Q & A: The White House Conference on Aging
By Sandra Bienkowski
The White House Conference on Aging (WHCoA) convened for four days in mid-December to discuss "The Booming Dynamics of Aging: From Awareness to Action." The conference, which only occurs once every 10 years, focused on the challenges and opportunities that face the 78 million baby boomers born through 1946 and 1964 and how to develop effective aging policies and initiatives for the future.
The 17-member WHCoA Policy Committee, appointed by the president and Congress, held 13 Listening Sessions in 2005 to gather information from the public, 20 Solution Forums that helped the committee define its agenda, as well as several mini-conferences. Delegates (1,200 total), including governors, the National Congress of American Indians, members of the 109th Congress as well as representatives of aging organizations, selected the top 50 resolutions they believe to be the most important policy initiatives for current and future generations of seniors. Delegates will use this list to make recommendations to the president and Congress. (To view the list in its entirety, visit www.whcoa.gov)
The Honorable Dorcas R. Hardy
Former Commissioner of the Social Security Administration
Current Chairperson and Policy Committee Member, WHCoA, and President of Dorcas R. Hardy & Associates
MM: What outcomes can we expect from the conference that will assist people with disabilities?
Ms. Hardy: We don't have all of the end results and all of the excellent ideas or what we call implementation strategies that came from the conference. It is collected, but it is not necessarily into the computers yet because it takes time. With everyone's viewpoints and with so many delegates who participated in the sessions, we still have a ways to go. We hope to get the strategies at least out to the governors in the middle of March. I can't tell you specifically that this resolution led to the following three implementation strategies that were really dynamite because we aren't there yet; it is a long process to get things off the white board and into the computers. The way in which it was structured is that throughout the country we had 400 sessions of input prior to the conference including aging events, solution forums, mini conferences, etc. Almost 150,000 people had something to say and wanted it addressed at the conference. That level of response led to the specific 73 resolutions. The WHCoA conference told us "We know what the problems are," but we wanted the conference attendees to tell us how it can be done and by whom. We want to get everyone's comments: pros, cons, anti.
MM: Can you comment on how aging in place showed up in the resolutions?
Ms. Hardy: Aging in place, this phrase has been with us for quite awhile, because of the aging of the population and because boomers are strong, articulate and they know what they want. This is becoming far more of a discussion throughout the country with or without disabilities. Plus, it is not just aging with disabilities; it is becoming disabled to some extent or another when you become aged. I think people are beginning to understand that. The conference gave a face to this aging in place conversation and how do you use public and private resources to the best of one's ability to make it happen to aid consumer choice and to request aging in place. I have gone through this with my own mother who became technically very much dependent three days after the president asked me to do this job. It has been a wrenching experience. She did want to continue to age in place, but when someone collapses and becomes clinically diagnosed with vascular dementia, there is no way that can happen. I couldn't do it with her in Florida. I think the aging in place issue is twofold: It is for someone who does have the mental capacity to stay in their own home and how do we have public policy to support that? And the next issue becomes, what do we do as a society or what should that person be expecting if they don't have the ability from the mental side? The conference looked at how do we do a better job with transportation; how do we do a better job with universal design of our houses; what else should we incorporate? It is not just a fiscal conversation; it's a neighborhood conversation. What do you do with the person in a rural area? Can they afford dollar wise or mentally to age in place? I think the concept is great, but it can also lead to an incredible amount of isolation. The meal person coming by twice a day, that's not life. But where is the responsibility and is it even adequate if six people come by every day? You are still alone. How do we live? Maybe you age in place, but that place, maybe it's like different kinds of apartments where people are able to help each other. It's aging in place, but it's a little bit different place than your house. It is stages. It is fair to say that everyone in a perfect world would like to age in place, but how do we get there and what are the stages that one might go through to get there?
MM: Is it true that universal design and housing were repeatedly addressed at the conference?
