    [Senate Hearing 119-58]
    [From the U.S. Government Publishing Office]

                                                             S. Hrg. 119-58

                          BREAKING THE CYCLE OF SENIOR
                        LONELINESS: STRENGTHENING FAMILY
                             AND COMMUNITY SUPPORT

    =======================================================================

                                    HEARING

                                   BEFORE THE

                           SPECIAL COMMITTEE ON AGING

                              UNITED STATES SENATE

                        ONE HUNDRED NINETEENTH CONGRESS

                                 FIRST SESSION

                                   __________

                                 WASHINGTON, DC

                                   __________

                                 MARCH 12, 2025

                                   __________

                               Serial No. 119-05

             Printed for the use of the Special Committee on Aging

     [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

            Available via the World Wide Web: http://www.govinfo.gov

                                    __________

                       U.S. GOVERNMENT PUBLISHING OFFICE
    60-186 PDF                  WASHINGTON : 2025

    -----------------------------------------------------------------------------------

                           SPECIAL COMMITTEE ON AGING

                         RICK SCOTT, Florida, Chairman

    DAVE McCORMICK, Pennsylvania         KIRSTEN E. GILLIBRAND, New York
    JIM JUSTICE, West Virginia           ELIZABETH WARREN, Massachusetts
    TOMMY TUBERVILLE, Alabama            MARK KELLY, Arizona
    RON JOHNSON, Wisconsin               RAPHAEL WARNOCK, Georgia
    ASHLEY MOODY, Florida                ANDY KIM, New Jersey
    JON HUSTED, Ohio                     ANGELA ALSOBROOKS, Maryland
                                  ----------
                    McKinley Lewis, Majority Staff Director
                    Claire Descamps, Minority Staff Director

                            C  O  N  T  E  N  T  S

                                  ----------

                                                                       Page

    Opening Statement of Senator Rick Scott, Chairman................     1
    Opening Statement of Senator Kirsten E. Gillibrand, Ranking
      Member.........................................................     2

                               PANEL OF WITNESSES

    Andrew MacPherson, Founder and Executive Chair, Foundation for
      Social Connection Action Network, Washington, D.C..............     3
    James Balda, President and CEO, Argentum, Washington, D.C........     5
    Suzanne McCormick, President and CEO, YMCA of the USA, Tampa,
      Florida........................................................     7
    Tori Strawter-Tanks, Director, Clayton County Senior Services
      Department, Jonesboro, Georgia.................................    10

                                    APPENDIX
                          Prepared Witness Statements

    Andrew MacPherson, Founder and Executive Chair, Foundation for
      Social Connection Action Network, Washington, D.C..............    30
    James Balda, President and CEO, Argentum, Washington, D.C........    36
    Suzanne McCormick, President and CEO, YMCA of the USA, Tampa,
      Florida........................................................    41
    Tori Strawter-Tanks, Director, Clayton County Senior Services
      Department, Jonesboro, Georgia.................................    43

                            Questions for the Record

    Suzanne McCormick, President and CEO, YMCA of the USA, Tampa,
      Florida........................................................    47
    Tori Strawter-Tanks, Director, Clayton County Senior Services
      Department, Jonesboro, Georgia.................................    49

                           Statements for the Record

    The Alzheimer's Association and Alzheimer's Impact Movement (AIM)
      Statement......................................................    53
    ASHA Statement...................................................    55
    ASHA: Senior Living Communities Report...........................    59
    ASHA: The Surpassing Price of Staying in a House Report..........    77
    James Balda Statement............................................    91
    NANASP Statement.................................................    98
    Oshkosh Community YMCA Statement.................................    99
    YMCA Statement...................................................   106
    YMCA Florida Statistics..........................................   107

                          BREAKING THE CYCLE OF SENIOR
                        LONELINESS: STRENGTHENING FAMILY
                             AND COMMUNITY SUPPORT

                                  ----------

                           Wednesday, March 12, 2025

                                            U.S. Senate
                                     Special Committee on Aging
                                                        Washington, DC.
        The Committee met, pursuant to notice, at 03:31 p.m., Room
    106, Dirksen Senate Office Building, Hon. Rick Scott, Chairman
    of the Committee, presiding.
        Present: Senator Scott, Justice, Johnson, Moody, Husted,
    Gillibrand, and Warnock.

                     OPENING STATEMENT OF SENATOR
                          RICK SCOTT, CHAIRMAN

        The Chairman. [[added post: The U.S. Senate Special
    Committee on Aging will now come to order.
        Today, I want to address the tragedy of rising social
    isolation and]] loneliness among American seniors. Americans
    have never had more opportunities for connection than we do
    today, but studies are repeatedly warning that feelings of
    isolation and loneliness are rising dramatically, especially
    among elderly Americans. This is a problem.
        Here is why it should matter to everyone in this room and
    the American people. The cycle of loneliness in seniors impacts
    all of us, and if we don't figure it out now, we are doing
    future generations to suffer the same negative impacts of
    isolation. We can and must do better.
        Combating the feeling of isolation and loneliness for the
    aging community has endless benefits, from better mental and
    physical health, to stronger multi--generational relationships
    for families and communities. Another benefit to reducing
    isolation and loneliness is that this is critical in our fight
    against scams.
        The internet and social media are great for many things,
    but when isolated and lonely seniors turn to the internet for
    companionship and social interaction. They are far more likely
    to become victims of scams. It is heartbreaking because this
    only fuels a cycle of negative outcomes for vulnerable older
    Americans.
        That is why last week I was proud to be joined by Senator
    Mark Kelly and several of our colleagues on the Aging Committee
    to introduce and pass a resolution designating March 6th as
    National Slam the Scam Day and working to raise awareness of
    scams targeting older Americans. Seniors have lost so much to
    scams, in many cases their identities or their life savings.
        Seniors are attacked with grandparent scams, financial
    services scams, tech support scams, Government impersonation
    scams, romance scams, among others. All of these scams are even
    more effective with seniors who are struggling with loneliness,
    isolation, and depression. In 2023, people over 60 lost a
    combined 3.4 billion to fraud worldwide. We need to put an end
    to this.
        This is something that every American should be worried
    about. I know that every member of this Committee wants to put
    an end to this critical issue. I am glad that Pam Bondi is our
    Attorney General and Kash Patel is the Director of the FBI.
        I am confident they will fight for every senior in our
    country and make sure that criminals are held accountable for
    their despicable crimes. Beyond preventing scams, tackling the
    issues associated with loneliness are key to my goal as
    chairman of this Committee to improve the wellness of American
    seniors.
        I know the ranking member has the same goal. In our first
    meeting, I outlined four issues for this Committee to focus on
    as we work to improve the wellness of American seniors. One of
    these four issues was improving family and community support,
    and that is so important because when seniors feel they have
    purpose and are part of the community, they thrive.
        The sad reality we face today is that a growing number of
    senior citizens are suffering from mental and physical issues
    largely driven by an epidemic of loneliness. Despite public
    health officials sounding the alarm, the issue has not yet been
    addressed through any major legislation.
        That is why I introduced the Social Engagement and Network
    Initiatives for Older Relief, or SENIOR Act, to address senior
    loneliness. I am proud to have the support of Argentum, the
    Foundation for Social Connection Action Network, and the YMCA,
    who are all represented here today by our witnesses.
        The SENIOR Act has also been endorsed by Meals on Wheels.
    Finally, I think it is incredibly important to recognize the
    impact that COVID had on our seniors. Due to shutdowns and
    restrictions in places like hospitals, assisted living
    facilities, and nursing homes, many seniors weren't allowed to
    be near their children, or grandchildren, or any of their loved
    ones. In many cases, they were completely isolated to their own
    rooms. That is horrible. This was heartbreaking to see.
        We all know the importance of community and social
    interaction for our seniors and the great health benefits it
    has. We had so many seniors that weren't even allowed to have
    their loved ones next to them during their last time of need or
    their last moments on this earth. We all know that seniors
    contribute greatly when given opportunities to be active
    members in their communities.
        I hope to make significant progress on this issue to end
    loneliness and isolation among seniors, pass my SENIOR Act, and
    work together to improve the wellness of older Americans. I
    look forward to hearing your testimony and working with my
    colleagues on next steps to fight this issue. I would now like
    to recognize Ranking Member Gillibrand for her opening
    statement.

