased Risk for Older Adults2827      Malnutrition: Loss of meals (home-delivered or2828congregate) can lead to poor nutrition and worsening health.2829      Increased isolation: Reduced transportation or closure2830of senior centers limits social interaction, increasing2831depression and cognitive decline.2832      Unmet healthcare needs: Without transportation or case2833management, seniors may miss critical medical appointments or2834medication pickups.2835      Safety risks: Without home repairs or in-home care,2836falls and hospitalizations may rise.2837    3. Greater Long-Term Costs2838      More emergency room visits and hospitalizations: When2839basic needs aren't met, healthcare costs rise significantly.2840      Earlier nursing home placement: Seniors without2841caregiver or in-home support may be institutionalized2842prematurely, which is more costly for both families and the2843state.2844    4. Job Loss and Local Economic Impact2845      Fewer staff positions: Reductions in funding may lead to2846layoffs of drivers, case managers, and program coordinators.2847      Strain on caregivers: Family members may have to leave2848work or reduce hours to care for loved ones, affecting2849household incomes and overall productivity.2850    5. Pressure on State and Local Governments2851      Without federal support, state and local governments2852would face pressure to fill the funding gap , often without2853sufficient resources.2854      Counties with fewer tax dollars (especially rural ones)2855would be disproportionately affected.28562857    Question:28582859    Why is predictable funding important for the operations of2860senior centers?28612862    Response:28632864    Predictable funding is critical for the successful2865operation of senior centers because it provides the stability2866and security needed to plan, operate, and grow programs that2867directly support older adults.2868    1. Stability for Essential Services2869      Senior centers provide vital daily services, like meals,2870transportation, fitness, education, and socialization.2871Predictable funding ensures these can continue without2872interruption.2873      Older adults rely on consistent access, and gaps in2874funding could cause programs to shut down temporarily or2875permanently.2876    2. Long-Term Planning and Program Development2877      Predictable funding allows staff to strategically plan2878for:2879          New programs2880          Seasonal events2881          Community partnerships2882          Facility improvements2883      Without reliable funding, long-term planning is replaced2884by crisis management and uncertainty.2885    3. Staffing and Retention2886      With steady funding, senior centers can hire and retain2887qualified staff, including social workers, drivers, program2888coordinators, and health educators.2889      Frequent funding fluctuations can lead to layoffs, low2890morale, and high turnover.2891    4. Consistent Vendor & Supply Relationships2892      Many centers rely on external vendors for meals,2893supplies, transportation services, and programming.2894      Predictable funding ensures timely payments and helps2895maintain strong vendor relationships, which can result in2896better pricing and service.2897    5. Community Trust and Engagement2898      When the community sees reliable services and2899programming, it builds trust and participation.2900      Older adults feel safe and supported when they know the2901center will be there for them tomorrow, next month, and next2902year.2903    6. Stronger Grant Writing & Fundraising2904      Consistent funding provides a foundation that can be2905built upon with private donations, sponsorships, and2906competitive grants.2907      Grantmakers and donors are more likely to contribute to2908centers that show financial stability and sustainability.29092910=======================================================================29112912                       Statements for the Record29132914=======================================================================29152916                 U.S. Senate Special Committee on Aging29172918  "Breaking the Cycle of Senior Loneliness: Strengthening Family and2919                           Community Support"29202921                             March 12, 202529222923                       Statements for the Record29242925   The Alzheimer's Association and Alzheimer's Impact Movement (AIM)2926                               Statement29272928    The Alzheimer's Association and Alzheimer's Impact Movement2929(AIM) thank the Committee for its continued leadership on2930issues crucial to individuals living with Alzheimer's and other2931dementias. We appreciate the opportunity to submit this2932statement for the record for the Senate Special Committee on2933Aging hearing on "Breaking the Cycle of Senior Loneliness:2934Strengthening Family and Community Support." This statement2935highlights the profound impact of senior loneliness and social2936isolation on our nation's aging population, particularly those2937at risk of developing or who are living with Alzheimer's or2938another dementia.2939    Founded in 1980, the Alzheimer's Association is the world's2940leading voluntary health organization in Alzheimer's care,2941support, and research. Our mission is to eliminate Alzheimer's2942disease and other dementias through the advancement of2943research, to provide and enhance care and support for all2944affected, and to reduce the risk of dementia through the2945promotion of brain health. AIM is the Association's advocacy2946affiliate, working in a strategic partnership to make2947Alzheimer's a national priority. Together, the Alzheimer's2948Association and AIM advocate for policies to fight Alzheimer's2949disease, including increased investment in research, improved2950care and support, and the development of approaches to reduce2951the risk of developing dementia.29522953The Critical Role of Family Caregivers29542955    People living with Alzheimer's disease may experience2956changes in the ability to hold or follow a conversation. As a2957result, they may withdraw from hobbies, social activities, or2958other engagements. Caregivers of individuals living with2959Alzheimer's or another dementia play an essential role in2960combating this, maintaining the quality of life for their loved2961ones, and helping them live independently in their homes and2962communities for as long as possible. They are the backbone of2963our nation's health care system. However, the immense physical,2964emotional, and financial toll of caregiving often leaves them2965socially isolated themselves. In fact, 41 percent of dementia2966caregivers report having no additional unpaid assistance,2967highlighting the urgent need for stronger support systems. In29682023 alone, more than 11 million caregivers provided 18.42969billion hours of unpaid care - valued at nearly $350 billion -2970underscoring their indispensable role in our health care2971system.There are several types of caregiver interventions2972designed to assist caregivers of individuals with Alzheimer's2973or another dementia, such as support groups, which provide2974caregivers the opportunity to share personal feelings and2975concerns to overcome feelings of isolation in a community-based2976setting.2977    It is evident that Alzheimer's takes a devastating toll on2978caregivers, from facing social isolation to battling the2979financial strain associated with caregiving. Amid these2980challenges, there is an urgent need