Issue: 27.6  
Posted: May 19, 2020 at 6:34 pm

GBO NEWS: COVID’s Invasion of the Elder Snatchers; Dr. Aronson’s “Elderhood” Named Pulitzer Finalist; Joe Biden and Getting Medicare to Age Zero; Ageism Epidemic in the Pandemic; Virus Sledgehammer on Older Workers; COVID, Age & Racial Equality; & MORE

GENERATIONS BEAT ONLINE NEWS 

E-News of the Journalists Network on Generations – Our 27th Year.  

May 20, 2020 — Volume 27, Number 6

EDITOR’S NOTE: GBONews, e-news of the Journalists Network on Generations (JNG), 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. [pfkleyman@gmail.com]. To subscribe to GBONews.org at no charge, simply sending a request to Paul with your name, address, phone number and editorial affiliation or note that you freelance. For each issue, you’ll receive the table of contents in an e-mail, so just click through to the full issue at www.gbonews.org. GBONews does not provide its list to other entities.

In This Issue: Please Wash, Sanitize and Mask-up before Reading.

1. LEADS FROM LIZ: ***COVID’s Invasion of the Elder Snatchers.

2. THE BOOKMOBILE: ***Dr. Aronson’s Elderhood Named Pulitzer Finalist.

3. MANAGING COVID NEWS: Q&A With PBS Next Avenue’s Managing Editor Richard Eisenberg.

4. HEALTH CARE REFORM SCHOOL: *** “Biden’s Plan to Drop the Medicare Age to 60”  (Maybe, Though, by Getting to Age Zero), Mark Miller interviews Marilyn Moon, Retirementrevised.com.

5. THE STORYBOARD

*** “Are People of Color Hit Harder By COVID-19 In Your State or City?” Tracking tool by Matt Kauffman, Solutions Journalism Network; 

*** “Pandemic Exposed Painful Truth: America Doesn’t Care About Old People,” by Nina A. Kohn, Washington Post; 

*** “COVID-19 Hitting Older Workers Like a Sledgehammer — What Congress Can Do,” by Fay Lomax Cook and Elaine Weiss, The Hill; 

*** “Pandemic Amplified Ageism. ‘It’s Open Season for Discrimination’ Against Older Adults,” by Laura Newberry, Los Angeles Times;

 *** “The Case for Racial Equality in Aging Never Stronger,” by Robert Espinoza and Jean C. Accius, ASA Update, American Society on Aging.

1. LEADS FROM LIZ: Nursing Home Pandemic Sources

COVID’s Invasion of the Elder Snatchers

By Liz Seegert

Show of hands–how many of you feel like you’re in an unending Twilight Zone episode?

With 100,000 Americans deaths  approaching — many of them older adults—COVID-19 has become something akin to a really bad, way-too-long movie; a hybrid of  Invasion of the Body Snatchers and Contagion. Will our hero(es)triumph over the bad guys — or in this case, the bad virus?

It wasn’t until recently that those caring for the most vulnerable among us, in nursing homes and senior living facilities, were acknowledged as heroes, along with hospital workers, grocery store clerks and USPS and UPS workers. Many nursing home staff are underpaid, and often without health insurance themselves. Yet, they continue showing up each day, despite a lack of adequate personal protective gear. The International Business Times calls the death toll in nursing homes “staggering.” I can’t think of a more apt adjective.

Currently, only 33 states provide any sort of information about nursing home deaths. Some, like Indiana, just provide the aggregate. This leaves many families scared, anxious, and angry.

What can health reporters do about it? 

Check out this story from Jared Whitlock at Voice of San Diego. He reached out to me a few weeks ago for some assistance in finding appropriate data resources; the reporting and analysis is all his. Importantly, he dove into the history of past violations at facilities to see if there was a correlation between that data and current facility deaths. It’s the kind of journalism that provides real value to all stakeholders, especially families who may be considering housing options for older loved ones.

Both ProPublica and CMS’ Nursing Home Compare offer breakdowns of what’s behind those “star” ratings. If you’re not familiar with these resources, they help sort out the better-run facilities from poor ones, based on dozens of metrics developed by the Centers for Medicare and Medicaid.

Under each topic, like staffing, you’ll find  inspection reports, which are issued by an external auditor. These reports can tell you if there’s a pattern of violations, how quickly they were corrected, and how often they occurred. You can also check with your state nursing home ombudsman or department of elder affairs (or whichever agency is responsible for nursing homes where you live) to see whether these homes have had additional run-ins with state regulators.