                      OPENING STATEMENT OF SENATOR
                 KIRSTEN E. GILLIBRAND, RANKING MEMBER

        Senator Gillibrand. Thank you, Chairman Scott, for calling
    today's hearing. Imagine growing old by yourself with no
    friends, no family, no loved ones around. I have seen it
    before, and it is really lonely. It is the reality of many of
    our seniors today.
        A heartbreaking one in four older Americans report being
    socially isolated, and 43 percent report feeling lonely.
    Loneliness and social isolation have detrimental consequences,
    increasing risks of early death, chronic disease, and dementia.
    This is not the kind of life that we want for our loved ones.
        It is not the kind of life we want for ourselves. The good
    news is there are many things we can do to reduce and prevent
    loneliness and social isolation. For example, home and
    congregate meals deliver both life--sustaining nutrition and
    social connection for older adults in their homes and
    community.
        Transportation programs allow adults with limited mobility
    to participate in community and social activities. There are
    also various innovative programs, such as intergenerational
    initiatives, that can help reduce social isolation. I look
    forward to working with my colleagues to support and strengthen
    programs that do reduce loneliness and social isolation for
    older adults.
        This includes protecting and strengthening critical federal
    funding for these programs, including in the Older Americans
    Act. I am proud to lead and support efforts to increase funding
    for the Older American Act programs, including the nutrition
    programs.
        I look forward to hearing from our witnesses today, and to
    hear all the ways that they can help--that we can help seniors
    stay engaged, connected, and integrated in their communities.
        The Chairman. Thank you, Ranking Member Gillibrand. Now, to
    welcome our witnesses here today. Before I introduce our first
    witness, I would like to ask each of you to be mindful of our
    limited time together today and keep opening statements to five
    minutes. First, I would like to welcome Andrew MacPherson.
        Mr. MacPherson is the Founder and Board Chair of the
    Foundation for Social Connection Action Network, an
    organization representing some of the most influential consumer
    groups, patient advocates, health plans, community-based
    organizations, behavioral health groups, and private sector
    innovators in the United States. Thank you for being here
    today, and please begin with your testimony.

              STATEMENT OF ANDREW MACPHERSON, FOUNDER AND

                 EXECUTIVE CHAIR, FOUNDATION FOR SOCIAL

              CONNECTION ACTION NETWORK, WASHINGTON, D.C.

        Mr. MacPherson. Chairman Scott, Ranking Member Gillibrand,
    and distinguished members of the Aging Committee, thank you so
    much for the opportunity to testify today on the critical issue
    of loneliness among older adults.
        My name is Andrew MacPherson, and I am the Founder and
    Executive Chair of the Foundation for Social Connection Action
    Network. Established in 2018, we convened a diverse multi-
    sector coalition of national organizations to develop and
    advocate for federal policy solutions that address the epidemic
    of social and loneliness in America.
        Since our establishment, the Action Network has been
    honored to play an important role in supporting and advising
    the policy efforts of Congress, on a bipartisan basis, as well
    as the executive branch. Chairman Scott, thank you for your
    leadership in authoring the bipartisan Social Engagement and
    Network Initiatives for Older Relief, or SENIOR Act, which
    underscores the role that the Older Americans Act plays in
    addressing loneliness.
        While significant progress has been made here in Congress,
    of course our work on this issue is far from over. As you know,
    social isolation and loneliness among older adults has reached
    epidemic proportions with devastating combined effects on
    public health, healthcare costs, and individual well-being.
        According to the National Academies, 24 percent of
    Americans aged 65 and older are considered to be socially
    isolated. Forty percent of adults aged 60 and older report
    feeling lonely, and chronic loneliness is linked to a 50
    percent increased risk of dementia, 29 percent increased risk
    of heart disease, and 32 percent risk of stroke.
        Beyond its impact on an individual's health, social
    isolation and loneliness among older adults carries a
    substantial economic burden to our country as well. AARP, a
    member of our coalition, estimates that Medicare spends an
    additional $6.7 billion annually on socially isolated older
    adults due to increased hospitalizations, emergency room
    visits, and over-reliance on long-term care services.
        Chairman Scott and Ranking Member Gillibrand, I have
    included much more comprehensive analysis in my written
    testimony submitted to the Committee. Fortunately, there are
    ways, a number of ways, that Congress can ameliorate loneliness
    and its deleterious impacts on older adults' health and well-
    being.
        First, pass the SENIOR Act. Adding the term loneliness to
    the Older Americans Act will allow and direct those funds to
    ensure older adults are more socially connected. Second, and as
    you know, the Older Americans Act serves as a vital cornerstone
    for aging services but demands far out seed available
    resources.
        By increasing funding for Older Americans Act nutrition
    programs and community-based resources like senior centers,
    older adults can access structured opportunities for
    socialization, supporting their overall well-being.
    Additionally, targeted funding for rural aging interventions is
    essential to address isolation and loneliness in areas with
    limited transportation resources.
        The Administration for Community Living's Commit to Connect
    Program, which Congress created, is just one example of an
    evidence-based model that can enhance and that should be
    protected and expanded.
        Third, strengthening and expanding intergenerational
    initiatives, such as shared housing programs, mentorship
    opportunities, and community volunteer projects have proven to
    significantly reduce loneliness across generations. To
    strengthen these bonds, evidence-based strategies can be
    implemented to include socially friendly environments,
    expanding community programs that connect diverse age groups,
    and investing in local institutions that serve
    intergenerational hubs.
        Fourth, we must promote technology access in this country
    for seniors. While technology holds significant potential to
    mitigate loneliness, nearly 22 million senior--older adults
    today lack broadband access.
        To bridge this gap, leveraging telehealth, assisted
    devices, online support groups, and expanded broadband access
    are truly necessary to address this issue, and finally, of
    course, Medicare plays a critically important role here in the
    growing crisis--to address the growing crisis of loneliness and
    isolation as well.
        Medicare can, for example, ensure that the annual wellness
    visit includes routine screenings for loneliness, expand
    coverage for peer supports and hearing aids, support non-
    emergency transportation opportunities through Medicare
    Advantage, and other non-medical supports that can enhance
    social connection and build social capital.
        In addition to recommendations, today I am proud to
    announce the launch of our organization's federal policy
    priorities for social connection, a comprehensive framework
    comprising a full 130 policy recommendations designed to foster
    social connection and end the public health crisis.
        Chairman Scott, Ranking Member Gillibrand, and members of
    this Committee, the Aging Committee, addressing the epidemic of
    loneliness among older adults is not only a moral imperative,
    but it is a critical public health and economic necessity in
    this country.
        Together, we can build a future where connection, not
    loneliness, defines the American experience for seniors. Thank
    you so much for the opportunity to testify today. I look
    forward to your questions. Thank you.
        The Chairman. Thank you, Mr. MacPherson. Now, I would like
    to welcome James Balda. Mr. Balda is the President and CEO of
    Argentum, the leading national trade association serving
    companies that own, operate, and support professionally managed
    senior living communities.
        Under his leadership, they have focused on critical
    advocacy and action to support seniors. Thanks for being here
    today. Please begin with your testimony.

                  STATEMENT OF JAMES BALDA, PRESIDENT
                  AND CEO, ARGENTUM, WASHINGTON, D.C.