to alleviate the2981overwhelming costs faced by caregivers. We strongly support the2982bipartisan Credit for Caring Act (S. 925/H.R. 2036), which2983would create a new, nonrefundable federal tax credit of up to2984$5,000 for eligible working family caregivers of individuals,2985regardless of age, with certain functional or cognitive2986limitations. The tax credit would help alleviate some of the2987financial strain on these selfless caregivers nationwide and2988could be used to offset some of the costs of caregiving,2989including the costs of respite care, transportation, lost2990wages, and more. We look forward to working with Congress and2991members of the Committee to advance the bipartisan Credit for2992Caring Act and other legislation to support caregivers, as they2993enhance the longevity and quality of life for our aging2994population.29952996Expanding Capacity for Health Outcomes (Project ECHO)29972998    Technology-enabled learning models, such as Project ECHO,2999are also transforming the way health care providers support3000individuals with Alzheimer's-especially in rural areas. These3001education models, often referred to as Project ECHO, can3002improve the capacity of providers, especially those in rural3003and underserved areas, on how to best meet the needs of people3004living with Alzheimer's. Project ECHO helps primary care3005physicians in real-time understand how to use validated3006assessment tools appropriate for virtual use to make early and3007accurate diagnoses, educate families about the diagnosis and3008home management strategies, and help caregivers understand the3009behavioral changes associated with Alzheimer's, which can be3010heightened during isolation. We ask that Congress continues to3011support provisions expanding the use of technology-enabled3012collaborative learning models. Expanding these programs will3013not only improve dementia care but also strengthen the support3014networks that help individuals with Alzheimer's and their3015caregivers feel less alone.30163017Social Isolation as a Dementia Risk Factor30183019    As of 2024, nearly 7 million Americans are living with3020Alzheimer's, a number expected to rise to nearly 13 million by30212050. Some researchers have surmised that factors such as3022social isolation from COVID-19 lockdowns, for example, no-3023visitor policies in long-term care facilities, and increased3024intensive hospitalizations may increase dementia risk at the3025population level, but research in coming years will be3026necessary to confirm this and examine whether the impact is3027time-limited or long term. With many more at risk of developing3028the disease or another form of dementia, the need for effective3029dementia risk reduction strategies that help all communities3030increases by the day. Two-thirds of Americans have at least one3031major potential risk factor for dementia. As the prevalence of3032dementia continues to rise, addressing modifiable risk factors3033- such as staying mentally and socially active and physical3034activity - is essential not only to reduce the number of new3035cases but also to prevent current projections from worsening.3036    Population-based and epidemiologic studies show that3037certain modifiable risk factors can increase the risk of3038cognitive decline and possibly dementia. A growing body of3039evidence shows that healthy behaviors can protect and promote3040brain health. Given the growing evidence that lifestyle factors3041play a significant role in cognitive health, larger studies are3042essential to further understand how we can effectively reduce3043the risk of cognitive decline and help individuals live longer,3044happier lives. The Alzheimer's Association U.S. Study to3045Protect Brain Health Through Lifestyle Intervention to Reduce3046Risk (U.S. POINTER) is a two-year clinical trial to evaluate3047whether lifestyle interventions that simultaneously target many3048risk factors protect cognitive function in older adults with an3049increased risk for cognitive decline. U.S. POINTER is the first3050such study conducted on a large group of Americans across the3051United States. Approximately 2,000 volunteer older adults who3052are at increased risk for dementia have been enrolled and will3053be followed for two years. Two lifestyle interventions will be3054compared, which vary in intensity and format. Eligible3055volunteers are randomly assigned to these interventions to3056evaluate whether cognitive benefits from a structured program3057differ from a self-guided program. Lifestyle interventions3058combining multiple behavior components show promise as a3059therapeutic strategy to protect brain health. We look forward3060to sharing the results of this groundbreaking study soon.30613062Conclusion30633064    By prioritizing policies supporting caregivers and3065combating social isolation and senior loneliness, we can help3066the aging population live longer, healthier lives. The3067Alzheimer's Association and AIM deeply appreciate the3068Committee's continued commitment to advancing issues vital to3069the millions of families affected by Alzheimer's disease and3070other dementias. We look forward to working with the Committee3071in a bipartisan way to combat senior loneliness and improve3072quality of life for those impacted by dementia.30733074                 U.S. Senate Special Committee on Aging30753076  "Breaking the Cycle of Senior Loneliness: Strengthening Family and3077                           Community Support"30783079                             March 12, 202530803081                       Statements for the Record30823083                             ASHA Statement30843085    The American Seniors Housing Association (ASHA) appreciates3086the opportunity to submit this statement for the record3087regarding the March 12, 2025, Senate Aging Committee hearing,3088Breaking the Cycle of Senior Loneliness: Strengthening Family3089and Community Support.3090    ASHA is a national organization of over 500 senior living3091companies that own, operate, or provide services to3092approximately 7,000 senior living communities across the U.S.,3093including independent living, assisted living, memory care and3094life plan/continuing care retirement communities. The3095Association's programs are focused on promoting quality and3096innovation, advancing research, exchanging strategic business3097information, and educating seniors and their families about the3098benefits of senior living communities.3099    As such, we have a keen interest in the policy agenda of3100the Senate Aging Committee and encourage the committee to look3101to ASHA as a resource for timely and relevant research on3102issues that impact seniors relative to their housing options3103and long-term care needs.3104    We appreciate the Committee addressing what has been3105described as an epidemic of loneliness. While the harmful3106effects of loneliness are currently receiving much needed3107attention, it has long been a top-of-mind issue for our members3108who prioritize social engagement as a core benefit of seniors'3109housing. The industry welcomes the opportunity to create more3110awareness about what it is achieving to combat this serious3111public health issue through the hard work and dedication of3112senior living professionals, compassionate caregivers and other3113essential team members.31143115    Our comments focus on the following:31163117      The epidemic of loneliness and its harmful health3118impacts3119      How senior living communities