State oversight varies, but one important aspect to consider is how they are holding facilities being held accountable, especially since the Centers for Medicare and Medicaid Services (CMS) wants to relax oversight even further. (Nothing like loosening infection control guidelines during a pandemic). If your state isn’t already doing so, push them (hard) to release data on individual facilities. Families, and the general public, have a right to know.

In New York, at this writing, over 5,300 nursing home residents have died of Covid-19. The nursing home lobby successfully pressed for a provision that makes it hard for their families to sue hospitals and long-term care facilities, as the New York Times reported (“Nursing Homes Are Hot Spots in the Crisis. But Don’t Try Suing Them,” May 13, 2020) by Amy Julia Harris, Kim Barker and Jesse McKinley.

It can be even more tricky to get good information about assisted living facilities and small group homes. While they’re licensed by the state, many don’t undergo the more rigorous inspections conducted in larger care homes. Yet, reports of COVID cases continue to increase in many locations. (For background, I wrote this story for Next Avenue 2018 on adult care homes).

It’s been difficult to determine what, exactly, is going on in these facilities, since almost every one of them has strict “no visitors” policy. Talk to families, if you can. Wait in the parking lot to speak with workers as they leave their shifts (at appropriate social distance, of course). Talk to the administrators, and if possible, try to connect with residents to literally get an “inside scoop” on safety. 

Perhaps the biggest challenge for residents in all of this is isolation. Everyone is essentially confined to their rooms with almost no social contact, aside from phone or, FaceTime/Zoom calls in some places, or staff interactions. We know loneliness and isolation take a huge toll on physical and mental health of older adults—how are facilities addressing this need, especially with dementia patients? (The Gerontological Society of America’s Todd Kluss can help point you to researchers on loneliness and isolation). 

Unfortunately, this is one story that will linger long after the worst of the pandemic has passed. Also, for reporters following the ongoing number of cases, if you don’t have it already, here is the  link to the Johns Hopkins case tracker.

“Leads From Liz” columnist Liz Seegert is program coordinator for GBONews.org’s parent, the Journalists Network on Generations. A New York-based freelance journalist, she is also editor of the Association of Health Care Journalists’ Core Topic section on Aging.

2. THE BOOKMOBILE

*** Pulitzer Congratulations for Louise Aronson, MD, MFA, for being named one of only two Pulitzer Prize Finalists for her general nonfiction book, Elderhood: Redefining Aging, Transforming Medicine, Reimagining Life (Bloomsbury, 2019). The book is an especially compelling read in the shadow of the COVID-19 pandemic for prescribing for how the United States needs to change our health care system, not only for older Americans. Notice the MFA after her MD? That’s her Master’s of Fine Arts for creative writing, a good sign that the book, while thorough on the issues, also is a good read. 

Regarding the coronavirus, see Aronson’s New York Times op-ed, “’Covid-19 Kills Only Old People Only? Why Are We OK with Old People Dying?” (March 22, 2020). 

In addition, Aronson, a professor and geriatrician at the University of California, San Francisco, presented a crisp and concise TEDMed talk (17 minutes) recently on her key points. Reporters can reach her at UCSF:  (415) 502-1000 x14595; Louise.Aronson@ucsf.edu; Twitter: @louisearonson. 

Awarded the Pulitzer Prize were The Undying: Pain, vulnerability, mortality, medicine, art, time, dreams, data, exhaustion, cancer, and care, by Anne Boyer (Farrar, Straus, Giroux), and The End of the Myth: From the Frontier to the Border Wall in the Mind of America by Greg Grandin (Metropolitan Books). The second Finalist named was Solitary, Albert Woodfox’s memoir of his decades incarcerated in Louisiana’s most notorious prison, written with Leslie George (Grove Atlantic).

3. MANAGING COVID NEWS: PBS’s Next Avenue Site

*** How Is PBS’s Next Avenue Managing the Flood of COVID-19 Coverage? With older people thrust to the forefront of the world’s all-consuming—and news-voracious—pandemic, 

GBONews asked the website’s Managing Editor Richard Eisenberg about his challenges in directing the site’s online traffic flow. 

The Next Avenue website, a leading 50-plus news and features source (and freelance reporting venue) has shifted, like other virtual “newsrooms,” into ongoing coronavirus reporting, such as Eisenberg’s May 19 piece, “The Pandemic Paradox for Older Workers” (“How job losses and furloughs can lead to a downward economic spiral”).

Meanwhile, he and the Next Avenue staff are juggling virus topics with their ongoing stories on retirement finance, caregiving, technology and other continuing categories. How, exactly, are they keeping five balls in the air while spinning all the plates in the air on those sticks? Here’s what Eisenberg, who is also Next Avenue’s Senior Web Editor, had to say.

