White House Conference 2015: New Paths for Aging

After a year spent gathering facts and opinions from everybody who’s anybody in the world of aging, the White House on July 13 held a comprehensive session to discuss what needs to change in the United States.

President Barack Obama addressed a crowd of about 200 aging experts  — the first president to speak to a White House Conference on Aging (WHCOA) since 1995. He praised the achievements and abilities of older Americans, noting that many have broken athletic records after age 60. "Diana Nyad is here, and you don't want to race her in anything," he said.

And he referred playfully to Supreme Court Justice Ruth Bader Ginsburg as "the notorious RBG,"  saying the "oldest on the court is arguably also the toughest."

On a more serious note, the President affirmed the importance of Social Security and Medicare to the financial security and health of older Americans. Despite what the critics say,  "Medicare and Social Security are not in crisis," he said later adding, "The goal is not to cut back on services, the goal is to get all the services you need and less of what you don't," he said.

Nora Super, the Executive Director of the 2015 WHCOA, also welcomed those in Washington, D.C. and those gathered for 600 watching parties in all 50 states. Looking at the audience, she said: "Wow... Dreams really do come true." It was her job to seek out input from across the country, and having so much participation strengthened the results and proposals, she said.

Not everyone was happy with the invitation-only nature of the event, noting that without delegates in attendance, ideas couldn't receive full debate. Mark Miller pointed out for Money.com that too much of the conference agenda felt like a re-hash of ideas the administration has been promoting for years, and that issues such as the diversification of the aging population and economic disparity in retirement savings were ignored.

Even before the 10 a.m. kick-off, the President announced steps his administration is taking in the four key areas the conference studied: retirement security, long term services and support, elder justice and healthy aging. His proposals include clarifying rules around how states could provide retirement savings plans similar to 401(k) accounts; updating quality and safety requirements for nursing homes; and introducing access to food for the homebound. And they've launched Aging.gov, a one-stop shop for government-wide information for older adults , and Data.gov,  opening government data relevant to aging.

Here are synopses of the many sessions held today:

Actor David Hyde Pierce, known for his role as Dr. Niles Crane in the NBC sitcom Frasier, moderated the conference’s panel on caregiving. Pierce is a spokesman for the Alzheimer’s Association; members of his own family were affected by the disease.

Secretary Robert A. McDonald of the U.S. Department of Veterans Affairs (VA) said that, with so many veterans under its care for such a long span, his agency has been a “canary in the coal mine” for medical issues in the United States. It will be the same for aging, he said.

By 2017, with the aging of the boomers, there will be 10 million veterans over the age of 65, he said. “Disability claims have gone up by 50 percent in a short period of time, and this has put tremendous stress on our system,” McDonald said.

The VA has responded by, among other things, establishing a new national caregiver support line at 855-260-3274. Licensed social workers have fielded over 190,000 calls and provided 33,000 referrals, McDonald said. Another program, REACH (Resources for All Caregivers Health) is designed to “teach caregivers how to solve problems and get things done.”

Other caregiving panel members included Ai-Jen Poo of Caring Across Generations and author of The Age of Dignity: Preparing for the Elder Boom in a Changing America; Frank Fernandez, president and CEO of BluePlus of Blue Cross and Blue Shield of Minnesota Foundation; Harry Leider, a physician and chief medical officer with Walgreens and Britnee Fergins, a caregiver in Shreveport, La.

Leider said Walgreens is in a unique position to help older Americans by virtue of its reach and availability (8,300 stores, with many open 24 hours a day); its services (medication management and immunizations); and its position on the “front line” of health care for many patients.

“The average diabetic or their caregiver comes to our pharmacy 20 times a year,” he said. That translates to much more frequent contact than that person’s primary care physician has with him or her, Leider said.

Fergins, a full-time chemist, is a single mother of a 2-year-old son and also takes care of her father, who has Alzheimer’s.

“It’s been very difficult,” she said, “but he is my father and he’s been a great father, so I do it.”

Asked what would help her the most with her caregiving responsibilities, Fergins said: convenience.

“All the great programs that I hear them talking about — I’ll call and either no one answers the phone or they won’t return a phone call,” she said. Or she is told she has to call another number because she has the wrong department. She can’t get the resources or benefits that her father needs if she can’t get through to the right people, she said.