promote social engagement3120in creative and innovative ways3121      Important policies to address loneliness should be3122advanced in Congress and Agencies31233124The Epidemic of Loneliness and Harmful Health Impacts is Well3125Documented31263127    As the population ages, it is critical that our nation3128adequately meets the demands of providing quality long-term3129care, especially given the significant and growing numbers of3130seniors who are lonely, isolated and socially disconnected.3131According to Johns Hopkins, nearly 25% of adults aged 65 and3132older are considered socially isolated-as they're more likely3133to live alone or experience the loss of family members and3134friends. Facilitating opportunities for connection for older3135adults is one way to address the heightened risk of loneliness.3136    In a report by the National Academies of Sciences,3137Engineering, and Medicine (NASEM), findings on loneliness and3138social isolation in older adults conclude that social isolation3139significantly increases an individual's risk of premature death3140from all causes, rivaling the risks associated with smoking,3141obesity, and physical inactivity. Social isolation was3142associated with a 50 percent increased risk of dementia, a 293143percent increased risk of heart disease, and a 32 percent3144increased risk of stroke. These are stunning outcomes that3145should prompt action to address ways to mitigate the source of3146these harms.3147    We are grateful your committee is raising the visibility of3148this epidemic among seniors, and we look forward to assisting3149with your efforts.31503151Senior Living Promotes Socialization and Engagement as a Core3152Benefit to Residents31533154    There are approximately two million older adults who call3155senior living "home", and numerous reasons why they move into a3156community. In addition to the myriad services offered, the3157added benefit of promoting social engagement with others in the3158community ranks among the most important aspects of senior3159living for residents and family members.3160    The average assisted living resident is an 84-year-old3161woman who is widowed, has multiple chronic and functional3162limitations, requires assistance with her activities of daily3163living such as, bathing, eating, and dressing. She and her3164family are looking for quality care, safe housing and balanced3165nutrition in an environment that allows for independence (with3166assistance, as needed) and the ability to age in place with3167dignity. These services are the core characteristics of senior3168living, but creating opportunities for engagement and personal3169connection is intrinsic to everything offered in a community.3170    Life in a community means always having something to do -3171and people to enjoy life with, creating a meaningful lifestyle.3172We know the role that social, economic and physical living3173conditions play in achieving good health, well-being, and3174quality of life. These non-medical factors (the "social3175determinants of health") that influence health care outcomes3176are at the heart of senior living. This doesn't just happen; it3177is purposeful in design with the goal of creating environments3178where residents have the opportunity to thrive.3179    Given the high priority senior living providers place on3180the benefits of socialization, ASHA sponsored a research report3181to focus on this topic. We are pleased to share with the3182Committee,: Senior Living Communities: Uniquely Positioned to3183Reduce Social Isolation and Promote Social Connection in Older3184Adults. This brief was prepared for ASHA by ATI Advisory and3185included a literature review, senior living company surveys and3186individual case studies that highlight the impact of social3187opportunities on residents' wellbeing.31883189    The goals of this report were twofold:31903191      (1) to explore the relationship of social isolation to3192physical and mental health outcomes and utilization of health3193care services and;3194      (2) to highlight approaches that senior living3195communities are taking to reduce social isolation and promote3196social connection among their residents.31973198    I hope you will find this full report of value to your3199efforts in further addressing this issue. For purposes of the3200statement, I want to highlight a few key observations in the3201report.32023203Key Observations:32043205      Senior living plays a critical role in reducing social3206isolation among older adult residents, limiting the risk of3207negative health effects and promoting critical social3208connections. Many residents move into a community and become3209more active than when they lived in their former home.3210      Senior living improves quality of life by fostering a3211cohesive social environment and encouraging participation in3212social activities. The authors highlight a recent study which3213found that senior living residents had increased resilience,3214mood, optimism and satisfaction with their lives compared to3215their counterparts in the general population.3216      Senior living offers diverse activities to meet the3217needs, desires, and interests of their varied community base.3218Quality of life is improved by offering opportunities that3219promote resident and community connection.3220      Case studies demonstrate that while no two senior living3221communities are the same, they offer innovative approaches to3222promoting social engagement. See more below.3223      Senior living socialization efforts, enhanced during the3224COVID pandemic, continued, albeit with a twist. While3225interaction with friends and family decreased during the3226pandemic, virtual interaction dramatically increased. Staff3227were on hand to navigate new technologies, thus uncovering new3228ways senior living communities allowed for greater access to3229social, physical and intellectual wellness than their3230counterparts living in the greater community.3231    Figure 1: Senior Living Communities Offer Diverse3232Opportunities for Social Connection32333234[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]32353236Other Studies/Reports:32373238    NORC/University of Chicago: Findings demonstrate that upon3239moving into senior housing, vulnerability increases for a short3240period as residents settle into their new community before3241leveling off and showing improvement. "Non-medical care and3242services like socialization, transportation, exercise, balanced3243nutrition, medication management, and others have a positive3244impact on a resident's health," said Dianne Munevar, lead3245researcher at NORC.3246    US News and World Report: Released new findings from their3247survey of residents who had recently moved into senior living3248communities and their families about their experiences with3249loneliness, the health impacts of social isolation and how3250moving into a senior living community positively changed that3251experience. (How Senior Living Communities Reduce Loneliness3252and Improve Senior Health: 2025 U.S. News Survey Report)32533254Important Policies to Address Loneliness Should be Advanced in3255Congress and Agencies32563257    There are many opportunities Congress can take to enact3258policies and programs and raise general awareness about and3259enhance what is already available. The Senate Special Committee3260on Aging is positioned to do this by promoting policies to call3261more attention to the harms of loneliness and