Q: What did we consider in framing our ongoing approach to our COVID-19 coverage for our readers and in prompting them to respond? And what’s been the response so far? 

A: Next Avenue readers are primarily in their 50s and 60s and the pandemic is, and will be, affecting them and their loved ones in many different ways. We’ve been focusing on pieces we think are especially important to them, rather than stories that would be of interest to people of any age, the kinds of stories we think are easy to find in national and local media outlets. 

Just as before the pandemic, many of our pieces have been helpful service stories, with insights and advice for readers and their families. Some have been essays by people in our readers’ demo talking about what the experience has been like for them and what’s helping them get through it. 

We’ve also invited our Influencers in Aging  (Next Avenue’s annual list of people we think are doing important work in aging and how we think about it) to write thought leadership pieces about COVID-19 relating to their specialties. These pieces focus on their ideas for opportunities and new or improved programs and services coming out of the pandemic experience. Many of our readers have responded to these articles, and we’ve been using feedback to inform our stories and the information we provide. Our media partners, Forbes and MarketWatch (from Dow Jones) have republished many of our coronavirus pieces.

Also, the reader response has surpassed our expectations. We hear daily from readers with their questions and concerns about the pandemic and we’ve seen a strong response to our articles on Next Avenue’s Facebook page.

Q: What were your main challenges in organizing your coverage with staff and freelancers? And what adjustments have you found yours making along the way, such as sorting out story lines and framing?

A: We are a small team (total of under 10 people in edit and audience engagement) with a small freelance budget, so the main challenge was focusing on the best, timeliest stories given our resources. Before the pandemic, the editors had a weekly pitch meeting on Tuesdays to discuss story ideas. We still have one, but we now also send each other messages daily on Teams (Microsoft’s version of Slack), with ideas we want to pitch and can’t wait until the Tuesday meeting. 

We’ve had to tell some freelancers that we can’t pitch their non-coronavirus stories right now, unless their pitches are especially timely. Our site has six channels: Health, Caregiving, Money & Policy, Work & Purpose, Living and Technology and our coronavirus stories have appeared in each one, based on their topic. Each channel editor has handled her or his own stories, as always.

Q: How are things with Next Avenue’s staffing and funding levels? Such as, are you having to plan for how to balance the need for copy with freelance vs. staffing costs and needs? And are we working in different locations than we did before the pandemic? 

A: As a nonprofit (we’re published by Twin Cities Public Television, or TPT), we are always careful about our funding restraints. We have about the same number of people working at Next Avenue as before the pandemic with the same funding as before. If we need to adjust in the future, we will.

Before COVID-19, most of the Next Avenue team worked out of the TPT offices in St. Paul with two exceptions — I’ve worked from my New Jersey home office and one of my colleagues, from his Los Angeles home. For the past few months, all Next Avenue staffers have been working from their homes (which is also true for nearly everyone at TPT). We’ve been doing a lot of Teams video calls, mostly for serious work, but sometimes for Virtual Coffee Breaks and Virtual Happy Hours, along with our colleagues at our sister site, Rewire.org (primarily for people in their 20s and 30s).

Q: What coverage areas do you see next for Next Avenue, after the pandemic peaks and you settle in for the long haul? What areas we hope to delve into? 

A: Most of our articles (other than the Influencers’ thought pieces) have been about today’s concerns and challenges. After the pandemic peaks, we’ll continue to address current concerns and challenges, but we’ll also start to publish pieces looking into the future, talking about what readers might expect and might want to plan for. 

Q: As the managing Editor for the website, what have been some of your challenges in overseeing coverage and your schedule from New Jersey? And how’s the social distancing scene working out in the newsroom in St. Paul? 

A: I wouldn’t say the pandemic has changed managing the coverage schedule much, except that our story planning has become more fluid. That is, we’ve been swapping story dates around more to make room for urgent pieces we need to publish. Otherwise, my hours are pretty much the same and that’s true for the rest of our team. The social distancing has been working out pretty well; occasional wifi issues, but a lot of happiness about eliminating commutes for the time being.

GBONews readers can reach him at reisenberg@nextavenue.org; http://nextavenue.org; Twitter: @richeis315.