“And you don’t have time to make the call in the first place,” Pierce said.

Panelist Ai-Jen Poo stressed the importance of establishing systems to support and value the nation’s 50 million professional and family caregivers, whose numbers will double by the year 2050.

We need “to see caregivers as a huge part of the solution for the future, as a huge part of the equation for quality of life” for our elders, she said.

In his remarks, President Obama said: “Too many people are leaving their jobs without having saved enough for a dignified retirement. It’s not as though they haven’t tried. It’s really really hard.”

Obama noted that most workers don’t have pensions (as many of their parents did) and “a Social Security check on its own often is not enough.” Since roughly one-third of workers lack access to retirement plans at work, the president said that by the end of 2015, the Administration will propose rules to make it easier for states to set up programs allowing “tens of millions” of residents without employer-based retirement plans to save. Illinois recently passed just such a law and about 20 states are considering one.

Obama said he wants to make sure that all workers could benefit from the tax advantages of 401(k) and similar employer-sponsored retirement plans. That way, he said, “even if you don’t have googobs of money or fancy financial advisers, you can put away a little nest egg so you’re protected when you’re old.

That led to the White House Conference on Aging’s morning panel, Planning for Financial Security at Every Age with U.S Secretary of Labor Tom Perez and four panelists: Jean Chatzky (AARP Financial Ambassador and NBC Today Show’s financial expert); Andy Sieg (head of Global Wealth and Retirement Solutions at Merrill Lynch Bank of America); Robin Diamonte (Chief Investment Officer at United Technologies) and Vickie Elisa (President of Mothers’ Voices Georgia).

When Perez asked what the panelists thought was the most significant barrier to a secure retirement, Sieg said it was the need to “expand the way we think about later life and our bonus years,” since “retirement has been transformed as a concept in society.”

Merrill Lynch has been trying to do this by working with the University of Southern California Davis School of Gerontology to provide gerontology training for its 14,000 financial advisers. And today, Sieg announced, the firm will soon offer similar training to Human Resources staffers at more than 35,000 companies with its retirement and benefit plan services.

Chatzky thought the biggest barrier to a secure retirement is that “we’re human.”

She said: “When you ask humans to plan for retirement, you’re asking them to do things that really anathema to human nature — to save, which they’re not particularly good at — and to do it consistently. Life has a way of surprising us. And then they’re asked to consistently stick with markets when they’re not a lot of fun. And then once they’ve accumulated money, not to pull it out and spend it all at once. We’re asking to climb a mountain previous generations didn’t have to climb.”

Elisa, who spoke candidly of financial challenges she has faced and money mistakes she has made (“I went way, way way off track and ended up in a fiscal nightmare with bill collectors and foreclosure looming”), offered this advice — speaking particularly to women: “You can always find a way to save. Baby steps will get you where you need to go. Reduce your credit card debt to help you secure your economic future.”

The challenge, Elisa added, is “staying consistent and keeping your retirement goal ever-present despite what may seem like setbacks.”

Diamonte mentioned some of the progressive ways her company helps its employees save for retirement and to “make it simple.” Essentially, United Technologies makes people save a lot automatically unless they specifically say they won’t. And the firm offers generous cash to help.

United Technologies has an “auto-enrollment” 401(k) plan where employees put in 6 percent of pay as soon as they start working, unless they opt out. Then, that amount rises by one percentage point a year. The company kicks in 3 to 5.5 percent, depending on the employee’s age.

Diamonte’s firm also does something interesting to help employees’ money last. It has a “lifetime income strategy” where the plan’s money is invested in quasi target date fund that gets more conservative as an employee ages and then it generates lifetime income in retirement.

“It’s important for industry to put products in place that give employees lifetime security and flexibility,” said Diamonte. “At ours, you have control over your balance; there are no penalties if you want to take money out in retirement the way there are with traditional annuities.”

Elisa had one request for Washington: “Make the Social Security and Medicare rules more user-friendly.”

That doesn't seem to be in the cards, but the White House said today that the Social Security Administration is providing individuals with an "easily transferrable data file" with information in their Social Security benefit statement so they could look at their Social Security benefits along with their retirement savings.