incentivizing3262creative programing to enhance social engagement in senior3263living communities32643265      The Social Engagement and Network Initiatives for Older3266Relief (SENIOR) Act (Senior Act) creates a meaningful approach3267to initiating the broader conversation on loneliness among3268older adults. Adding loneliness to the definition of disease3269prevention and health promotion services under the Older3270Americans Act, requiring the Department of Health and Human3271Services to create a report on the effects of loneliness on3272older adults, and recommending solutions and analyzing the3273relationships between multigenerational family units, has the3274ability to place this health crisis front and center in the3275minds of policymakers, health care providers and systems,3276academics, research institutions and the entire long term care3277industry.3278      The Care Across Generations Act. There is much evidence3279to date to indicate that fostering relationships between young3280and old are beneficial to both in terms of increased3281socialization and overall wellbeing. Taking action to increase3282such arrangements is encouraged. ASHA supports additional3283voluntary programs that encourage these relationships. The Care3284Across Generations Act is a worthy program to encourage these3285relationships. We need to promote intergenerational care, such3286as encouraging child-care and early-learning programs to be3287established in relation to senior living communities.32883289Other Areas for Consideration:32903291    Workforce Shortage in Senior Living: Given the importance3292of senior living as a positive factor in addressing the crisis3293of loneliness, it is important that the industry continue to3294meet the current and future needs of the aging population. To3295do so, it is important that policymakers understand the3296workforce challenges we are facing in the caregiver, nurse3297assistant, housekeeper, and dining staff positions.3298    ASHA supports an "all of the above" solution that creates a3299pipeline of caregivers in a number of ways including 1) through3300workforce training and development programs, specifically3301targeted for long term care positions; and, 2) the advancement3302of proposals to enact legal immigration reform for worker3303visas, to allow foreign workers to work in the senior living3304industry to help meet the growing needs.3305    There are simply not enough native-born workers to meet the3306current and future demand for long-term care. Left unresolved,3307it will ultimately impact the ability to care for older adults.3308As the aging population grows exponentially, organic workforce3309growth in the country is expected to stagnate. We understand3310the need to address border security, but we also need to create3311a legal immigration process where visas are made available to3312caregivers and other essential workers in long term care. We3313support efforts to address both challenges.3314    Costs of Long-Term Care: In addition to sharing and3315promoting these favorable studies and reports about the3316benefits of senior living in reducing the level of loneliness3317for older adults, it is also important to recognize the cost3318effectiveness of senior living relative to other settings.3319    Specifically, as explained in the ASHA sponsored report,3320The Surprising Price of Staying in a House, Cost Comparisons3321Often Favor Senior Living, the emphasis on keeping people in3322their homes at all costs may be shortsighted. While we3323understand most people do not want to leave their homes given3324their personal attachment, the decision should not be based on3325cost alone, without further examination of what it takes3326financially to remain in the home.3327    A recent analysis challenges the cost assumptions. The math3328most seniors and families use does not capture all of the costs3329associated with living in a house, such as taxes, insurance,3330HOA fees, maintenance, system failures, etc. or enjoying meals3331and transportation to appointments, grocery store, movies, etc.3332When all of these factors are considered, the costs tell a3333different story. This information should be made widely3334available to older adults in all public service information3335sharing efforts to ensure they have important facts to make an3336informed decision. NOTE: The figures below under Home Health3337Care, do not reflect a 24/7 care environment as included in3338assisted living. Therefore, as more hours are needed, the costs3339grow exponentially.33403341[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]33423343    ASHA welcomes the opportunity to create more awareness3344among the Senate Aging Committee about what the industry is3345achieving in senior care for residents, caregivers, families,3346and the broader healthcare system. As noted above, the senior3347living industry's work to promote social engagement and thus3348reduce the associated health risks is especially relevant to3349the current inquiry by the Committee. The hard work and3350dedication of senior living professionals and the overwhelming3351resident and family satisfaction deserves to be recognized.3352    The aging population and booming demand for long-term care3353in the very near future requires policy makers to give serious3354thought to innovative approaches to create more options for3355older adults who need care and housing. We look forward to3356working with the Committee to advance opportunities to meet3357this critical need.33583359    Sincerely,33603361    /s/3362    David Schless3363    President and CEO33643365                 U.S. Senate Special Committee on Aging33663367  "Breaking the Cycle of Senior Loneliness: Strengthening Family and3368                           Community Support"33693370                             March 12, 202533713372                       Statements for the Record33733374                 ASHA: Senior Living Communities Report33753376[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]33773378                 U.S. Senate Special Committee on Aging33793380  "Breaking the Cycle of Senior Loneliness: Strengthening Family and3381                           Community Support"33823383                             March 12, 202533843385                       Statements for the Record33863387        ASHA: The Surpassing Price of Staying in a House Report33883389[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]33903391                 U.S. Senate Special Committee on Aging33923393  "Breaking the Cycle of Senior Loneliness: Strengthening Family and3394                           Community Support"33953396                             March 12, 202533973398                       Statements for the Record33993400                         James Balda Statement34013402    ADDENDUM: Testimonials from senior living stakeholders on3403importance of socialization in senior living communities.34043405                                  ***34063407    Helen, a 97-year-old woman from the Bay Area, had been3408struggling at home with loneliness and feeling particularly3409isolated, especially since she had lost her husband. Feeling3410resigned to leave her home behind, which for her symbolized3411leaving her entire life behind, she reluctantly made the3412decision to move into one of our Bay Area Assisted Living3413communities. To her surprise, she found renewal when she met3414Barbara, another resident in her nineties, and today the two3415are inseparable. As Helen told us in an interview with