4. HEALTH CARE REFORM SCHOOL

*** “Biden’s Plan to Drop the Medicare Age to 60 is a Small Step in the Right Direction,” (Maybe By Start at Age Zero), by Mark Miller, Retirementrevised.com (April 15, 2020): In his weekly podcasts, Miller, a columnist for Reuters and frequent New York Times contributor, interviewed Marilyn Moon, one of the nation’s top authorities on Medicare, who is a former public trustee of Medicare and Social Security. The news peg for this edition was Joe Biden’s announcement in April that he will support lowering the age of Medicare eligibility to 60. 

In part, Moon discussed the relative merits of reducing Medicare eligibility from the current 65 to 60, 55 or 50, and she concurred that age 60 is apt to be the more effective choice in concert with the Affordable Care Act for those younger. (That’s assuming the Supreme Court doesn’t strike ACA down.) But, short of installing a full Medicare for All (M4All) plan, she noodled over opening Medicare access to those ages 18-25—or maybe age “zero” newborns in getting to universal coverage.

Dismissing Medicare access to age 50, Moon called it “Medicare for All on training wheels.” Because people ages 50-64 are remaining in the workforce longer now (since increasingly they “can’t afford to retire”), many continue having work-related private insurance. That may change because layoffs due to the coronavirus pandemic will likely become permanent for midlife and older workers.

But with an incremental approach to wider health insurance coverage, such as Biden prefers, adding those 60-64, Moon said, would help the more health-vulnerable workers of that age group. Further, she said, including that age bracket would not add much cost to the Medicare program because “some of them are actually pretty healthy and pretty cheap to cover.”

The interview then took an intriguing turn toward speculation about the better training wheels toward a program of M4All-type coverage. Moon, speculated that inching Medicare eligibility down to 50 and then lower, might not be the most effective strategy to ween people off of their existing private plans. She said, “If you wanted to train people what to expect, why wouldn’t you start with the 18-year-olds? Why wouldn’t you start with newly insured people, who’ve never had health insurance before on their own and say that everybody from 18-25 is going to be covered by Medicare.” She added, “It would be very cheap to do” for that largely healthy population segment. 

Moon went on, “If you’re really thinking it through in terms of how best to transition [to universal coverage], you might not just lower the age, you might start at the other end. You might start with combining Medicare and Medicaid, for example, and cover all children and have Medicaid be the supplemental program to provide extra subsidies for low-income people, rather than the primary insurance for them. I might start with age zero and move up. … So you meet in the middle and have these curmudgeonly 40-year-olds in managed-care plans, and they eventually get absorbed in the system.” (Joe, are you listening?)

Miller continued exploring ways to expand Medicare the following week with economist Peter Arno of the University of Massachusetts-Amherst. Generally, Miller’s Retirementrevised.com podcasts on economic policy during the COVID-19 pandemic and election year are virtual graduate classes with top-rated policy experts. He recently talked with the New School for Social Research’s Teresa Ghilarducci on the unemployment situation for older workers in the wake of the April jobless report, for instance.

5. THE STORYBOARD

*** “Are People of Color Hit Harder By COVID-19 In Your State or City?”
created by Matt Kauffman (formerly of the Hartford Courant) for the Solutions Journalism Network (SJN): This new collection of data from more than 50 states and localities can help reporters with reporting on racial disparities. According to SJN co-founder Tina Rosenberg, of the New York Times Fixes column, “The database is dynamic — it simply links to each state or city’s page where it reports the data. So it’s always current.”

*** “The Pandemic Exposed a Painful Truth: America Doesn’t Care About Old People,”  by Nina A. Kohn, Washington Post (May 8.2020): Kohn, a law professor at Syracuse University and a visiting professor at Yale Law School, wrote: “We speak of the elderly as expendable, then fail to protect them.” … across America — and beyond — we are losing our elders not only because they are especially susceptible. They’re also dying because of a more entrenched epidemic: the devaluation of older lives. 

“Ageism is evident in how we talk about victims from different generations, in the shameful conditions in many nursing homes and even — explicitly — in the formulas some states and health-care systems have developed for determining which desperately ill people get care if there’s a shortage of medical resources. . . . 

“Yet this is not an inevitable tragedy. . . . The U.S. Department of Health and Human Services found that about 20 percent of Medicare beneficiaries in skilled nursing facilities suffer avoidable harm. . . .  Ageism is most explicit in official policies governing whose lives should be saved if equipment or medical staff become scarce during the pandemic. . . . [States] all prioritize patients who are likely to benefit from treatment over those who are unlikely to benefit, but many also rate them based on age — with younger patients getting the nod. . . . Talk of age-based rationing also subtly reinforces the idea that shortages of equipment and other resources are inevitable, and that older people will ‘make way’ for more deserving patients. In the absence of vocal objection, this reduces pressure on policymakers to pull out all the stops to provide such resources.” 

