GBO NEWS: Encore Study–Recession Lifting; Challenge to Ice Bucket Challenge & More


E-News of the Journalists Network on Generations

August 26, 2014 — Volume 14, Number 11

Editor’s Note: GBO News, e-news of the Journalists Network on Generation publishes alerts for journalists, producers and authors covering generational issues. Send your news of important stories or books (by you and others), fellowships, awards or pertinent kvetches to GBO News Editor Paul Kleyman. If you receive the table of contents as e-mail, just click through to the full issue at

IN THIS ISSUE: For You, An Unlabored Week.

1. ENCORE—MORE THAN A CATCH-PHRASE:’s Survey Shows Signs Encore Career “Recession” Is Lifting; Freedman’s WSJ blog Calls for More Flexibility in Social Security.

2. GEN BEATLES NEWS: PBS Next Avenue’s New Online Health Editor; WNET/Thirteen’s Developing National Project on Aging

3. HEALTH CARE REFORM SCHOOL: Los Angeles Times columnist Michael Hiltzik’s Challenge on the ALS Ice-Bucket Challenge

4. END-OF-LIFE STORY BOARD: Doctored: The Disillusionment of an American Physician on Fresh Air with Terry Gross; *** Fraud, Marketing Just Part of Problems with Hospice System” on the Association of Health Care Journalists “Aging” blog;

***Columbia Journalism Review’s Trudy Lieberman on “Medicare Fraud Stories Ignore Larger Issues of Reform,”*** In “Medicare Experiment Could Signal Sea Change For Hospice,” Kaiser Health News



Group’s Survey Shows Signs Encore Career “Recession” Is Lifting

 *** Nicholas Kristof will Keynote the Encore 2014  conference and presentation of its $100,000 Purpose Prizes in Phoenix, October 28-30. The announcement from the nonprofit tempts GBONews’ editor to snip at it and similar catch-phrases (“encore careers”) with an snarky “Encore Schm-encore.” Ten years ago it was the even more oblique “Civic Engagement” of older adults.) But it’s hard to ignore the serious attention many journalists are giving to what has developed into a movement to involve older people, who are too often set on idle in the American culture and economy.

The conference focuses on networking and honoring older leaders and unsung heroes who are developing solutions to our most pressing problems. If you’ve hear the term umpteen times and aren’t quite sure what it means, their website explains that these efforts involve Americans, usually ages 50 to 70, who wish to share their skills, passions and expertise in new careers that address social needs, typically in education, health care, human services and the environment. The gathering will celebrate the winners of’s 2014 Purpose Prize, which awards $100,000 to people over age 60, who have used their encores to address tough social challenges.

More than lining up prominent journalists, such as New York Times columnist Kristof, has just released its new survey showing that interest in pursing encore jobs, such as working with nonprofits, has risen 17% since their first poll in 2011. Among other signs that the improving economy is increasing people’s inclination to devote their later years to doing good work are that study respondents expressed significantly less concern about encore income and threats to their personal flexibility. They regarded those factors as major obstacles in 2011.

In his Aug, 7 guest blog for the Sloan Center on Aging & Work, Boston College, Encore Executive VP Jim Emerman, says the as the new study shows that as the job market slowly strengthens, work options for older people may begin more to “speak to their need for purpose and social impact will also improve.”

More than wishful thinking, Emerman points to signs of change in Encore’s new study. In 2011,for instance, “30% of those interested in an encore career had significant concerns that a next act focusing on social impact wouldn’t provide the income they needed. This concern was among the top barriers just three years ago. In 2014, it dropped to one of the least significant obstacles.”

Also, three years ago, fear that an encore career would be at the cost of flexibility in taking on such other important needs as family caregiving was quite high. In 2014, though, that concern dropped by two-thirds.

Emerman suggests, “It’s possible that this relates to the diminishing concerns around income since people may believe that they can now afford to have jobs that allow them the flexibility they need. It’s also possible that there is a growing perception of greater workplace flexibility, perhaps especially in the nonprofit sector.”

However, he emphasizes, “Fear of age discrimination remains a significant concern, although it dropped too.” Emerman noted that the crew “sometimes feel inundated with horror stories of older people shunned in their job searches.” That likely reflects the “depressingly high” level at which 50-plus workers who lose their jobs remain out of work longer than the unemployed in any other age group.”

