This Saturday is National Health Care Decisions Day, a reminder everyone should have plans in place in case they need medical attention and are unable to state their wishes.

Kim Callinan, president and CEO of Compassion & Choices, which advocates for medical aid in dying for people with terminal illnesses, said having medical directives for end-of-life care is important not only for the person, but for their family.

"One in two seniors now die with or from dementia, and unfortunately, most are not planning for what the end might look like," Callinan stated. "Without planning, you're leaving your loved ones and caregivers having to make just heart-wrenching decisions about the care you receive or do not receive at life's end."

She added there is an even greater need in the Latino community, which research shows is the group least likely to complete advance health care directives.

Compassion & Choices has an End-of-Life Decision Guide in Spanish as well as English.

Texas is among the top 10 states for Alzheimer's deaths, and of the estimated 6.2 million Americans over age 65 with Alzheimer's disease, more than half are women. Women are also more likely to have other forms of dementia.

Callinan noted advances in medicine have prolonged life for many people, but in some cases, it can also lead to years of suffering.

"With planning, you're able to disrupt the system and have a much more compassionate end," Callinan contended. "Without planning, you're subjected to a health care system that is going to focus on prolonging life, which in the case of someone with advanced dementia, often prolongs suffering."

Callinan acknowledged it is not easy to have such conversations with loved ones, but pointed out there are resources available to help.

"For National Health Care Decisions Day, I would encourage everyone to have conversations with their loved ones about the care that you would want at the end of life," Callinan urged. "In particular, use our Dementia Values and Priorities Tool, so that you can document your care preferences to safeguard your future."

In Texas, more than one million family members and friends provide unpaid care to people with dementia, putting in almost two billion hours a year, care which would otherwise cost the state more than $25 billion.

June was Alzheimer's and Brain Awareness Month, but the Michigan Alzheimer's Association says these should be year-round priorities.

More than 200,000 Michiganders over age 65 are living with Alzheimer's - although only about half receive a doctor's diagnosis. This can delay necessary care and future planning.

Kathryn Ribant Payne - communications director with the Alzheimer's Association in Michigan - said this year, the focus is on educating the public about how to take control of their brain health.

She said when there's a concern, early diagnosis is key.

"We're kind of coming into an era of treatment where we're seeing treatments come down the pipeline that necessitate early diagnosis," said Ribant Payne. "So, if people are experiencing cognitive decline that they've noticed, or their family members have noticed, we really encourage them to speak with their healthcare provider."

Ribant Payne said up to 40% of dementia cases could be caused by risk factors that a person could change by developing healthy habits.

These include challenging yourself by learning new things and staying in school.

Not smoking, getting regular exercise and properly managing other diseases, such as diabetes and high blood pressure, also improve brain health.

She said protecting your head by wearing a helmet for activities like biking, is important - as well as eating a healthy diet and sleeping well.

She added that if you think it's too late to improve your routine - you're wrong.

"These things that we are talking about, as far as the healthy habits, are not something that you have to start when you're in your 20s for them to do something," said Ribant Payne. "Any little thing you can start at any time will affect your health in a way that can cause positive results."

Ribant Payne emphasized that it's critical for caregivers of people with Alzheimer's disease to seek respite and reach out for help themselves.

Michigan leads the nation in the number of caregiver hours - and about two-thirds of caregivers in the state report having a chronic health condition as a result of the stress.




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Washington has received designations highlighting the state's efforts to become more age and dementia-friendly.

Washington is the 12th state to join the AARP Network of Age-Friendly States and Communities.

Susan Engels, Unit on Aging office chief for the Washington State Department of Social and Health Services, said the designation builds on work the state is already doing to support people of all ages.

"Age-friendly communities consider goals that promote high quality of life for each person regardless of their age, allowing older people the opportunity to remain active in their community," Engels pointed out. "The designation begins a book of work that we're very excited to do."

Some cities in the state have already joined the AARP network, such as Puyallup, Renton, Seattle, Tacoma and White Salmon. Some of the goals for age-friendly communities include ensuring people can age in place and building walkable communities to ensure people can maintain both their independence and connection with others.

Washington is also joining U.S. Aging's Dementia-Friendly America network. Engels noted the state is already supporting people with dementia.

"Developing more community opportunities for families living with dementia," Engels explained. "Things like zoo walks and cafes where people can come and not worry about being judged if their loved one behaves differently."

Family caregiving is another important area as the population ages. According to AARP's statistics, the ratio of family caregivers per adult over 80 available in Washington will decline from about 4.5 to 1 in 2030 to less than 3 to 1 in 2050.

Engels added the state has support in caregiving as well, such as through respite and counseling to help people maintain the sometimes difficult roles.

"We have innovative programs, both state funded and federally funded, where we are able to support family caregivers regardless of income levels," Engels stressed. "With services that help those family caregivers be able to maintain their role."

More people over the age of 64 are being targeted by scams through social media and are more likely to lose money.

According to AARP, around half of American adults report having been a victim or a target of financial fraud.

Judy Dollison, president of the Better Business Bureau of Central Ohio, said the most common and dangerous scams for seniors involve investments, romance, and home improvement.

"Scammers oftentimes go door to door, looking for victims," Dollison pointed out. "Sometimes we see this after a big storm or, you know, hail or tornado comes through the neighborhood, and they tell them that, oh, you know, we got up on your roof, and there's hail damage."

People who suspected they have been scammed or their personal information has been compromised should contact their local police department and their financial institution to get help stopping the payment or disputing the charge. Report scams at BBB.org/ScamTracker or call 614-486-6336.

Dollison explained warning signs include asking for payment immediately and unusual payment types such as debit cards, Zelle, and Venmo, along with claims of a free or unrealistic low-cost product or service.

"Some of the big red flags are, you know, a pressure to act," Dollison emphasized. "So often we see scammers try to really convince you to do something urgently, because they don't want you to ask your friend or family. They don't want to you to research."

A decline in cognitive functioning, such as Alzheimer's disease and dementia, social isolation, and a lack of financial literacy tend to make older adults more susceptible to scams and fraud. Dollison stressed it is important to remind loved ones and neighbors scammers are out there.

"We always encourage just vigilance," Dollison added. "Empower the seniors to be suspicious of things, to question, to pause and seek guidance. Discuss telemarketing and email fraud. Just really highlight how much is out there."

Elder financial abuse costs older Americans at least $36.5 billion each year and more older adults are becoming victims of financial scams, according to the Department of Justice.


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