        Mr. Balda. [Technical problems]. Excuse me. Chairman Scott,
    Ranking Member Gillibrand, and members of the Committee, thank
    you for this opportunity. My name is James Balda, the President
    and CEO of Argentum, the leading national association
    representing senior living, including independent living,
    assisted living, and memory care, where over two million
    seniors are overwhelmingly satisfied with calling our
    communities home.
        Argentum commends you, Senator, and Senator Smith, and
    Senator Warnock on the introduction of the SENIOR Act and for
    holding this important hearing. You all know, which is why we
    are here today, that loneliness is an epidemic among our
    Nation's elderly.
        As many as 50 percent experience it, and the physical,
    mental, and cognitive consequences can be devastating and
    overwhelming, particularly for those with some form of
    dementia.
        The toll of loneliness impacts an individual's quality of
    life and adds an ever--escalating cost to our healthcare
    system. As has already been mentioned, this former Surgeon
    General outlined the health consequences of loneliness, and the
    Harvard, Stanford AARP study also recognized the costs of that
    loneliness.
        The Alzheimer's Association has identified that loneliness
    increases the risk of dementia by over 50 percent, which in
    turn translates to over $230 billion in Medicare and Medicaid
    expenses annually, which is projected to increase by over 200
    percent by 2050.
        While these data points are staggering, the personal impact
    is often tragic, reducing the quality of life for seniors and
    putting a strain on caregivers and loved ones, but there is a
    commonsense solution, offering seniors greater opportunities
    for support and engagement. Socialization is a crucial aspect
    of healthy aging.
        It promotes a sense of purpose and connection with others,
    and significantly improves the mental, cognitive, and physical
    health of seniors. We see this every day in senior living
    communities, where residents become friends, and friends
    ultimately become family.
        Our assisted living model, which is predominantly private
    pay and supports all activities of daily living, was created to
    allow seniors to thrive. It strives to recognize the importance
    of dignity, choice, and community to keep them living as
    independently--for as long as possible and providing them with
    a sense of purpose and belonging and providing them with a wide
    range of social and interactive activities, such as gardening,
    educational programs, tours, exercise classes, book clubs, and
    so much more.
        The social atmosphere of assisted living actually decreases
    loneliness. A national survey of more than 130,000 assisted
    living residents based on the UCLA loneliness score identified
    that just 14 percent of seniors identify themselves as being
    lonely living in an assisted living community compared to
    nearly 30 percent in the broader community.
        Just yesterday, U.S. News reported that about two-thirds of
    seniors said loneliness or isolation contributed to a decline
    in their health before they moved into a senior living
    community, but that 61 percent of residents say their feelings
    of loneliness or isolation improved after moving in.
        Mr. Chairman, we believe our communities offer many
    opportunities for seniors to combat loneliness, but we know
    more can be done and more needs to be done outside of the four
    walls of our buildings. That is why Argentum commends you on
    taking the important step of introducing the SENIOR Act. This
    bill will take critical steps to address the epidemic of senior
    loneliness by promoting key programs specifically designed to
    support seniors.
        Additionally, the requirement to direct the Secretary of
    HHS to focus on the importance of multi-generational
    relationships to mental health and loneliness is incredibly
    significant. Argentum is also pleased to support House
    Resolution 1812, the Care Across Generations Act, a bipartisan
    bill that will create opportunities for intergenerational
    connection through the establishment of a grant program for
    assisted living and long-term care settings to co-locate a
    childcare facility with the senior community.
        We believe the benefits to both seniors and children will
    be invaluable, and I can speak firsthand to the value of
    intergenerational programs, whether it is the experiences my
    children have shared volunteering in a senior living community,
    or through stories told to me by my wife about one of her first
    jobs working in a preschool adjacent to an assisted living
    community.
        Then there is the benefits of pet therapy, when Buttercup
    and Sugarplum, two golden retrievers, visit a memory care
    center in Maryland and bring the room and residence to life. Or
    the impact of music therapy on Mary, a lifelong Beatles fan who
    today is often non-verbal until "Let It Be" starts playing and
    she is quickly leading the room in song.
        The World War II veteran who became isolated after losing
    mobility, but after moving into a community, making friends,
    and accessing physical therapy received a new lease on life.
    While these are just a few stories I can share today, these
    stories are commonplace in our communities.
        Mr. Chairman, thank you for the hearing and for taking the
    first steps to break the cycle of loneliness, and we look
    forward to working with you and the Committee on this and other
    critical issues.
        The Chairman. Thank you, and thank you for what your
    companies do for seniors. Now, I would like to welcome Suzanne
    McCormick. She is the President and CEO of YMCA of the USA, the
    National Resource Office for the Y.
        Everyone of course knows the YMCA, operating in 10,000
    communities across all 50 states, D.C., and Puerto Rico. The
    YMCA is a key community partner in combating senior loneliness.
    Thanks for being here today and we look forward to your
    testimony.