In examining socioeconomic obstacles for those interested in encore careers, Emerman says he was “pleasantly surprised to see that perceived barriers dropped across all income levels.”

He continues, “Still, there is greater concern among the lowest earners than among those in higher income brackets. And some issues pose greater challenges to those with lower educational levels. Those with only some college expressed more concern than those who had completed college about their own confidence in trying something new, the need to learn new technologies, their health, age discrimination and the state of the economy.”

Emerman regards investing in those at lower education levels “a priority for the encore movement. The growth of programs addressing the 50-plus population in community colleges is a positive sign, but there is much more that can be done in this arena” – even at four-year colleges and universities.

***Meanwhile, Encore founder Marc Freedman recently blogged in the Wall Street Journal (WSJ, broaching another angle on bringing American retirement security into the 21st century.

Freedman’s WSJ piece, “How to Modernize Social Security,” raises the need to retool the nation’s income-security capacity to maximize people’s ability at different points in their working lives so they can adjust to their changing situations and remain productive at every level.

Although Freedman’s specific recommendations should generate careful scrutiny, what he brings to the national conversation is a renewed emphasis on the understanding that today’s greater longevity is not a “silver tsunami” threatening to drown national economies–so often the crux of policy and budgetary discussions. Instead, it is a golden opportunity to maximize our capacity to provide sustenance to our selves and those around us at any point in our lives. That is, it’s time to grasp that Social Security and other social insurance programs are not merely a cost burden, but an investment in human capital.

Media Registrations: For media registrations and to learn more about the conference, visit the ENCORE 2014 website and for information, contact Marci Alboher at



*** Laine Bergeson is Next Avenue’s the new Senior Web Editor of the Health & Well-Being and Living & Learning channels of the PBS’s website on aging. She’s researched and written about health for 15 years, says her bio, “covering everything from the nutritional benefits of rhubarb to the proper way to swing a kettlebell.” (That’s usually a solid exercise orb with a handle, although in Minnesota that could mean the kettle is filled with rhubarb for one of Garrison Keillor’s signature pies.)

Previously, Bergeson was a senior editor at the health and wellness magazine, Experience Life. And, yes, Lake Woebegon listeners, she was an English lit major at St. Olaf College in Northfield, Minn. She also studied language and literature at the National University of Ireland, Galway. Bergeson admits to being “passionate about chronic disease prevention.”

*** Elsewhere in the PBS fold, Julie Anderson of WNET/Thirteen in New York, is newly assigned to developing a multipart series of documentaries on aging for PBS. Anderson, executive producer for documentaries and development, e-mailed that the project will be “a robust interactive informational website. Her crew will ask other PBS shows, such as Nova and Frontline, “to produce related programming, screenings through grants provided to our 200-plus local stations throughout the countries, grass roots outreach campaign.”



Funding and the Ice Bucket Challenge

*** Los Angeles Times columnist Michael Hiltzik’s Ice Bucket Challenge commentary (Aug. 16)—“A Few (Impolite) Questions About the Ice Bucket Challenge” bravely takes on a critical aspect of what’s editor has long considered a major flaw in the U.S. way of capitalizing research and services in health. Hiltzik stipulates that the beneficiary of the viral challenge, the degenerative condition amyotrophic lateral sclerosis, or Lou Gehrig’s disease, is a worthy cause championed by a demonstrably effective nonprofit, the ALS Association.

The spontaneous campaign began a couple of weeks ago—to the surprise of the association—through the efforts of one family with a member afflicted by this devastating disease. The charming, fun first video soon sparked celebrity involvement —music and movie starts, NFL coaches, media personalities, politicians and even California Gov. Jerry Brown’s dog, Sutter, who heroically shook off a smaller bucket of ice water—presumable not to waist water during the drought–for his master on camera). The campaign has, by this GBONews deadline, raised over $70 million dollars for the ALS Association, astronomically beyond the group’s donations of $1.8 million through August a year ago. And NPR’s “Morning Edition” (Aug. 25) reported that other countries are trying variations. One, where water is scarce, is doing a “Rice Bucket Challenge” to highlight the country’s poverty and hunger.