the3416pair, "We just have a very close friendship. Barbara has a3417heart of gold, and I just love her. I never thought I would3418find my best friend at age 97."34193420                                  ***34213422    George and Mary have led a full life together - raising3423their children, traveling the world, and enjoying virtually3424every outdoor pursuit one can imagine. When George was3425diagnosed with Lewy body dementia with Parkinsonism, Mary3426stoically took on the role of caregiver. But within weeks, she3427began experiencing extreme symptoms of stress and anxiety. "I3428wound up in the hospital. I was ignoring my best friend's needs3429over some misconception of mine that I had to do it," she3430shares in this documentary video. She and her family made the3431decision to bring George into one of our communities, and it3432has been transformative for them. Today, Mary continues to live3433at home just a few miles from the community. One might think3434she would be lonely living alone, but she's not. She still3435spends much of each day with George, engaging in life in the3436community alongside him and the other residents and associates3437in our Prema Memory Support neighborhood. "George is doing so3438much better," says Mary. "The Nayas here love their work, they3439love being with the residents. George has made friends with the3440Nayas. They are able to be with one another as family."3441(Watermark's Nayas, which is a Sanskrit word for "guide," are3442more than caregivers - they participate in daily life alongside3443our memory care residents.) In many ways, the decision to move3444George into our community enabled them both to regain strength3445and find new modes of engagement, while avoiding loneliness.3446"We've always had a very adventuresome life," says Mary. "And3447it's continuing."34483449                                  ***34503451    The health and well-being benefits of socialization at our3452communities are enjoyed not just among people, but also between3453people and animals. Every Watermark community is pet-friendly.3454And among Watermark's award-winning signature programs is In3455the Presence of Horses, which brings equine therapy into the3456community, enabling residents and horses to interact in ways3457that benefit both. Janet, a resident in Memory Care in one of3458our Tucson communities who came to us at age 93 with late-stage3459dementia, had not spoken a word in nearly a year. Her daughter,3460who visited her regularly at the community, was bereft at3461seeing her mom slip away. But in her first week at the3462community, Janet met Brown, one of the program's horses, and3463there was an instant connection. "It was as if this horse knew3464her, and she knew him," said the equine program director. At3465another session just a few weeks later, Janet greeted Brown3466with a "Hello." And from that day forward she was speaking3467again, which also enabled her to reconnect with her daughter.34683469                                  ***34703471    Panelists share how they use content as a versatile and3472scalable tool to deliver outstanding resident engagement3473programs for veterans and memory care groups; session includes3474stories about the importance of enriching versus entertaining3475and their strategies for implementing technology to help your3476community flourish.34773478      https://lifeloop.com/flourishing-communities-sitter-3479barfoot-veterans-care-center-on-demand-webinar-ty34803481                                  ***34823483Breaking the Cycle of Senior Isolation: A Community Story34843485    When Hurricane Helene tore through Western North Carolina,3486it didn't just damage homes-it cut off the most vulnerable. In3487the rural townships of Ramsay Creek and Bernardsville, seniors3488were already struggling with isolation, living miles apart with3489limited transportation and spotty phone service. Many relied on3490neighbors, local groups, or a rare internet connection for3491help. But when the storm hit, those lifelines disappeared.34923493From Isolation to Connection34943495    With power and communication down, many seniors were left3496alone, unable to call for help or even know when it might come.3497For those with mobility issues, getting food or medicine became3498impossible. Roads were flooded, homes were unreachable, and3499fear set in.3500    In Bernardsville, the community supply center became a3501beacon of hope. What had once been a quiet space turned into an3502emergency hub. Volunteers worked tirelessly, delivering food,3503water, and medication to those who had no way to get to safety.3504For many seniors, it was the first human contact they had in3505days.35063507More Than a Roof Over Their Heads35083509    For some, the storm took everything. Their homes, already3510fragile, were now unsafe-waterlogged, crumbling, and unlivable.3511The reality of displacement hit hard, especially for those who3512had lived in the same place for decades. Losing their homes3513meant losing familiarity, routine, and a sense of security.3514    A church in Spruce Pine opened its doors, turning its3515sanctuary into a temporary shelter. Volunteers set up cots,3516cooked meals, and offered comfort to those who had nowhere else3517to go. But as days turned to weeks, it became clear that this3518wasn't a permanent solution. These seniors needed real, stable3519housing-something ALG immediately began working on with local3520leaders and families to make happen. Through these efforts, we3521were able to house around 25 seniors.35223523Beyond the Storm: Building a Future of Connection35243525    Hurricane Helene was more than a disaster-it was a wake-up3526call. It exposed how fragile the support system for seniors in3527rural areas really is. It showed how critical human connection3528is, not just in emergencies, but every day.3529    Since the storm, communities have stepped up. Volunteer3530programs now pair seniors with regular check-ins. Local3531organizations are improving transportation access. Plans are in3532motion to strengthen emergency networks so no senior is left3533alone in a crisis.3534    Isolation doesn't have to be a way of life. Through3535connection, compassion, and proactive support, these3536communities are proving that seniors can do more than just3537survive-they can thrive.35383539                                  ***35403541    Meet Zelma Bennett, one of our newest residents at3542Commonwealth Senior Living at Stratford House. Zelma moved into3543our community on January 29th, after spending the past year3544living with a friend. Zelma, who had previously run a group3545home for adults, enjoyed maintaining a vibrant social life with3546assistance, but her memory loss prompted her to seek a3547community where she could continue engaging socially while3548receiving the support she needed. From the moment she arrived,3549Zelma embraced every opportunity for socialization,3550participating in nearly every activity offered. She uses her3551calendar so frequently to keep track of events that she wears3552it out and needs to replace it before the month's end! Her3553enthusiasm has been contagious, and she has made many new3554friends in a short time. Zelma's story is just one example of3555how socialization in our communities has dramatically improved3556the quality of life for seniors. The friendships and activities3557she's engaged in have helped alleviate her feelings of3558loneliness and have given her a renewed sense of purpose and3559joy. We are so