               STATEMENT OF SUZANNE MCCORMICK, PRESIDENT
                AND CEO, YMCA OF THE USA, TAMPA, FLORIDA

        Ms. McCormick. Chairman Scott, Ranking Member Gillibrand,
    and other distinguished members of the Committee, I want to
    thank you for inviting me today. I am here representing the
    2,600 YMCAs, which serve 10,000 communities across our country.
    I am grateful for the opportunity to share the story of how
    they connect and support our older adults every day.
        At the Y, our mission is to strengthen communities by
    connecting people of all ages, abilities, and backgrounds to
    their potential, their purpose, and each other. This has been
    at the core of who we are for 175 years, but today we know that
    so many people are struggling to make these life-changing
    connections, especially our seniors.
        Forty percent of adults say they feel lonely sometimes or
    even more than that, and the mortality rate of being socially
    disconnected is similar to the impact of smoking 15 cigarettes
    a day, which is greater than the impact associated with obesity
    and inactivity.
        The health risks for our older adults are heightened even
    more because they are more likely to feel isolated and
    disconnected than younger Americans. A bright spot, however, at
    the Y, older adults find the support and meaningful
    relationships they need to feel connected and healthy.
        YMCAs engage 17 million Americans every year, and nearly
    four million are over age 55, and five million are over 65.
    Seniors make up one-quarter of our members. A few years ago,
    the Y partnered with NORC at the University of Chicago to find
    out if older adults report better quality of life and social
    connectedness when they visit our facilities and participate in
    our programs. Results of this study showed significant
    increases in overall well-being and social connectedness.
        They also showed a decrease in loneliness and improvements
    in social well-being, spiritual well-being, physical health,
    and mental health. The results were even better for older
    adults who were able to engage more frequently in their Y.
        Our programs not only help participants build friendships
    and connections that we all need to thrive, but they also help
    prevent, delay, or control chronic disease. Thanks to a 20--
    year partnership with CDC, the Y is the leading in-person
    provider of evidence-based chronic disease prevention and
    management programs, which address issues like diabetes,
    hypertension, arthritis, falls, and cancer.
        These programs have been proven to improve health outcomes
    and quality of life, and they often save health care dollars.
    In fact, The Y is recognized for its work with the Centers for
    Medicare and Medicaid Innovation.
        During a national study of 8,000 Medicare recipients, the
    YMCA's Diabetes Prevention Program saved $2,650 per
    participant, while preventing or delaying diabetes among the
    majority of participants. The Y is also the leading provider of
    Medicare Advantage fitness benefits, larger than the next seven
    providers combined, but for as much as we are able to
    accomplish on our own because of our national scale and
    community level credibility, the Y is always looking to
    maximize our impact through partnerships. In communities across
    the country, YMCAs collaborate with partners like senior
    centers, libraries, and places of worship to reach and engage
    more seniors. The Y looks forward to also partnering with the
        Select Committee on Aging to improve both physical and
    emotional well-being of our Nation's older adults.
        We urge Congress to continue supporting the highest level
    of funding for the CDC, to help the Y innovate our evidence-
    based chronic disease prevention and control programs, to
    uphold Medicare Advantage's ability to offer supplemental
    benefits like fitness and socialization opportunities and
    enable Medicaid to help low-income seniors improve their
    physical and mental health by helping them access the Y and our
    evidence-based programs.
        Every dollar invested in community-based organizations like
    YMCAs, organizations that are trusted and have on the ground
    credibility, pays a dividend in the form of improved health and
    wellness, especially for our older adults.
        There are a thousand stories I could share but I will leave
    you with just a few. There is Pam from Palm Harbor, Florida.
    Her husband passed away, she lost her home in a hurricane, and
    she has become a caregiver for her adult son. She called it the
    darkest period of her life and said she didn't even want to get
    out of bed in the morning. At the Y, she found friendly people
    and opportunities to engage and get active. She says it is the
    best thing she has ever done for herself.
        In Phoenix, 86-year-old Gloria has a new bestie. That is
    what she calls Lisa, a volunteer with the Y's Outreach Program
    for Aging Seniors. Each week they go grocery shopping, they get
    their hair done, and they have lunch together. Gloria says this
    relationship helps her stay active and feel young.
        Lastly, serving so many older adults creates employment
    opportunities for them as well. Althea and Oscar, both in their
    80's, work part time at their Y. She works at the front desk.
    He is a greeter who gives tours and manages the coffee bar.
    These jobs, they say, help them find fulfillment and purpose in
    their lives.
        On a personal note, I have had the great privilege of
    meeting three Y members who bragged to me about celebrating
    their 100th birthday with friends and family at their local Y,
    their Y in Athens, Georgia, Kansas City, Missouri, and
    Anchorage, Alaska.
        It still warms my heart to remember the joy on their faces
    when they told me all their friends who turned out to celebrate
    with them at their Y. This is the magic of creating places,
    experiences, and opportunities for people to genuinely connect
    with each other. This is the magic of the Y. This is the magic
    our seniors need more than ever.
        In closing, there are YMCAs in every state represented by
    the members of this Committee that are helping older adults
    stay engaged and healthy every day. I would be happy to share
    examples and submit them as part of the record today.
        Again, Y's across the country want to be your partner.
    Thank you for the opportunity today and thank you for your
    leadership.
        The Chairman. Thank you. We will take those and put them in
    the record.
        Ms. McCormick. Thank you.
        The Chairman. Without objection, and thank you for being
    here. Next, I would like to recognize Ranking Member Gillibrand
    to introduce the next witness.
        Senator Gillibrand. I would like to give Senator Warnock
    the privilege since she is from Georgia.
        Senator Warnock. Thank you, Ranking Member Gillibrand.
    Thank you, Chair Scott, so grateful that we are hosting this
    hearing today on such an important issue, this issue of
    loneliness.
        I look forward to our continued partnership and work,
    including by passing the SENIOR Act, to address this issue, but
    while I am working in the Senate to improve access to these
    programs, I am in awe of how Georgians back home are stepping
    up every day to serve their communities.
        Grateful for the work that we get to do here, but it is
    really the folks on the ground who are the tip of the spear, so
    today I am so very proud to introduce a Georgian, Ms. Tori
    Strawter-Tanks. Tori has served as Director of Clayton County
    Senior Services for the past 12 years.
        As Director, Tori oversees five centers and manages the
    Clayton County aging program, which provides essential services
    to seniors, including home-delivered meals and transportation.
        Beyond her role in Clayton County, she is the President and
    Founder of the Georgia Association of Senior Centers, so as
    someone who has long been committed to this work, Tori thank
    you for the work that you do every day for seniors all across
    our state but particularly in Clayton County.
        We are all very, very grateful that you are here today to
    share your experience and your perspective.