The goofy-videos idea that has captured so many imaginations is that people appear on YouTube being doused and then challenge other people to do the same or donate $100 to the association. Evidently, celebrities from Matt Lauer to Martha Stewart, have both donated and gotten their public splash-and-giggle moment as good sports.

Hiltzik stipulates to the public benefit, but also asks readers to reflect on what I’ve long seen as the ongoing, laissez faire approach to curing and caring for those with so many disease conditions.

He notes that terrible as ALS is, it affects 12,000 Americans at any one time, according to the Centers for Disease Control and Prevention (the association says its 30,000), compared with 5.2 million Alzheimer’s patients in the U.S., and 25.8 million with diabetes.  

He writes, “Stunt philanthropy like the ice bucket challenge doesn’t accommodate such distinctions and comparisons–it just feeds whatever charity hits on a catchy device and treats all causes as essentially equivalent, distinguished only by their momentary claim on public attention.” Although many contributors may be opening their wallets anew for this cause, though, Hiltzik asks how much this one campaign “might cannibalize other donations” for other socially responsible spending.

So-o-o, what about boosting research funding for, say, Canavan disease? ever heard of it? It’s another, but even less visible incurable degenerative condition. How about spina bifida, the spinal birth defect in children? Parkinson’s, of course, has Michael J. Fox, and that’s great. But where’s the support and “viral” media coverage of the recent funding cuts for research at the National Institutes on Health?

I’ll add to this longstanding concern in aging that even the most earnest and worthwhile efforts to steer funding to this or that condition have often skewed more equitable distribution of research funds within current budgetary limits. It’s about 15 years since The Gerontologist ran a benchmark commentary by two distinguished scholars in aging calling attention to what was then seen by many as the “Alzheimer’s-ization” of federal research funding in aging, because of the considerable lobbying prowess of its proponents.

No one can fault the Alzheimer’s Association for doing great and effect work. But competitive factors, such as community-awareness campaigns, family involvement, celebrity “chairpersons” or appearances and so on—vital as they are–should be supplemental to the national, if not global, effort to apply modern science and best-practice models of care to ending suffering and advancing the human condition. Curing and caring shouldn’t be left so dominantly to the whims of a Bill Gates (bless him and Melinda for what they’re doing) or the group with more and better lobbyists.



*** Doctored: The Disillusionment of an American Physician by Sandeep Jauhar, MD, (just published by Farrar, Straus and Giroux) provides an authoritative view of what we all know, that the U.S. health care system is derailed by perverse incentives.

His thoughtful and nuanced critique of the system in which he practices as a cardiologist comes through in Terry Gross’ Aug. 19  interview with Jauhar,in which today’s increasing challenges of chronic illness and eldercare are especially prominent. Later in this roughly 35-minute interview, he admits to having “deceived” himself into imposing highly invasive treatment on a terminally-ill patient, superseding her family’s insistence that she wanted to spend her final days in peace.

His thoughts also reflect the findings we reported recently of Stanford University Medical School palliative care expert, V.J. Periyakoil, MD. In New American Media, I’d written about her study published in the journal PLOS One showing that although nine in 10 physicians she surveyed want the same comfort as their patients do at life’s end, they tend to order invasive procedures anyhow, even against patients’ written directives.

Jauhar’s experience confirms the insight of Periyakoi, who heads palliative care training at Stanford, that what physicians do in those moment of decision-making is complex, harking back to their intensely conditioned medical training. Jauhar explains that in previously overriding his patient’s wishes—only to see her die eight days later after one medical-tech intervention after another—he did so never thinking of cost issues. Instead,  says he didn’t want to lose a patient he’d come to love for her vitality should. That should remind reporters that for all the cynicism we see and sometimes expose in American health care, most physicians are driven to practice medicine from the heart–not only with a mind to treating it. Medical communicators, such as Jauhar and Periyakoil, reveal disturbing fissures in our system in the search for ways to heal the multiple fracture between dysfunctional financial incentives, outmoded medical education and the essence of high-touch healing.