*** “COVID-19 Is Hitting Older Workers Like a Sledgehammer — Here’s What Congress Can Do,” by Fay Lomax Cook and Elaine Weiss, The Hill (May 1, 2020): Lomax Cook, former director of the Institute for Policy Research at Northwestern University, and Weiss, policy analyst on income security, are both at the nonpartisan National 

Academy of Social Insurance. The write: “Like millions of others, workers ages 50 and older are losing their jobs (and their health coverage) and are struggling to navigate severely overwhelmed state unemployment Insurance. systems. Their odds of being rehired when the economy begins to reopen, however, may be lower than those of their younger counterparts.” The National Academy of Social Insurance, recently led a Social Security policy innovations challenge that identified four complementary first steps in this direction. 

“Together, if implemented, they would: Change the regulations for those claiming early Social Security benefits so they can start and stop benefit receipt as needed or claim partial benefits. This would facilitate gradual retirement, which many prefer, and reduce the lifelong penalty associated with early claiming. The recommendations call for Congress to enact a “bridge benefit” for vulnerable older workers facing the need to claim Social Security early, due to long-term joblessness and/or serious health problems.” Read their whole piece to learn of the other recommendations.

*** “The Pandemic Has Amplified Ageism. ‘It’s Open Season for Discrimination’ Against Older Adults,”  by Laura Newberry, Los Angeles Times, May 1, 2020: “As the debate rages over when or how to resume public life, older adults like Bonnie Reed have increasingly borne witness to behavior and rhetoric that implies that their lives are not as valuable as reviving the economy. Ageism has been quietly pervasive in American culture for decades, according to those who work with and study the health of seniors. But they fear that this particular form of discrimination has become magnified during the pandemic as those who have lost income and stability look for someone to blame.

“The stigma [against elders] is growing,” said Dilip Jeste, a geriatric psychiatrist at the UC San Diego Center for Healthy Aging. ‘Anytime you mention the virus and risk, immediately people think of older adults. They think of the people more likely to be hospitalized, to take up beds in the ICU.’”

The story goes on, “Eight prominent psychologists from across the globe were so concerned about mounting ageism that in mid-April they wrote an academic paper on the issue for the Gerontological Society of America. “What we are seeing in public discourse is an increasing portrayal of those over the age of 70 as being all alike with regard to being helpless, frail, and unable to contribute to society,” they said. 

“The negative health effects of ageism are well-documented. When seniors face age-based discrimination and internalize harmful stereotypes, they are more likely to experience stress and depression and are at higher risk for chronic illnesses. A 2018 study from researchers at Yale University found that ageism could lead to $63 billion in additional annual healthcare costs in the United States. . . .

“The institutional concept of older people being worth less than younger people predates the pandemic. Cass Sunstein, a legal scholar who worked for the Obama administration, once proposed focusing government policies on saving years of life rather than individual lives. The Environmental Protection Agency used a similar calculus during the George W. Bush administration when it was weighing the benefits of power-plant emission regulations. The agency determined that people over 70 were worth just 67% of the lives of younger people.”

*** “The Case for Racial Equality in Aging Has Never Been Stronger,” by Robert Espinoza and Jean C. Accius, ASA Update, American Society on Aging (April 22, 2020): Subhead: “Racial Inequality Often Determines Who Survives COVID-19.” Espinoza, Policy VP at PHI, a nonprofit advocate for direct-care workers, and Accius, senior vice president of Global Thought Leadership at AARP, state, “New data have revealed the profound disparities in COVID-19 infections and deaths among black and Latino people in areas hit hard by the coronavirus. . . .

“By the time people of color reach older age, a lifetime of discrimination has accumulated, harming their physical, emotional and economic well-being. In addition, they now face a variety of aging-related vulnerabilities tied to economic insecurity, social isolation, physical and cognitive decline and widespread ageism, among others. Aging services also are saddled by the racial inequality that marks America’s COVID-19 crisis, as this sector disproportionately employs and serves people of color. Direct care workers, for instance, are a predominant segment of the aging services workforce that provides daily support to older people and individuals with disabilities across settings—placing them on the front lines of this pandemic and at greater risk of being exposed to COVID-19.” 

The Journalists Network on Generations (JNG), founded in 1993, publishes Generations Beat Online News (GBONews.org). JNG provides information and networking opportunities for journalists covering generational issues, but not those representing services, products or lobbying agendas. Copyright 2020 JNG. For more information contact GBO Editor Paul Kleyman. 

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