              STATEMENT OF TORI STRAWTER-TANKS, DIRECTOR,

                     CLAYTON COUNTY SENIOR SERVICES

                     DEPARTMENT, JONESBORO, GEORGIA

        Ms. Strawter-Tanks. Thank you so much for that
    introduction. Thank you for the opportunity to speak before you
    today. I am Tori Strawter-Tanks, and I have the privilege of
    serving as Director of Senior Services in Clayton County,
    Georgia, and as Senator Warnock said, I am the President of the
    Georgia Association of Senior Centers.
        I am honored to be here today to discuss a critical issue
    facing older adults across the country, social isolation and
    the vital role senior centers and other aging programs play in
    combating it.
        Senior centers are hubs of a high-impact exercise, cultural
    engagement, physical wellness, and lifelong learning. The Older
    Americans Act, it contributes funding to senior centers and
    other important aging services.
        Protecting that funding is critical to ensuring that older
    adults continue to have access to the services that I have
    spent over half of my life carrying out. Across Georgia and
    throughout the Nation, senior centers provide vital programs
    that enhance the lives of older adults, keeping them socially
    engaged and supporting their overall well-being.
        These programs include health, wellness, aquatic,
    technology, fitness classes, lifelong learning, theatrical
    productions, cultural arts programs, trips, and also evidence-
    based programs.
        These programs play a vital role in improving seniors'
    physical health, reducing fall risk, preventing chronic
    disease, enhancing mental well-being, fostering creativity,
    promoting social engagement, strengthening community
    connections, and bridging the generational digital divide.
        At Frank Bailey Senior Center in Riverdale, Georgia, we saw
    firsthand the extraordinary potential of older adults when Ms.
    Dorothy Steele who started acting at the age of 80. Ms. Steel,
    she took the stage, and she was a Hollywood sensation. She went
    on to become a Hollywood sensation, starring as a tribal elder
    in Marvel's Black Panther and Black Panther 2, Wakanda Forever,
    proving that dreams do not have expiration dates.
        Ms. Steel has appeared in several other movies. You can
    Google her to see her entire amazing body of work. Her story is
    a testament to the power of senior centers to unlock potential
    and rewrite the narrative of aging. Another essential service
    that senior centers provide is congregate meals.
        For many older adults, these meals aren't just about food,
    you see. They are about connection, dignity, and community.
    Congregate meals ensure that seniors receive balanced,
    nutritious food, reducing the risk of malnutrition and diet-
    related illnesses. They combat isolation by providing
    opportunities for older adults to gather, talk, and form
    meaningful relationships.
        For some seniors, this may be the only hot meal they
    receive in a day. Without adequate funding for congregate meal
    programs, like these provided by the Older Americans Act, too
    many older adults risk going hungry or becoming further
    isolated. Along the same line, home-delivered meals also
    provide nutritious food, social interaction, and wellness
    checks for older adults who may not be able to leave their
    homes.
        These services are especially critical for those who are
    aging alone without family or other community support.
    Additionally, transportation services provided through
    assistance from federal funding help seniors to get to their
    medical appointments, buy fresh and healthy foods at the
    grocery store, and to see their friends, rather than being
    isolated at home because they are not able to drive.
        Beyond their social and emotional benefits, senior centers
    and other aging programs save our economy billions of dollars
    annually. Research has shown that healthy, active seniors who
    participate in community-based programs reduce healthcare costs
    significantly, both for themselves and for taxpayers, and you
    know what? We cannot begin to overlook the sandwich generation.
        These are those that are caring for aging parents while
    supporting their children. As the senior population grows,
    working caregivers face mounting financial, emotional, and
    logistical challenges. When older adults stay active, healthy,
    and engaged, it eases the burden on their families. Without
    proper investment in senior centers and community-based
    services, caregiving falls heavily on adult children already
    juggling careers, finances, and family life.
        Access to social engagement, nutritious meals, health
    programs, and transportation supports not just seniors, but
    their families. It impacts workforce retention and the economy.
    Yet despite their proven benefits, senior centers remain
    underfunded, leaving many older adults struggling with barriers
    like transportation, awareness, and the lack of investment.
        If we are really serious about combating senior isolation
    and improving public health, we must, one, expand funding for
    senior centers and other aging services. Improve transportation
    access, especially to those in rural areas so older adults can
    actively participate in community life.
        Strength in digital inclusion for seniors so they can stay
    connected in a technology-driven world. Recognize senior
    centers--I am going to say this one more time. Recognize senior
    centers as essential infrastructures to support aging in place,
    health, and well-being. Invest in meal programs to fight food
    insecurity, combat isolation, and promote nutrition for older
    adults.
        Support caregivers by ensuring seniors have access to
    services that promote independence. Social isolation is not
    just an individual problem. It is a public health crisis with
    consequences as severe as smoking and obesity, but senior
    centers and programs like congregate and home delivery meals
    offer a proven solution, helping older adults not only stay
    socially engaged but thrive in ways they never imagined.
        When we invest in senior centers, when we invest in senior
    centers, we are not just enriching lives. We are saving money,
    we are strengthening families, we are supporting working
    caregivers and ensuring a better future for generations to
    come. Thank you for your time and commitment to this issue. I
    look forward to your questions and to working together to build
    a stronger and more connected future for our Nation's seniors.
        The Chairman. Thank you, Ms. Strawter-Tanks, and thanks for
    what you do.
        Senior centers down in Florida, and they are fun to go
    visit, so there is a lot of action. Now, we will go to
    questions. Let's start with Senator Moody.
        Senator Moody. Thank you Senator Scott and Ranking Member
    Gillibrand. We appreciate you holding this hearing. I think
    that the two of you in charge, I don't know that we have ever
    seen so much activity on this Committee.
        I love it. It has been--protecting seniors within the State
    of Florida, certainly while I was the Attorney General in the
    State of Florida and growing up with a mother who dedicated her
    entire career to helping seniors, low--income seniors. This is
    an important committee, and this is an important hearing.
        I appreciate all of you taking time to be here. Certainly,
    it is nice to see not only our sister state and neighbor state
    people from Georgia, but from Florida as well. It was so nice
    to see Ms. McCormick from Tampa Bay, which is my home.
        It is great to see a friendly face being here only a little
    over a month. I crave folks from the Sunshine State coming up
    here, and I remind them when I left and came up from the
    Sunshine State, so much leadership came up here to Washington
    that it snowed in Florida.
        It was crazy, but this is a great hearing, and certainly
    the leadership of Senator Scott does not go unnoticed. He has
    always been one to dig into the details of really complex
    problems and I have always admired that about him, not only as
    the Governor of Florida, but certainly as a Senator.
        What is remarkable to me is hearing from each of you--and
    each of you pointed out very significant ways we could address
    isolation of seniors, improve the health of seniors, and it
    touched a lot on funding. Protecting funding, certainly
    important. All of us on this Committee understand that, but
    additional funding.
        I know that so many of us, whether you are on the
    Republican side of the aisle or the Democratic side of the
    aisle, so many of us I take very seriously this responsibility
    we have to make sure that the fiscal health of this Nation
    isn't driven right off a cliff.
        We have been seeing so much of that in the last few years
    with pandemic spending never returning to normalcy. We ramped
    it up during a time of emergency and was never backed off, and
    so, many of us are struggling with, OK, we have got to face the
    reality of we have very limited taxpayer funds to work with,
    and as I am hearing from each of you, the answer is, in many
    respects--one of your answers, I don't want to limit it to
    that, is funding, and what I have been so interested in--and
    yes, I understand that, and I am glad that you are here, and I
    am glad you are advocating for that.
        What I have seen work so well throughout communities,
    including with organizations like the Y and others, if they
    have identified ways to combat problems that might not be
    asking for more money.
        For example, I have seen--I heard about putting daycares,
    and I know that is attached to a grant, but the idea of putting
    a daycare within a senior living community and what that might
    do just by being creative and thinking outside the box and
    planning programs that put these two together in a way that
    might benefit both.
        I have seen high school seniors around the Nation come up
    with community service projects. Number one, to satisfy
    graduation rates, but also it looks really good to colleges
    when you are applying and showing what you do that are creating
    programs to volunteer with seniors, and programs to help them
    cleanup, or help take them places, or volunteer at senior
    community centers.
        I think that not only helps the seniors and addresses
    isolation among our seniors, but I think in a young person's
    world where they are seeking validation, and inspiration, and
    teachings, and modeling through an empty influence of social
    media, I think it is so great that they are now spending time
    with people who have lived a life and experienced the great
    joys of life, and the tribulations and challenges of life, and
    maybe have overcome them, or can warn about downfalls or risks.
        I think there is a mutually beneficial thing there too, and
    I will start with you, Ms. McCormick. Are there any programs
    like that, that the Y is fostering, that may not be asking for
    large amounts of money, but that are facilitating the