grateful she chose to join our community.3560    -Dale Smith, Resident Program Director, Commonwealth Senior3561Living at Stratford House35623563                                  ***35643565Testimonials from Brookdale Residents:3566    One of my biggest fears is being all alone in the world. We3567just enjoy doing things together and talking and it just works.3568We are a group.35693570                                  ***35713572    I think it just enriches your life. It gets rid of that3573loneliness that so many people at this stage in their life3574experience.35753576                                  ***35773578    Not only do you have somebody else that you feel like you3579can talk to, but it's also supporting that somebody else and3580knowing that they're going to support you.35813582                                  ***35833584    To me, Friends for Life means that the people that you meet3585here are going to be your friends for life because no matter3586where you go, these people have impacted your life. They've3587enriched your life. Hopefully you've enriched theirs.35883589                                  ***35903591    The closeness that is offered to making yourself feel at3592home is to have that beautiful relationship with all of these3593people. Friendships are very, very important. I feel that being3594a friend means being there through the good times as well as3595the bad. Just being with people has taught me so much about the3596healing power of friendship.35973598                                  ***35993600    I must tell you, I didn't know I was lonely until I moved3601into Brookdale. And to this day, I have wonderful friends that3602I luncheon with. And it's just a privilege. I found my people3603at Brookdale. It's the people I break bread with. We care for3604each other. And it's wonderful. It's like an extended family,3605really and truly.36063607                                  ***36083609    We all talk and we all laugh. And that's good for3610everybody. It is certainly good to live here and do it all.36113612                                  ***36133614    I told my kids, I want to move where there'll be friends3615and social things because I needed it. And it's been absolutely3616marvelous. So I'm really glad. And the people I met, I felt3617closer to because this gives us a chance to kind of live again.36183619                                  ***36203621    And now you can't be lonesome because there's somebody on3622the elevator. There's somebody sitting with you at a meal.3623There's people all around you. All you have to do is reach out.3624I don't know what I would do without these people.36253626                                  ***36273628    We have a nice bunch of friends. And you know what? We3629confide in each other. We tell each other things. We sit and we3630talk to each other and we hug each other. You know, this is3631part of our everyday routine.36323633                                  ***36343635    I noticed these ladies sitting at a table in the lounge and3636they seem to be having fun and they're chattering away. So I3637said, "May I join you?" And they said, "Yes." And the rest is3638history. I love them all dearly and they're fun to be with.36393640                                  ***36413642    Nolan is a native Oregonian, born in Bend in May of 1938.3643When he was seven, he and his family moved Eugene, OR where3644Nolan lived until about ten years ago, moving to Gresham, OR.3645    Sadly, when Nolan's wife passed away, he began experiencing3646some health concerns, landing him in the hospital. Nolan's3647family reached out to Merrill Gardens at Sheldon Park for an3648evaluation. At that time our Senior Health Services Director,3649Kellie Williams, drove from Eugene to Mt. Hood to meet Nolan.3650    After meeting Nolan, it was an easy YES from Kellie as3651Nolan wasn't a hard sell with his giant grin and kind heart. He3652was soon to be part of the Sheldon Park family.3653    Now, here's the most heartfelt part! Nolan recently called3654Kellie over to his table and stated, "You saved my life!" When3655Kellie asked what Nolan was speaking of, he shared a story of3656what he calls a heroic act.3657    Nolan's water heater at his home in Mt. Hood was found to3658be leaking natural gas (carbon monoxide) for quite some time.3659Nolan was unknowingly being poisoned in his home. Nolan stated,3660"I was sitting in a time bomb and didn't even know it. It may3661have killed me if you had not got me moved here."3662    Nolan expresses deep gratitude to the Merrill Gardens team3663for "saving" him. We are all so thankful Nolan is safe, happy3664and healthy. He is a true delight and brings so much joy to our3665community.3666    Thank you, Nolan, for letting us be part of your family.36673668                                  ***36693670Truewood by Merrill, Keller, Texas36713672    When Mr. Jerry first arrived in our memory care unit he was3673faced with a whirlwind of life changes. Having just lost his3674wife and relocated from California to Texas, he understandably3675felt scared, withdrawn, and overwhelmed by the unknown. The3676adjustment to such significant changes in his life wasn't easy,3677and it took time for him to trust us.3678    However, through consistent, one-on-one interactions and3679building a relationship based on sharing our personal stories3680and experiences, we were able to earn his trust. Over time, Mr.3681Jerry began to let his guard down, allowing us to become a part3682of his journey. He found comfort in our steady presence, and it3683wasn't long before he became an ambassador for our community.3684    Now, Mr. Jerry is an integral part of our family here. He3685regularly expresses his gratitude for the staff and shares how3686much he loves living here. You can often find him participating3687in bingo games, solving crossword puzzles under our reading3688tree, or most joyfully, spending time with his daughter and3689grandchildren around the community. His joy is contagious, and3690it brings so much warmth to all of us.3691    Mr. Jerry holds a special place in our hearts, and we are3692honored to be a part of his extended family. His transformation3693from a scared, withdrawn newcomer to a vibrant, engaged member3694of our community is a testament to the strength of his3695character and the bond we share with him. We are truly grateful3696to have him here with us.36973698                                  ***36993700    Just four short months ago, a sweet and gentle woman joined3701our memory care unit. At first, she was very shy and quiet, and3702her husband, deeply devoted to her, would come in several times3703a day to check on her. He shared that his wife wouldn't eat3704unless he was there with her, and she would be hesitant to3705participate in activities unless he was present. She also3706didn't like noise, having lived a quiet, settled life at home.3707    For the first few weeks, her husband kept to his routine,3708sitting in on meals, participating in activities, and ensuring3709she was away from any noise. It was clear how much he cared for3710her, and we respected their need for comfort and familiarity.3711However, on one particular day, he had a doctor's appointment,3712and we decided to gently test the waters by bringing her out3713for some musical entertainment. We knew that music was3714something she enjoyed, as we often heard her husband sing songs3715to her during their walks through the unit.3716    Sure enough, the music was