Financial advisory firms such as Financial Engines, Betterment and Hello Wallet are working on software incorporating this new data. "We're proud to be working closely with the Social Security Administration to help Americans plan accurately for retirement, said Kelly O'Donnell, executive vice president of Financial Engines.

An afternoon panel at the conference included distance swimmer Diana Nyad, who set a world record by swimming from Cuba to Florida in in 2013 at age 63.

When she walked up on the Florida beach, “The first words I said were, ‘Never, ever give up. If you want to get to that other shore, you will find a way.’ The other thing I said was you’re never too old to chase your dreams.” She said she is now organizing a walk across America to encourage greater physical activity. “In 10 years, we will see the numbers of childhood diabetes, heart disease, obesity and depression and all the things that come from inactivity, disappear.”

Matt Hayek, mayor of Iowa City, Iowa, said that local governments have an important role to play in encouraging healthy aging. Iowa City provides incentives for senior housing and promotes walking and bicycling, he said. Small loans can help older adults make needed home repairs, thereby extending their ability to live independently. “Our goal is to make our community welcoming to seniors,” Hayek said.

The U.S. Surgeon General, Vice Admiral Vivek Murthy, called for a “culture of prevention in America.” The nation has a high rate of obesity; almost half of adults have some chronic condition. The solution is a combination of healthy nutrition, physical activity and mental health care, he said.

But the cultural factors that affect change are not generated from Washingon, Murthy said. He once spoke to a pastor whose church served a weekly meal of fried chicken; the pastor believed switching to baked chicken for the health advantages was a tough pill to swallow. “About a month in, he thought, ‘This baked chicken tastes pretty good.’ So we can change norms, beliefs and practices based on what we do in our neighborhood,” Murthy said.

Dr. Michael Smith of WebMD moderated the panel. YMCA President Kevin Washington and Fernando Torres-Gil, director of the UCLA Center for Policy Research on Aging, also took part.

Torres-Gil, who contracted polio as a child, said we need to break down stereotypes about age, ethnicity and disabled vs. “temporarily abled.”

“I’ve never felt healthier or happier as I do now as a polio survivor getting older with a disability,” he said. “Life is good at any age … as long as we stay active and stay engaged.”

As you likely sadly know, elder financial abuse is a tragic problem in America. As Richard Cordray, Director of the federal Consumer Financial Protection Bureau said at the Elder Justice in the Twenty-First Century panel of the White House Conference on Aging: “Older Americans all too often fall prey to financial exploitation.”

In a recent Wells Fargo survey of 1,005 investors, 32 percent of respondents said they know someone who has been the victim of investment scams or financial abuse targeted at the elderly.

What you might not know: “Only a small fraction of elder abuse is ever reported,” said Cordray.

Panelist Lynne Person, Long-Term Care Ombudsman at the Office of the D.C. Department of Health Care, said “often, victims are fearful of reporting abuse from a caregiver because the caregiver is the one they depend on for the activities of daily living.” Another panelist, James Baker, Director of Law Enforcement Operations and Support at the International Association of Chiefs of Police, added that “often they are embarrassed or there’s no one there to help them ask for help.”

Panelist Elizabeth Loewy, a former prosecutor and now General Counsel and Senior VP of Industry Relations at Eversafe.com, an elderfraud prevention service, said: “We have blindfolds on with respect to the tsunami of elder fraud.”

The moderator of this panel, U.S. Department of Health and Human Services Assistant Secretary for Aging Kathleen Greenlee, who’s the administration’s de facto point person on elder abuse (“it’s in my DNA”) said: “It’s an outrage against humanity.” President Obama seems outraged, too. He railed against elder abuse in his morning remarks at the conference. It may have been the first time a president has ever mentioned “elder abuse,” Greenlee said.

Older people are attractive targets, Cordray and Greenlee noted, because they have money, homes or both; they may have impaired mental capacity and they’re often socially isolated.