    communication or the creation of these outside the box programs
    so that both age groups, young and old, benefit?
        Ms. McCormick. Without question. I do appreciate it, it
    does feel often when any of us come to Washington, all we are
    asking for is money. I think one of the things I would like to
    highlight as an example is in our universe of Ys, one of our
    strategies to increase services is through partnerships, and
    often through public-private partnerships.
        We see many more YMCAs around the country finding private
    partners, often their healthcare providers, to come into their
    space and serve clients together, so leveraging resources that
    exist in the community outside of Government funding.
        I think that is something that we have to continue to push
    for, and we definitely see that in regards to serving seniors.
    The other nugget I heard in your comments is community service,
    and without question, we are an organization that is built on
    volunteerism.
        The ability to bring volunteers in to deliver--but, you
    know, it is a balance, and I think that is what we are all
    striving for is how--what is the way that we can all contribute
    something so that we can leverage our gifts and what we can
    bring to achieve shared outcomes.
        Senator Moody. Thank you, Chairman.
        The Chairman. Thank you, Senator Moody. Now, I would like
    to recognize Ranking Member Gillibrand.
        Senator Gillibrand. Thank you, Mr. Chairman. I really
    appreciate everyone's testimony. Thank you so much for being
    experts in this and caring so much about our older adults. I
    really, really appreciate it.
        Ms. Strawter-Tanks, the goal--first of all, thank you so
    much for being here and testifying. In your testimony, you
    mentioned that you run various senior centers which are the
    setting for the congregate meals.
        Can you describe the ways congregate meals have improved
    the health of and reduced social isolation for older adults in
    your centers? And where do you get your funding for congregate
    meals, and are there any innovative ways to fund congregate
    meals that you have thought of?
        Ms. Strawter-Tanks. Yes, so inside of our senior centers,
    we offer congregate meals, and right now, our congregate meal
    program is funded through the Older Americans Act funding, and
    our seniors, they come--they also receive transportation to get
    to our centers to get congregate meals.
        Right now we are exploring ways that we can come up with
    better ideas to provide meals to them because we have faced
    issues where funding has been cut. Our county is an amazing
    county and our county supplements our congregate meal programs
    whenever there are cuts or fluctuations with the budget.
        Right now we are just really exploring how we can be
    prepared in case something happens where we can't provide those
    congregate meals, but our congregate meal clients, they come to
    our center, and they also receive some form of case management
    where our staff is actually meeting with them, and talking to
    them, and finding out what their needs are, because sometimes
    it is a little bit more than just the meal, but we do know that
    the meal is really important for our clients that come for
    congregate meals.
        Senator Gillibrand. Can you--would you imagine if we asked
    people who are on SNAP benefits if you could use your EBT card
    to pay for congregate meals? Do you think that would be a
    useful opportunity for settings that offer it?
        Ms. Strawter-Tanks. I think that would be an amazing
    setting, especially in our side of our senior centers. Our
    senior centers have full cafeterias where we have a contract
    with, you know, local restaurants.
        I think that would be a really great benefit if we could
    have that because some of our seniors do not qualify for
    congregate meals, and so, they do have to pay for their meals,
    but again, Clayton County does an amazing job with our senior
    centers.
        Our senior centers are not underfunded. They are actually
    funded very well. However, our meal program is kind of
    underfunded because we need more funds to provide services to
    those seniors who need meals.
        Senator Gillibrand. Then, you know, in New York, we have so
    many good--in God's Love We Deliver, we have Meals on Wheels,
    we have all these different types of organizations that are
    willing to bring homebound seniors a cooked meal at least once
    or twice a week.
        What we have heard is that that sometimes is the only
    person who has visited them all week. It is the only person who
    checks in on them to make sure they are okay, taking their
    medicine, having heat on in the apartment. What is your
    experience with home delivery of meals, and why is that
    important for your constituencies?
        Ms. Strawter-Tanks. Home delivered meals are so important.
    It is even greater than just that human contact. When the Meals
    on Wheels driver comes to the door, all of our seniors who
    receive home delivered meals also receive case management.
        Again, someone is actually talking to them, finding out
    what their need is. Talking to them about are they having
    issues with falling, do they need more than a meal, and just
    connecting them with resources.
        It starts there. Once a Meals on Wheels driver is assigned
    to that senior, that Meals on Wheels driver is actually
    checking on them to make sure that everything is OK with the
    senior as well, and then in our county, we also do things
    around the holidays. We take Christmas food to them.
        We take turkeys to them. It is truly a collaboration of the
    community and our county. We pull together to make sure that
    those home delivered meal clients have everything that they
    need socially and beyond the meal.
        Senator Gillibrand. Ms. McCormick, do you have a
    perspective on either of those two questions?
        Ms. McCormick. I was just thinking as I was hearing you
    talk, I was recalling a visit that I made to Buffalo, New York,
    actually, and it was--it was on Halloween, and they did a
    congregate meal lunch on the gym floor of one of the Y's there
    in Buffalo in a historically underserved community, and it was
    packed.
        In addition to the food, which I went and met with the
    staff, and I heard it is--when I went to meet with the staff
    and I heard the benefits are always two-fold. It is nutritional
    you know, first and foremost, but it is also the ability to
    bring seniors together in a setting where they can be with each
    other, where they can make friends.
        In this particular forum, they had an opportunity to meet
    with at least four of their public elected officials to talk
    about what was going on in the city of Buffalo, so I think it
    is always two-fold. It is always about nutrition and making
    sure that that the health aspect, physical health is being met,
    but as importantly, it is always about the social wellness that
    congregate feeding--or it is not feeding, it is congregate
    dining because it is usually a very festive atmosphere, so I
    think, you know, we see that too in the Y.
        Senator Gillibrand. Thank you. Thank you both. Thank you
    all.
        The Chairman. Senator Justice.
        Senator Justice. Thank you, Mr. Chairman. I haven't had the
    opportunity to be here, you know, with different committees
    that we had to go to and everything, and I didn't hear your
    testimonies. I just caught the tail end of yours. It was great
    and everything, but I would like to say just this.
        You know, I am one of the new kids on the block. You know,
    I am a new kid that came here with white hair, and if you show
    up with white and you are a new kid, you are here for a reason
    other than just maybe some self-satisfying reason for yourself.
    You see, I don't want anything. I don't want a thing, but I can
    tell you what I really do want beyond anything for myself is I
    want to do goodness.
        I want to do goodness absolutely for everybody that I can
    possibly touch. I meet up with being a patriot, but I would
    read just this, "breaking the cycle of senior loneliness,
    strengthening family and community support." I am going to tell
    you just this, in my State of West Virginia, you see plenty of
    loneliness.
        I don't know how it gets any worse. That is all there is to
    it. Let me just say just this and then I will ask a couple of
    real quick questions. Again, to me, our seniors need so much
    more than just contact with their seniors.
        You know, at the end of the day, they need kids involved.
    They need animals involved--dogs. They absolutely need to be
    able to give of their wisdom. You see, there is so many out
    there that really want their wisdom, and they want to give it
    so bad it is unbelievable because they want to feel worth,
    worth in what they are doing.
        You know, we can have lots and lots of meetings, and we can
    try to move the ball, but I am telling you just this from the
    bottom of my heart, if you are speaking of loneliness and you
    are speaking of our seniors, we have got to do a lot more. We
    have got to do a lot more than we are doing.
        We can absolutely, and I hate to say this in any way, but
    we can just call them seniors. You are a senior. You are a
    senior. For God's sake the living, I am a senior, and before
    you know it, we have become almost labeled or pigeonholed. I am
    not a senior. I am Jim Justice.
        They are individuals, and they should be loved and
    cherished in every single way, and we should be trying to help
    in every way. For God's sake the living, they have given us
    everything, everything, and they still stand ready to give us
    more.
        Again, I didn't hear your testimony. I can ask you a
    question like, you know, all the things we hear about, whether
    it be the phones, or the internet, and everything we hear
    negative about it, can we use that in a way to really help us
    do better? And the last thing I will tell you is just this, and
    I will open up to you and let any of you that wants to answer
    the question to answer it.
        I would say to all of us, to all of us, to our Ranking
    Member, to this great Chairman, to all those that are on this
    Committee that have come and gone and everything, I would say,
    net--net, we better get at it doing more, because we are
    losing, we are losing our knowledge, and for crying out loud,
    our seniors, that I wish to goodness we didn't even use that
    name, but our seniors are really wanting to give to all of us.
        They have already given so much. I say this in the military
    over and over, but our military of all, of all, they absolutely
    give so much and ask so little. They have done it, and done it,
    and done it. We have got to do something about it, so anyway,
    you don't have to answer my questions because I didn't hear
    your testimony, so anyway, but I love you for being here. Thank
    you so much.
        The Chairman. Thank you, Senator Justice. Mr. MacPherson,
    we know that criminals prey on lonely seniors, making them more