Ms. Hardy: We had a lot of interest in universal design and housing. There has been a lot of conversation about universal design over the years, but many people don't understand what it is. It is not just a mandate: universal design. It is a real public/private partnership. If you are going to have that kind of housing, you have to make the builders aware that it is not that difficult to use the concept of universal design. We are certainly beginning to see it with a master bedroom on the first floor of a two-story home. That is not unusual anymore. Maybe that will translate to family homes in the future. I wouldn't be surprised by that at all. I think much of how apartments are built are also going to be wider hallways, all the kinds of things that ADA has done for all of us, but that is not enough. One of the conference positives is to be able to bring some attention to these issues, to use the conference as a bully pulpit and these are the kinds of things that are going to be coming out of the report.
MM: We have heard that many people with lifelong disabilities are living longer. Was this discussed at the conference?
Ms. Hardy: This was discussed at the mini conference on disability and aging. That report covers a lot of these issues and these ideas went into the big conference. This will be mentioned across the board. Maybe it's because I am very familiar with disability because I used to run a rehab technology company. These issues really cut across everything from the work place to the economic side to our conversation with how the community is put together that assist people with disabilities. On the tech side we had a very successful exhibit hall that was called the technology pavilion and CAST, the center for assistive services and technology, showed that there is more hope of aging in place because of technology that is out there and is coming. That doesn't mean that everyone has to have a robot ? whether it's the end of a cane, the interaction between a house that is correctly wired and sending a message to the caregiver's Blackberry ? the use of technology is really going to make the future different than we have today. It is just tremendous and mind-boggling as to what is out there. Most of what we saw is available. The private sector is really ahead of the curve on this.
One of my personal hopes for those of us who are caregivers ? since in some cases there is too much information and for others there is not enough ? is a community college course that teaches caregivers to provide care to family members who need it and teach them about how to use products. What should you expect as a caregiver and how do you determine if one [HME company] is better than another? And consumers don't have that kind of information.
Robert B. Blancato
President of Matz, Blancato & Associates Inc., Washington, D.C.
White House Policy Committee Member
MM: How do you think the resolutions will help create an accessible nation?
Blancato: It will depend on the degree to which the resolutions and the implementation strategies are followed up. The WHCoA will ultimately file two reports: one that goes to all the governors for their input in early 2006, and later a final report to the president, Congress and the public. In both, key resolutions and correlating implementation strategies will be included. These will include, some mentioned earlier, especially in the areas of transportation and housing which are key areas to improve if we are to better achieve an accessible nation.
MM: How can communities promote aging in place?
Blancato: Aging in place is no longer some hypothetical term in our nation. Demographics, especially the aging boomers, dictate that aging in place should be a goal wherever possible in communities where people choose to either remain or move as they age. Communities can promote aging in place first and foremost by planning. This includes the need to consult with all of those who represent the community today and who can be expected to be the community of tomorrow. Communities must recognize the importance of transportation as the life blood to achieve successful aging in place. The importance of housing with universal design features and supportive services is also key to aging in place. To ensure productive aging in place, meaningful volunteer opportunities must exist for all who wish to participate. Finally, to successfully age in place, health care must be accessible and affordable for those who need it.
MM: Do you think the conference made a significant impact in addressing the needs of people with disabilities?
Blancato: The conference was responsive to addressing issues impacting people with disabilities. The real measurement of this or any WHCoA is what is done after the conference with the resolutions adopted by the conference. It was a good development that language related to people with disabilities was included in various implementation strategies and resolutions adopted by the delegates of the conference. This includes a call for expansion of home-based volunteer opportunities and transportation assistance for Americans with disabilities in the main civic engagement resolution. Also, in the key housing resolutions, there were important implementation strategies which included a call for a new federal housing trust fund to meet planning and development needs for low income and disabled older adults. In addition, the resolutions and the implementation strategies addressing the SSI and SSDI programs were also important. The WHCoA felt that issues related to people with disabilities needed to be viewed as cross-cutting to impact a wider range of issues. I hope we can do this again when I have more specific implementation strategies. I think the whole disability, home health, aging in place and all of those issues were passionate ones for all of the delegates. I expect a lot of bright ideas for these issues.