just what she needed. She began3717to relax, her smile brightening with each note. One song even3718got her up out of her seat, and before we knew it, she was3719clapping and dancing-something we had never seen before. We3720managed to capture the moment on video, and when we showed it3721to her husband, his face lit up with surprise and joy. His3722gratitude was overwhelming, and he couldn't thank us enough for3723taking the chance and helping her break free from her shell.3724    That moment marked a turning point. From that day forward,3725her husband knew he could trust us to do what was best for his3726wife. He no longer felt the weight of needing to be present for3727every meal or activity, knowing she was in good hands. She had3728found her comfort, and he shares with us often how much she's3729growing. Not only was she comfortable without him, but he began3730participating in activities as well, knowing that she was safe3731and content.3732    The progress we've seen in her has been truly remarkable.3733What started as a quiet, reserved woman has blossomed into3734someone who now enjoys the company of others, embraces3735activities, and even dances to her favorite songs. This3736transformation wouldn't have been possible without the trust,3737patience, and understanding of both her and her husband-and we3738are grateful of having the privilege of supporting them on3739their journey.37403741                                  ***37423743Merrill Gardens at Sheldon Park, Eugene, OR37443745    When Shirley moved in with us, she was very quiet, reserved3746and preferred to stay in her apartment. After a short3747adjustment period she felt comfortable with joining in3748conversations in the dining room and became fast friends with3749Donna. The two of them are now darn near inseparable and3750Shirley is out socializing more often than not.3751    Frieda moved in with Bill and his care was her singular3752focus. After he passed, she enjoyed the sense of community and3753her neighbors made her want to stay. She is often found with3754Weezy and laughing and joking. She tells everyone she meets how3755much she loves it here and often says "I can't imagine going3756home to that empty house and having no one to talk to. You all3757have provided that sense of community that I didn't know I3758needed.37593760                                  ***37613762Merrill Gardens at The University, Seattle WA37633764    We have a resident who moved into our community in his 70s,3765initially planning to stay only for six months. He loved it3766here so much that he's been with us for almost four years and3767doesn't plan to leave. He fell in love with the sense of3768community. When he walks out of his apartment every morning, he3769greets our receptionist and says hello to those in the bistro,3770reading their morning paper with a cup of coffee. He has3771considered moving to a regular apartment building, but he3772wouldn't want to be anywhere else because you don't get the3773sense of community elsewhere. This resident spends most of his3774time out and about during the day but loves coming home to his3775own apartment in the community he loves and has now called home3776for the past four years.37773778                                  ***37793780Merrill Gardens at Kirkland, Kirkland, WA37813782    Prior to moving into a Merrill Gardens at Kirkland Senior3783Living , Joann M, age 88, a widow of 18 years, lived alone3784independently in her own home. The isolation took a toll on3785both her physical health as well as her cognitive health.3786Because of the social isolation, she spent most of her time3787sitting in her chair, reading or watching movies on her IPAD.3788Family noticed that she started to become withdrawn and showed3789a lack of interest with most things. She also became less3790sturdy on her feet and at times they would notice bruises on3791her face and body, as well as watching her walk in pain3792concealing that she had fallen. She finally made the decision3793that she had been putting off and agreed that it was time to3794move into a community to make new friends and to start getting3795active again. Within a few short months of embracing the new3796community, her strength and balance came back. She started3797going on all the outing, participated in all the social3798activities, and never missed a meal with her new friends.3799Family reported that all cognitive concerns had gone away since3800she moved in, and this resident never had a fall during the two3801years she moved to this senior living community. The community3802described her as a resident that was aging backwards in real3803time. When we talked to this resident and asked if she had any3804regrets about leaving her home and moving to the community, she3805told us bluntly, YES, I regret not moving in five years sooner.3806This was the best decision she had made in the last 20 years,3807and she was having the time of her life.3808    This resident is my own mother who just recently passed3809away. She absolutely loved living at Merrill Gardens at3810Kirkland3811    -Brian Madgett, General Manager38123813                                  ***38143815Merrill Gardens at Burien, Burien, WA38163817    The community had a resident who was never married, was3818scared, living alone in her own home, failing mentally and3819physically. Was fiercely independent, however friends noticed3820she needed help and was able to have her move to our community.3821She has since regained weight, is very active within the3822community and now has a fellow resident as her "boyfriend" and3823living her best life.3824    A family from California toured with us months back wanting3825to move to Washington to be with local family in a year or so.3826Unhappily, the husband was diagnosed with terminal cancer. It3827was so very important for the children to get Mom & Dad up to3828WA and in our community - knowing that when Dad passed if Mom3829was not already living in a senior community their fear was Mom3830would follow Dad soon after. The family was able to move them3831in, Dad on hospice and passing soon after their arrival. The3832community of residents and staff wrapped their arms around her,3833and she is thriving; active and engaged.38343835                                  ***38363837Merrill Gardens at Renton Centre, Renton, WA38383839    When we first met her, Maureen refused to get out of bed.3840Her apartment was dark at 3:00 in the afternoon and she was3841still in bed. She hadn't eaten, showered, or dressed for the3842day. I began seeing her on a regular basis and talking with her3843daughter, who lives out of state. I started to accompany her on3844medical appointments. Because of her memory impairment, she3845couldn't ever recall what was said at prior appointments. I3846took notes, which I shared with our staff and her daughter.3847    A number of things resulted from the initial visit. The3848doctor prescribed antidepressants. Our nurse scheduled a3849virtual care conference with her daughter. All agreed that3850Maureen needed more care than she was currently receiving. With3851constant encouragement, she began to take baby steps toward a3852more fulfilling life. She started dressing up and having all of3853her meals in the dining room. We connected her with in-house3854therapists and she began receiving both physical and3855occupational therapy. Maureen began to thrive in our community.3856She missed entertaining her friends for tea in her home. I3857helped her to reconnect