    susceptible to fraud and scams. Can you speak to the connection
    between social isolation and the increased risk of being
    targeted or falling victim to scams?
        Mr. MacPherson. Yes. Mr. Chairman, thank you for the
    question, and it is a significant issue in this country.
    Studies show that socially isolated seniors are twice as likely
    to fall victim to scams compared to those with more regular
    social connections, and that is why holding this hearing is so
    critically important here in the U.S. Senate.
        Loneliness is linked to 40 percent increased risk of
    cognitive decline, as we know, which leads older adults to be
    more susceptible in this country. I do want to go back to the
    Older Americans Act. You know, a fraction of the federal
    budget. It adds a pretty--fairly small amount of money but
    high-impact dollars.
        A critically important component of the Older Americans
    Act, of course, is focusing on elder abuse and protecting our
    seniors, so we want to make sure that we continue that funding.
    That we reauthorize the Older Americans Act. I also think, you
    know, the previous Surgeon General, Dr. Vivek Murthy, really
    took this issue on, and released a report in 2023 that our
    organization was very much involved with.
        We sort of--he put an idea forward that we should have
    connection in all policies, right, so whether it be healthcare
    policy, whether it be labor, pick your poison, we need to
    infuse connection in everything that we are doing in this
    country, and Senator Justice, that is the only way that we are
    going to have a comprehensive solution to a very complex
    problem.
        Thank you for the question, Mr. Chairman.
        The Chairman. Thank you. Mr. Balda, sort of like our three
    states, has a huge senior population, so naturally, there are
    larger amounts of senior living communities. What is one clear
    link between senior living communities and healthy aging?
        Mr. Balda. Thank you for that question, Mr. Chairman. When
    you think about what goes on in our buildings, at its heart, it
    is the social determinants of health. It is nutrition. It is
    physical activity. It is mental and cognitive activity. It is
    socialization.
        It is all of those twenty-four hours a day, seven days a
    week, and that has enormous benefit to the health outcomes of
    the residents that live in our buildings. A study done by NORC,
    you had mentioned NORC earlier, took a look at the frailty of
    individuals right before they moved into our communities, and
    right after they moved into our communities, and then over a
    period of time.
        What they found was right before they moved in, they were
    on a decline, and that persisted for a short period of time
    after they moved in, but then it leveled off and over the next
    several months it started to improve in terms of their frailty,
    and that is because of the activity and the engagements we do
    on a regular basis.
        I think the issue we need to figure out, and there were
    questions earlier about, you know, funding and such, we are
    predominantly a private pay model, and I think as a country we
    need to figure out how to help more seniors access that model,
    whether it is in the four walls of our building or it is in
    their own private residence.
        We think a lot about what we call sort of the forgotten
    middle of seniors in this country, the seniors that don't
    qualify for Medicaid and might not quite be able to pay for the
    current assisted living product, and we estimate that there is
    going to be more than 16 million of those in the coming
    decades.
        How are they going to get the care and the services they
    need? How are they going to get access to the nutrition and the
    physical activity? And we think there is a lot that we can do
    to support that. We just need to be able to identify a model
    that is actually affordable for those individuals. There is
    also the concern that we have about the workforce in the long
    term and who is going to care for all of these seniors.
        We have proven that our model works. It saves Medicare
    money. It saves Medicaid money, and I think there is much more
    that we can do to get those types of services and supports to
    more seniors in the country.
        The Chairman. Thank you. Ms. McCormick, with your
    experience being President of YMCA, what real life instances of
    physical health linking to mental health and reducing
    loneliness among seniors have you seen?
        Ms. McCormick. Well, I will share a Tampa example with you,
    because we have already had the Florida love today. You know,
    it is very hard not to see the connection when you go into a Y.
    The seniors that I encountered have such a vibrancy and energy
    to them.
        One of the first people I met when I took this job, which
    was about three and a half years ago, he reached out to me on
    LinkedIn. His name is Danny Ferry. He is a retired Army
    veteran, and he has been--he had been actively participating in
    the Y in a swim program to rehabilitate a knee injury, and so,
    his initial engagement with the Y was around a health benefit.
        He fell in love with the sense of belonging that it offered
    him. It gave him a place to go and feel like he could make
    friends. He has become an Uber volunteer with the Y. We held a
    large national fundraising conference down in Tampa about three
    years ago, and every day he was there dressed as a pirate with
    a parrot on his shoulder, serving as a greeter and giving
    directions.
        He continues to reach out to me and tells me that the Y
    gave him a second chance after having just an incredible career
    in the Army and then transitioning out. He now has a sense of
    purpose.
        What I see every time I go into a Y, we see seniors who
    come in potentially with the goal of working on their health or
    their physical activity, those are often the same thing, but
    the added benefit from their participation is that they are
    seen as people, and they make friends, and they have a joyful
    time, and those two things go hand in hand in almost every case
    I have seen.
        I could tell you story after story of seniors. Walk into a
    Y. At around 10:30 a.m., they will either be in the pool
    exercising as a group, they will either be doing chair
    aerobics, or they will be socializing around the coffee clutch
    after they are done with their activities.
        Sometimes it is hard to get them out of the Y just because
    they want to stay. We have our own version of a senior center
    some days.
        The Chairman. Give me some--what are some of your important
    programs you think impact seniors?
        Ms. McCormick. Some of our chronic disease prevention
    programs. We have programs that focus on arthritis mitigation.
    Diabetes prevention is one of our strongest signature programs.
    We have incredible results in that program. We have blood
    pressure self-monitoring program.
        We have a cancer survivorship program, and we also have
    many wives who participate in falls prevention training with
    seniors, so it really covers the gamut of chronic disease--you
    know, the whole portfolio of chronic diseases many Ys are
    participating in, and I would say almost every Y in Florida is
    very engaged in that work.
        The Chairman. Ms. Strawter-Tanks, can you give me some
    stories of how the seniors' activity in one of your centers is
    impacting--reduce the cost of Medicare and Medicaid?
        Ms. Strawter-Tanks. Yes, so inside our senior centers, we
    have wonderful opportunities. The average age of our staff
    inside our senior centers is around 50 or 55, so seniors
    actually come to our centers looking for social engagement,
    looking for a meal, and some of them actually receive
    employment opportunities inside our senior centers. All of our
    exercise programs inside our seniors--are high impact, which
    actually improves their quality of life.
        We do fall prevention classes. We do evidence-based
    classes. We do--it is a whole gambit of different activities
    and programs that we provide to keep seniors socially engaged
    and to improve the quality of life and their health.
        The Chairman. Mr. MacPherson, what can we do to strengthen
    community ties and protect seniors from these bad actors?
        Mr. MacPherson. There is a lot we can do. You know, the
    community-based interventions that we have heard some of them
    here today are just critically important. I think we need to
    take a settings approach, Mr. Chairman, to this issue, whether
    you are talking about health centers, community centers,
    housing, schools, workplaces, places of worship.
        Our 130 policy recommendations that we have, that we just
    released today, addresses all of those settings, and ideas for
    the Federal Government, but also states, to invest in a--as I
    said, a comprehensive approach to a really challenging problem.
    Again, going back to the Older Americans Act.
        It is just critically important that we protect that
    funding, expand that funding. It is a drop in the bucket in the
    federal budget that has an outsized impact on seniors across
    the country. The last thing I will say is that we have touched
    on intergenerational today, but I think it is worth emphasizing
    that.
        Ranking Member Gillibrand, you have an extraordinary
    program in your state, DOROT, which is a member of our Steering
    Committee, that receives funding from the Older Americans Act
    and private sources as well, that has a whole range of
    intergenerational programming. That has been very successful in
    not just addressing social isolation and loneliness, but also
    addressing the well-being of the communities that they serve.
        This is a complex issue, and there is a lot of different
    ways to address it. At the Foundation for Social Connection
    Action Network, again, we have got almost 70 national
    organizations involved in our work to come together to find a
    whole range of solutions, so thank you for the question.
        The Chairman. If you have had 20 years of work in the
    healthcare policy space, what do you think is the most
    effective, or one of the most effective, I am sure there is a
    lot, of initiatives that combat loneliness among seniors?
        Mr. MacPherson. I really appreciate that question. 20
    years. Look----
        The Chairman. Is that true?
        Mr. MacPherson. It is true. Thank you for saying that. My
    hairline said it.
        The Chairman. At least you have some.
        Mr. MacPherson. You know, I will say raising the visibility
    of this issue is the most important aspect from my perspective,
    and this hearing is a critically important way to do that.
    Look, there is still a lot of stigma in this country around
    being socially isolated and, or lonely.
        The way that we break down those barriers and allow people
    to be more connected at a very fundamental level is to talk
    about it, so, that is number one. Number two, as I said the
    former Surgeon General I think did an extraordinary job in
    raising the visibility of this issue and releasing a number of
    really thoughtful reports.