“I am deeply concerned, but I can see progress,” Greenlee said, pointing to the administration’s interdisciplinary approach. Three upcoming government initiatives the White House described today:

• This fall, the National Institutes of Health will convene an elder abuse workshop with researchers, clinicians and others on understanding, preventing and intervening in elder abuse (financial and otherwise).
• The Department of Justice will fund a multi-year pilot project to evaluate the means to avoid and respond to elder mistreatment. The department also plans to train prosecutors around the country how to effectively curb elder abuse and financial exploitation.
• The Consumer Financial Protection Bureau, by the end of 2015, will release an advisory to help financial institutions prevent, recognize and report elder financial exploitation.

The panelists agreed on the importance of trying to detect elder financial abuse as early as possible. As Loewy told me in an interview during the conference, “You need to be proactive, not just reactive.”

Panelist Scott Dueser, Chairman, President and CEO of First Financial Bank, based in Abilene, Texas said: “I have made many calls to family members telling them they had a problem. Getting them convinced there was a problem was a problem.”

If you see a family member becoming a victim, said Dueser, “you’ve got to take a stand and move; you cannot wait, because if you wait, the problem gets worse.”

His bank is particularly aggressive. About 1 ½ years ago, it began educating all bank employees on how to detect elder financial abuse and how to stop it. Then, First Financial started partnering with police departments, Adult Protective Services and the Better Business Bureau for each of its 62 communities.

The bank now also gives out a Fraud Buster Award when staffers take action. “Unfortunately, this award goes out two or three times a week,” said Dueser. “To date, we’ve stopped over one million dollars worth of fraud in our bank.”

Other, bigger banks are sometimes leery of taking such action, fearing concerns of the invasion of privacy of their customers, Loewy said.

Dueser’s response: “When we see problems, families expect us to call. We’ve never had a family scream privacy when we were doing the right thing.”

Dueser reminded the WHCOA audience that not all elder abuse victims are wealthy. “Unfortunately, one customer lost $40,000, which was everything she had and then some, because the fraudsters had the run of her credit cards,” he said. “It happens across all walks of life.”

Technology was a theme throughout the day, with a dedicated panel on Technology and Future of Aging and two, shorter, related discussions on innovation and universal design.

In planning the conference, the White House emphasized engagement with the business community to solve some of the challenges facing an aging population.  (The fact that 10,000 Americans turn 65 each day was repeated several times throughout the day.) Representatives of several companies who would like to reach those consumers, including uber, Airbnb, Peapod, Walgreens and Care.com were invited to share ways they are serving and thinking about older consumers.

Seth Sternberg, co-founder and CEO of Honor, a start-up for in-home care, was frank in his assessment. In the tech industry, he said, “We haven’t done a good job thinking about our older Americans. It’s a population we have ignored.”

Sternberg raised some eyebrows by saying, “In my world the senior space is not sexy.” But, he said it proved easier to recruit developers than he thought with the promise of a tool that could make "millions of people’s lives fundamentally better."

Anita Roth, ‎Head of Policy Research for Airbnb said the home-sharing company noticed more people over 50 were using the service as hosts and guests than they originally anticipated. Older guests on fixed incomes are finding that Airbnb saves them money and offers social engagement. Older hosts are finding that they can supplement their income while making use of a spare bedroom. She also noted that older hosts are typically among the highest rated by guests, with a lot to teach their younger counterparts.

Joseph Coughlin, Director of the Massachusetts Institute of Technology AgeLab, said: “Real innovation is not about technology, it’s about putting these innovations to use.“ He added that “the next generation careforce” will need training to make use of innovations to improve the quality and efficiency of caring for others.

Barbara Beskind, a 91-year-old designer for IDEO, said it best when she said companies should “design with, not for” older adults.

Labor Secretary Tom Perez finished the day with a rousing call to action. “The arc of justice does not bend on its own,” he told the dwindling and somewhat tired crowd. “Without advocacy, there is no Social Security Act. Without advocacy, there is no Medicare, no Medicaid. Without advocacy, there is no Affordable Care Act. We need your help.”

Executive Director Super said she was pleased with the outcome. “I think the day was great. It was just a wonderful opportunity to bring everyone together. I think we touched on some issues that were tough issues like elder abuse and retirement savings, but were able to raise awareness of those,” she said, noting that her staff will produce a final report by year’s end.