Notes during the previous century, americans gained an average age of an extra 30 years of life. So 80 is the new 50, and there are many more octogenarians nonagenarians enjoying life than ever before are given and technological advance is empty rights. There has never been a better time to be old. This also means that millions more people than ever before need and will continue needing care. Yet current systems focused on caring for the elderly can be baffling and really do vary quite a bit in quality. Aging can be hard m. T observes. Its been made infinitely and unnecessarily harder by our failure to. Build the infrastructure we need to age well now empties. Ames in in the measure of our age she says was to provide a clearer sense for people of where the relevant systems are now and where might be headed in hopes of enabling us to forge what she calls a more just gentle and joyful old age for ourselves and for those we care about an empty is herself, especially well qualified to write a book like this . Shes a leading expert on elder justice, having served as a prosecutor in the civil fraud section of the justice department, a focused on elder care issues a doj she establish the departments Elder Justice Initiative and develop new legal theories of liability and, a novel investigation and strategies that led to successful prosecution cases involving the abuse and neglect in Nursing Homes. She also was instrumental in drafting the elder act, which in 2010 the First Comprehensive federal law to address the issue. Her commitment to raising of elder abuse and to seeking solutions. It was recognized a dozen years ago by the macarthur, which awarded her one of those genius grants. She knows as well as anyone whats been achieved in this field, but also her authoritative, thought provoking book makes clear. She also very well how much more needs to be done now in conversation me this evening will be Chris Jennings, who served as the Health Policy coordinate coordinator in two administrations for two president s and has also been a senior staff member on senates special committee on aging. Chris now heads a Consulting Firm that assists foundations and others in developing policies to secure more affordable, Quality Health care for all of us. So, ladies and gentlemen, please join me in welcoming m t connolly and Chris JenningsChris Jennings. Oh. Wow. Rock star. I used to my father a he used to play recitals and you know, i would just move piano and thats how i feel tonight. So. First of all, thank you so much for coming out tonight. We it means the world to me and to us. It couldnt be a more important issue. And i have to say, this issue in particular is special to all of us. There is, as Rosalyn Carter, as ill paraphrase her, all of us are either past or future givers or recipients of caregiver, caregiving. And i have to say, this story that empty has conveyed to us for this wonderful evening and for this through this book really talks about in a very compelling way the challenges they face and how best to deal with them. I want to also say to you right. You know, many of you, i can tell our such fans of empty, but she is that person that was just introduced she is a special human being. Its a thrill to be with her and share the stage with her. She is not only an elder law and aging advocate, but she someone who can give us a prescription to better navigate the care, safety, money and. Probably most importantly, meaning aging in this society and my job today and i will youll see its going to be very easy, short as a fan and really sycophant of empty is to. Facilitate a conversation about her beautiful new book the measure of our age. So with that empty and give it turn it over to you im a little blown away. Thank you to politics and prose at my local bookstore for more than three decades and actually sort of a sacred place and i just have a reality check here you chris there are so many people i love and whom im grateful in the audience. I want. Make sure its not my funeral and are an angel or a human. Declare. Now im frequently not sure myself. I mean, why not both okay. Yeah, im a huge fangirl of chriss and you, brad, talk about himself. Thank you. Thank you all. So. Okay, fire away. I have no idea whats going to come out of my. All right, before we talk about this book, do want i want people to really give us give you the opportunity to tell you our tell these folks how you came to be such a defender and an advocate of aging. Well, you know, i had amazing parents, but they had decided on a course for me and. So i was supposed to be a psychiatrist and then sort of wasnt quite sure whether that was what made sense. And so to kind of, you know, test drive that proposition i went and lived in on a general admission psych ward at the Rochester State Hospital in rochester minnesota where i grew up, which was really sort of an amazing program, is called a volunteer a resident volunteer program. And i love the patients and i love the staff for many of them. But i also saw horrible things and was then sort of more interested figuring out where the levers of change were and it seemed to me that maybe would give me a better handle on the levers of change. So then i ended up at the department of justice. Brad was saying and doing civil fraud cases and i really didnt want to litigate anymore. And so i had this opportunity to head up something called the Nursing Home Initiative that the truth is didnt really exist but it was a response to congressional hearings relating to terrible about Nursing Homes. And i thought, oh my god, this is, you know, this new revelation. But as i got into it, it became clear that was actually a very old revelation. And it was only new to me. And actually, chris had worked on it before i ever did. And that these things have been going on for a very long time. And then what became even more clear was nursing home abuse and neglect was just the tip of the iceberg that there were many, many other related issues