with those friends and invited them to3858her apartment for high tea, complete with scones, finger3859sandwiches, and petit fours (thanks to our chef). She also made3860new friends in the community. Thanks to these interventions,3861Maureen developed a brighter outlook and "a new lease on life"3862(her words) at age 91.38633864                                  ***38653866    Patricia Will, Founder and CEO of Belmont Village Senior3867Living, moderated a webinar entitled "Resilience and Wisdom in3868Senior Housing Communities" presented by Dr. Dilip V. Jeste,3869M.D., a renowned geriatric neuro-psychiatrist and Director of3870the Sam and Rose Stein Institute for Research on Aging at the3871University of California San Diego. . In the webinar, Dr. Jeste3872addressed conditions experienced by aging seniors, such as3873loneliness and isolation, and how a senior's quality of life3874can be improved by promoting the inherent resilience and wisdom3875of seniors when living in an engaging, communal environment3876among peers. . Dr. Jeste explained that older adults are at3877increased risk for loneliness and social isolation because they3878are more likely to face difficulties in living alone, the loss3879of family or friends, chronic illness, and hearing loss.3880Loneliness is described as the distress caused by a feeling of3881being alone, while social isolation is the inadequacy and3882infrequency of engaging social relationships. Loneliness can3883increase the risk of major diseases, such as heart disease,3884diabetes, obesity, depression, substance abuse and Alzheimer's3885and other forms of dementia.3886      -Belmont Village Senior Living and Dilip Jeste, MD,3887Present "Resilience and Wisdom in Senior Housing Communities,"3888a Webinar on the Benefits of Community Living Ahead of New La3889Jolla Community Opening.3890    Belmont Blooms Fashion Show (Video)38913892                                  ***38933894    Testimonial: Kay Allen, Belmont Village Fort Lauderdale3895(Video)38963897                                  ***38983899    Finding Friendship at Belmont Village (Video)39003901                 U.S. Senate Special Committee on Aging39023903  "Breaking the Cycle of Senior Loneliness: Strengthening Family and3904                           Community Support"39053906                             March 12, 202539073908                       Statements for the Record39093910                            NANASP Statement39113912    The National Association of Nutrition and Aging Services3913Programs commends the committee for convening the hearing on3914"Breaking the Cycle of Senior Loneliness: Strengthening Family3915and Community Support."3916    ANASP is an association of over 1,000 members across the3917country who form a vital lifeline through senior centers, dine-3918in and congregate meal sites, and home-delivered-meal services.3919These essential providers reach into every corner of America,3920from rural small towns to bustling urban hubs. Almost 60% of3921our older adult participants live alone, making our programs3922one of their few daily social connections.3923    Older adults are at higher risk for socially isolation due3924to factors like mobility limitations, health issues, lack of3925transportation, loss of loved ones, and financial constraints.3926In 2024, one in three older Americans reported feeling lonely.3927Social isolation not only creates health problems -it amplifies3928them, increasing the risk of premature death for older adults3929managing chronic conditions and increasing avoidable admissions3930to a hospital or nursing home. Those experiencing isolation and3931loneliness are more vulnerable to falls and depression,3932threatening their independence and self-reliance.3933    An effective answer to this silent epidemic already exists3934in a landmark program, the Older Americans Act (OAA). OAA3935programs offer vital nutrition and supportive services,3936breaking the cycle of isolation while improving health3937outcomes. A recent survey found 61% of home-delivered meal3938participants noted the daily meals helped reduce feelings of3939social isolation and nearly three-quarters of participants3940believe the program helps them to continue to live3941independently and improve their health. As Mr. MacPherson,3942Founder and Chairman of the Foundation for Social Connection3943Action Network, stated in his testimony, addressing this3944epidemic is not only a moral imperative, but also a critical3945public health necessity.3946    This year, the OAA will celebrate 60 years of success of3947delivering services and programs that create connections.3948Despite bipartisan support, the OAA wasn't reauthorized in39492024. We encourage the committee to work in a bipartisan3950fashion to reauthorize the OAA to ensure these essential3951services can reach even more older adults facing social3952isolation and loneliness.3953    Sincerely,3954    /s/3955    Bob Blancato3956    Executive Director3957    NANASP39583959                 U.S. Senate Special Committee on Aging39603961  "Breaking the Cycle of Senior Loneliness: Strengthening Family and3962                           Community Support"39633964                             March 12, 202539653966                       Statements for the Record39673968                    Oshkosh Community YMCA Statement39693970[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]39713972                 U.S. Senate Special Committee on Aging39733974  "Breaking the Cycle of Senior Loneliness: Strengthening Family and3975                           Community Support"39763977                             March 12, 202539783979                       Statements for the Record39803981                             YMCA Statement39823983  Social Connection & Fall Prevention - A Winning Combination at NYS3984                                 YMCAs39853986    Studies show that participation in group-based exercise3987programs designed for fall prevention can effectively reduce3988social isolation among seniors by fostering social connections3989and a sense of community.3990    In New York State, falls are the leading cause of injury3991and death in New York State, accounting for $1.7 billion in3992annual hospitalization charges. New York State YMCAs are rising3993to meet this challenge by expanding capacity in statewide fall3994prevention programs.39953996      YMCAs are engaged in a 4-year plan to enroll over 2,5003997New Yorkers in fall prevention programs, expanding access to3998life-saving resources and promoting social connection.3999      40 new instructors have been trained in the last six4000months, enabling evidence-based falls prevention programs to4001expand to new YMCA locations as well as senior centers,4002churches, and other community locations, making fall prevention4003more accessible than ever.4004      NYS YMCAs are preparing to launch a statewide, virtual,4005small-group based fall prevention program to reach those facing4006mobility challenges or lack access to transportation.40074008[GRAPHIC] [TIFF OMITTED] T0186.04740094010                 U.S. Senate Special Committee on Aging40114012  "Breaking the Cycle of Senior Loneliness: Strengthening Family and4013                           Community Support"40144015                             March 12, 202540164017                       Statements for the Record40184019                        YMCA Florida Statistics40204021[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]40224023                              [all]