*** “Fraud, Marketing Just Part of Problems with Hospice System” is a follow-up commentary I was asked to write stemming from my recent GBONews,org discussion of  the Huffington Post investigative piece, “Hospice, Inc.” The new piece appears on the Association of Health Care Journalists (AHCJ) “Covering Health” blog in the core section on Aging.

In response to it, I heard from health writer Ann Neumann, a visiting scholar at New York University’s Center for Religion and Media and contributing editor for the center’s publication, “The Revealer.” Neuman’s incisive analysis, “The Patient Body: Reading HuffPo’s ‘Hospice, Inc.,’” provides detailed examples of how investigative journalism that single-mindedly focuses on fraud and negligent government regulation in a complex field, such as health care, can fall short  when even diligent reporters don’t understand health issues underlying patient care decisions.

Neuman’s analysis is well worth reading, especially for the understanding it provides of where reporters might look to get closer to the truth of what’s going on in a health care investigation.

***At Columbia Journalism Review, Trudy Lieberman’s blogMedicare Fraud Stories Ignore Larger Issues of Reform,” (Aug. 22) quotes this editor’s AHCJ commentary, but in the larger context that “this has been a summer for Medicare fraud stories.” She cites recent Medicare investigations also from The Wall Street Journal, New York Times, and Washington Post. Lieberman doesn’t fault those exposés for revealing fraud, which steals 10% of Medicare’s annual spending, but for missing the bigger picture. She concludes, “When we weave in the larger ideas about what reform might actually look like, we serve our audiences better and maybe—maybe—nudge the conversation toward actual change.”

*** In “Medicare Experiment Could Signal Sea Change For Hospice,” [ ] Kaiser Health News reporter Michelle Andrews delved into the new pilot program under the Affordable Care Act aimed at correcting the major flaw in the Medicare hospice benefit. But her Q&A with Diane Meier, MD, director of the Center to Advance Palliative Care, raises important concerns about the change.

Meier, a professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai in New York City, first explains a fundamental difference: “All hospice care is palliative care — but not all palliative care is hospice. Palliative care is a team-based type of care focused on maximizing the quality of life for people and their caregivers at any stage of illness. It focuses on treating the pain, stresses and symptoms of serious illness. The emphasis is on need, not prognosis or how long you might have to live.”

When Congress passed Medicare hospice coverage three decades ago, however, it required two physicians must certify that a patient has six months or less to live, and then the patient or a family member has to waive regular insurance coverage for disease treatment, so the ill person would only receive comfort care, not full medical treatment. Meier calls this “a forced either/or choice between life-prolonging treatment and palliative care. It was an attempt to save money. Most people need—and want—both types of treatment.”

She explains, “We can’t predict who’s going to die in six months, in part because of the variation in people.” Later Meier observes that several studies have shown patients who receive both palliative care and appropriate life-prolonging medial treatment “actually live longer than those who receive life-prolonging treatment alone. It makes sense. People aren’t in excruciating pain, they’re not depressed, their families feel confident in their ability to care for their loved one. . . . They’re not getting less life-prolonging treatment with palliative care, they’re having less crisis. They reduce emergency care use because they don’t need it and that saves money.”

Noting that the new demonstration program implies the existing rule is “irrational,” Meier goes on to express concern about limitations in the revised program—restriction that have promoted several states to decline to participate. Although patients would be able to receive life-prolonging “curative” care, according to the rules, only those meeting the current eligibility requirements would be able to participate—those already considered so ill that they could be expected to have only six months left to live. She and other palliative care proponents argue that supportive palliation should start far earlier.

Also, under the new Medicare pilot, the Centers for Medicare and Medicaid Services will only pay hospices $400 per month for qualified patients. Still, Meier is hopeful that if some programs can successfully innovate to help patients while saving money at that rate, such as through “telephone intensive” care management and creative partnerships with community-based programs, like Meals on Wheels, there may well be “pressure to scale that up to people whose prognosis is two years or three years or even longer.”

And that’s also to remind readers that the good folks at Kaiser Health News do put out excellent Medicare and Aging stories, and they’ll send you a combined “Medicare & Aging” report with headlines and links to the stories. (Kudos also to The SCAN Foundation for underwriting much of that coverage.)


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