related to aging that we hadnt paid attention to for a very long time. And then i, you know, started to feel a little bit like the sorcerers apprentice, which, you know, not really knowing. I mean it was just like the issues started coming at. Me so and thats that was my start well and i have to say i would like you to build on so aging iceberg of nursing home and how much bigger the issue really is and what you found about and in particular you talk about the paradox the longer the scuse me the longevity paradox and what does mean to this country. So. Over the between 1902 thousand, we gained on average 30 years of life. I mean, that on average and that was due to all kinds of scientific Public Health and hygiene developments. And so we did this extraordinary thing of allowing people to live longer. But what we havent done yet, figuring out how to let people, how to help people age better and how to ensure quality life. In the years that weve gained. And we just we havent paid attention it. I mean, were fully capable of doing that. I think and so as i looked around, it became clear that this itself in so many different ways in our, you know, we relying on 40 million caregivers, family caregivers providing them very little support, and theyre doing a ton of work we have incredible financial issues, both in terms of families and in terms of budgets that we dont really talk about much. And we havent done very much to address. And so and theyre a really complex philosophical and ethical questions about, balancing autonomy and safety. So we just you know, we theres so much more we could do to improve old age. And so, you know, if were going to do all this work to live longer, why not figure how to live better to for not just for older people, but for everybody. And now i think we understand your motivation and, your inspiration for doing aging advocacy and doing the representation of the elderly, pushing for policy that youve done. But why do this book in particular . What was the reason . What motivated you to do this book . It certainly is no easy task. It was a cake walk chris. Hi so. So a bunch of different reasons. First of all, the problems were really invisible and really huge. And so there was sort of this disconnect in my head about how are there these problems that we that just kind of go under the radar. And a friend of mine whos a political told me that for really big social problems we need a language, we need a vernacular with which to even concept equalize the much less to have conversation about them or to debate them or to, you know or to start thinking about how to act on them or to change big policies. And so mean in a way, its a wildly ambitious goal. But what i wanted to do was to start figuring out how to put together the stories and the policies, the work of the professionals are working on these things and i really Extraordinary Group of professionals. Who are you know the heroes of the book in a sense. So theres that. Then there is just writing which id always wanted to do. Its a its a humbling process and i had an editor who said, you know, a lot of times the problem isnt so much in the writing. It is in the thinking. And its true. Its harder, you know, that hard writing often because the thinking is hard. So my hope is really, you know, to start some conversations in families among friends policymakers to say this is this universe style thing thats happening in life. What are we going to do about it . And i think its quite a gift actually, you know, i think youve captured personal and the policy so well but something i just need to know a little bit more about, which is, you know, ive known you for 25 years and all that time did elder abuse issues. So much stuff you were toiling in the fields you were very frustrated sometimes about the lack progress and and i guess i want to know, you know, to help us understand because you lived it. But id like you to define a little bit the scope of the problem in elder abuse that both how many people are affected, what is it . And really why does it take place. Oh, thats an easy question. Is so again, i was really shocked at how pervasive it was its at least one in ten people 60 and older and probably more a few because those are based surveys that are answered by people who dont have Cognitive Impairment and and and its its a problem to which mostly reacted as opposed to trying to get out ahead of it. Now thats endemic to all kinds of problems we we we think we should just let things get worse and, worse and worse and then, you know, send in the cops or send in the prosecutors and instead of preventing trouble often and so it is so that was that that was frustrating and i maybe one thing to do is to provide a case example of just how complex the issue is. And you know one relatively kind of prototypical case involve a parent who has a kid who has maybe some mental and Substance Use issues and been taking care of him for years, or at least hes been living with her and on her for housing and emotional support and financial support. And as she gets older her, her Health Declines and she needs more and suddenly son is put into the role of caregiver and then maybe she has a and ends up in the hospital and the caregiving needs escalate and you know, and that often may result in him taking her money and him screaming at her in him not providing her the of care she needs, but she wants to protect him. She wants to make she doesnt want to call the cops. She doesnt want to a protective services dont want to get him in trouble. And so a lot of people suffer alone and without any of recourse and. Its a really complicated family kind situation. So, yeah, so and i know its its so much its its thats why it makes it so hard to address. Its also the financial scams. Its the other things that prey. And i wonder if you could talk a little bit about how Older Americans feel about being preyed and whether they or even report about reports. You know, as with as with all complicated problems is no one answer. But a lot of older people dont want to report it because they, you know, well, for several reasons. Often they dont want to get the person they love in trouble, but maybe also they are worried about what might happen if they report maybe theyll be found to lack capacity, then not be able to live alone and then what happens to them then . And we have a much more robust system, residential care, that is to say nursing, assisted living, etc. Than well, its beginning to shift in because of advocates like chris, but to have more home and Community Based services so but the that the funding mechanisms work undermine peoples ability to get the care they want need in part because of the preferences for Nursing Homes and in part for a that a lot of people are unaware of which that medicare does not cover long care and most private health dont cover Long Term Care. So you either need to have private Health Insurance or you to basically impoverish yourself and rely on medicaid or you need to rely on family. And this is an issue weve talked about, which i think is really important in your whole travels in this process, you learned not just about the elder abuse issue, but how all these other issues were linked to the challenge. And id like you to talk a little bit about the breadth of that, but also why we havent made progress. I mean, weve been talking about you and i have been talking about this for a little while now, and i didnt used to not to have any gray in my beard when we first started. So when i have that effect on people, i you thats thats true. Those are so why havent we made some progress here . I think because were so freaked out about aging. We fear it. Were ashamed about it. We want to deny it. And we dont want embrace it as a society i think ive come to believe that thats a core part of it. And because of that sort of and because its invisible and because we tend to react opposed to prevent and, its just a huge problem. You know, that is visible in aging. So those are my three. And then i you have i know have eight others because youve told me about it, which why have we made progress on the legislative side. I mean people, i mean all politicians they lament they talk about they talk about doesnt seem that controversial. We care. We care, we care. Why dont you think there has been more progress on all this Long Term Care type support programs . Its well, its not ever the First Priority. And the consumers really pretty powerless and their voices are often not the people who need the care. And so. Yeah, i mean and its just not everybody, everybodys against it, but nobodys against it enough to really stake real political, financial social or other capital in being it. And i think this is a very important point and i think even amongst aging advocates, sometimes it isnt the priority. I do. I do my report that i think thats changing and im more encouraged i want to be more positive because i, i feel better about than i used to. I do want i want to shift. And i also want you know, im going to ask you to read a passage in a second because i think its so important because, well, i moved to the caregiving side of this issue and we speaking weve about the common issues. But what are the primary challenges we face when we try to navigate aging well . What would you say caregiving, money, balancing autonomy safety, a slew of broken relating to those and issues . How can i can i stop you right there about that caregiving . Because i, i want you to read first passage in the caregiving of the book because i just was so moved by that was right after. You quoted Rosalyn Carter do you know where im talking about . I think i happen to have it shocking. You have it here. Its hopefully its the its the first paragraph of the first chapter. Her. And this subsection is called and duty like a shift in the seasons its hard to pinpoint the moment when things begin to change as time and need recast our relationships and then recast them again. But whoever we become adults, some part of who were with our parents shadows us. If they live long enough to need our care. The role exists in a time warp, one that millions of us will at some point inhabit. The more i learned about aging, the more caregivers assumed center stage. They often determined, whether older people in ebbing health flourished or came harm their contributions as most unpaid or underpaid are measured in hours and days, in years and decades. Their work is composed of countless task rendered from near and from afar. Its beautiful. Thank you. Well, before i interrupted you, you were talking about caregiving money and autonomy, safety issues. And wonder if you could help navigate us in this conversation through. Those three care. So just one bridge. One bridge. Is that what i became convinced of . Is that really common issues aging end up getting us in serious trouble. I used to think that abuse and neglect was you know sort of this this thing that other that happened in other families that other people did. And just to be clear, not my family story, but but its a really its really common to run into trouble with issues caregiving. So i think we started to talk about it there. But theres no real decent for Long Term Care financing and people are really scared of going to facilities and. And so there are 41 Million People who are providing a lot of care every week. We dont have much care we dont have much help for those caregivers, even though theyre providing care for incredibly complicated illnesses that often, often people who are so sick that they previously would have been in Nursing Homes or hospitals and, you know, they dont. Its often mysterious for employers for Health Providers and the Health Impact of providing care is pretty serious, too. It it results in higher mortality rates and various other of Health Declines. So and that i think is in large part because dont honor the work because its invisible, because we dont help people take on this