        Went all over the country and talked about this. I will
    give you some more specifics though in health care policy, Mr.
    Chairman. Medicare Advantage--in 2018 Congress passed the
    Chronic Act, okay, and the Chronic Act was widely bipartisan,
    and what it did was allow Medicare Advantage plans in
    supplemental benefits to offer non-medical benefits.
        Things like nutrition services, home-based palliative care,
    non-emergency transportation. If I think back over, you know,
    20 years of doing this work, that was critically important--as
    Medicare Advantage was growing in the program, it was
    critically important that Congress gave them, and the Trump
    Administration at the time as well, gave the plans the
    opportunity to provide benefits that were non-medical in
    nature.
        We would love to see that expanded. We would love to see
    hearing reimbursement, for example, for hearing devices and
    hearing moved into original Medicare, which would create more
    space in supplemental benefits for more non-medical approaches.
        Those are just some samples--examples, Mr. Chairman, of
    things that I have seen over the years I think have been really
    impactful.
        The Chairman. Do you think the SENIOR Acts would help
    groups that you work with fight loneliness?
        Mr. MacPherson. I mean, look, absolutely, so the previous
    reauthorization of the Older Americans Act in 2020 included the
    word--added, I should say, the word social isolation. This is
    before the pandemic, by the way. Added the word social
    isolation to the Older Americans Act and attached about $250
    million for the--for ACL to implement programming.
        That programming was wildly successful, and I would argue
    saved the Federal Government money. By adding loneliness, Mr.
    Chairman, that allows the resources in the Older Americans Act
    and senior centers, nutrition programs, etcetera, to direct
    funding at the public health epidemic crisis, so we are 100
    percent supportive. We are excited to advocate for it and get
    more co--sponsors, and we are eager to see it pass the
    Congress.
        The Chairman. Ranking Member Gillibrand, do you have some
    questions?
        Senator Gillibrand. Mr. Balda, can you talk a little bit
    about the role that insurance companies play in helping our
    seniors? Can you talk a little bit about what do you feel
    health care companies could do to help communities congregate
    care settings, ensure older adults are less isolated, and
    address maybe any of the issues we have been talking about from
    the insurance perspective?
        Mr. Balda. Sure, absolutely, and thank you for the
    question, and unfortunately, over the last several years, we
    have seen the long-term care insurance market decline.
        I think if there is a way for us to determine how to shore
    that market up so that more people can have access to long-term
    care insurance policies, that can help support the isolation
    issue in the long term in terms of giving them access to
    supports and services, whether it is in their private residence
    or whether it is in one of our communities.
        I think programs like the YMCA have in terms of getting
    physical engagement for those that live outside of our settings
    and are supported through Medicare Advantage plans and things
    of that sort are incredibly helpful. Our communities already
    offer a lot of that just directly within their four walls in
    terms of activities in our pools, and activities in our gym
    centers, and yoga for seniors and such.
        Anything insurance companies can do to offer supports and
    services, like the Silver Sneakers program is one example,
    would be incredibly helpful, but I really think figuring out a
    way to shore up the long-term care insurance market would be
    incredibly helpful so that people can access those supports and
    services in any setting.
        Senator Gillibrand. Thank you. Mr. MacPherson, you touched
    upon intergenerational programs to reduce loneliness. Can you
    talk about which ones are most effective, what makes them
    effective, how they are funded, and what suggestions you have
    for this Committee?
        Mr. MacPherson. They are funded from a whole range of
    sources, but as I said, the Older Americans Act is a critical
    source of funding.
        You know, they really run the gamut. I would love to submit
    for the record some case studies, Senator Gillibrand, of some
    of the most effective programming and meet with your staff
    about that and kind of walk you through it.
        I know that DOROT, for example, has the Genuine Connections
    Program, which is actually a virtual volunteer program for
    teens and adults over the age of 65, where they run workshops
    through Zoom and have social connectivity through that. Chess,
    art, etcetera. I am the son of a hospice volunteer.
        I think that the hospice volunteer model could be a very
    effective way--that we have in communities across the country,
    could be a very effective way to address social isolation and
    loneliness, not just for seniors, but also for younger
    populations as well.
        We have got an infrastructure out there. The question is,
    how do we leverage it in a thoughtful way?
        Senator Gillibrand. Yes. Well, one of the ideas that my 16-
    year-old son had was--they have 10 hours of public service
    required every year at their school, so we came up with an idea
    that him and his friends would visit the local senior center
    and just spend hours upon hours getting to know different
    seniors and being part of their lives.
        I also thought about this risk that our seniors fear and
    are subjected to all day long, which is the scams, the digital
    scams, the phone scams, the online scams, you know, clicking
    the wrong button. I think our young people would be so helpful
    in creating digital awareness, digital hygiene for our older
    people because they are so native, and they can explain--
    certainly my sons explain to my mother all the time what not to
    click on and why.
        I think that could be the future of a great partnership,
    but I do hope you will keep exploring that and we would be
    delighted to receive your testimony and the studies because I
    think that intergenerational connection--a lot of our kids
    during COVID became deeply disconnected.
        They missed two, three whole years of maturity and
    development, and I think our seniors could help our younger
    people learn how to be more connected and learn how to, you
    know, don't look at your phone, talk to your friend, you know,
    what are you missing in those social interactions.
        I think the wisdom that our older generation has is
    extremely meaningful, so, I appreciate the work you do there,
    and then last, for Suzanne, I just wanted to ask you one more
    question about falls and social isolation. You know, every
    senior that I have talked to is worried about falling, so they
    buy the best sneakers. They try to take, you know, small steps,
    but they are very afraid to go out when the weathers bad. They
    are afraid--if they have had a fall, they don't want to go out
    at all.
        I know a lot of older people who won't drive at night, a
    lot of older people who won't engage at all at night, because
    they are afraid of falling, and this is a question for anybody
    actually. If you have any ideas about how do we prevent falls,
    how do we prevent fear, and how do we build confidence and
    allow for social interactions so that they don't--not engage
    because of that fear.
        Ms. McCormick. Excuse me, thank you for the question. I
    will start by building on something Mr. MacPherson said. I
    think part of the challenge and the opportunity before us is
    awareness about the opportunities to learn about falls
    prevention.
        In New York State, I am happy to say that we--our YMCAs are
    engaged in a 4-year plan to enroll over 2,500 New Yorkers in
    fall prevention programs, so we have the capability, but we
    have to create greater awareness and reduce the stigma.
        I think the Y wants to be a helpful partner in being that
    place where seniors feel like it is safe to come. In the summer
    months or the fall months to learn falls prevention so that
    they can continue to come. I do know, like the hard winters in
    the Northeast, but we are making progress in New York.
        As I said, it is a four-year plan. We have 40 new
    instructors, and they are going to be taking the falls
    prevention program outside of the Y's where seniors are
    meeting, so into senior centers, churches, and other community
    locations.
        We hope this will prove to be a good model, that we can
    meet seniors where they are. I think that is probably one of
    our great opportunities, not expecting them to come to us, and
    so we look forward to reporting back to you on the work that is
    happening in New York that hopefully can be scaled in--across
    the country.
        I think it is when we get to seniors, when they participate
    in the program, when they can learn falls prevention, we can
    take that fear away, and then they can engage in ongoing social
    connection activities with other community members.
        Senator Gillibrand. Thank you. Thank you, Mr. Chairman.
        The Chairman. Senator Justice.
        Senator Justice. Well, I will end, and I will end really
    quickly on my part, and Mr. Chairman, thank you, sir, and I
    will just say just this. In West Virginia, we value families
    like you can't imagine, and absolutely, the foundational part
    of our families and our culture is our families. There is no
    question whatsoever.
        Now, let me just go back just a second and just say just
    this. You know, there was a few years ago that in West
    Virginia--I always called the voters Toby and Edith, and I
    would say just this, and this reflects on loneliness, but let's
    say Aunt Edith wants to have a picnic, and she wants all of her
    grandkids to be there.
        We were in a situation in West Virginia a few years back
    where to be perfectly honest many, many, many folks left that
    had those kids because they had to go someplace else to find a
    job, and absolutely, if you haven't seen the ramifications of
    loneliness, then you have really missed something because it is
    sadness beyond belief.
        I really think just this, that we are plenty smart enough
    to solve this riddle. We are not doing enough. We have got to
    go back to what I said just a little while ago. We have got to
    get kids involved. We have got to get dogs involved.
        We have got to--I mean, for God's sake the living, you just
    think, and many of you probably don't know this, but if you
    know who Babydog is, honest to goodness, I can't tell you the
    number of places that I have gone to senior centers that
    absolutely--they don't care about me being there. They wanted
    Babydog to be there.
        You know, absolutely, I tell you, we can solve this riddle,
    and all of us--and if we don't, shame on us. All of us should
    be willing to take a blood oath that we are going to fix it. We
    are going to fix this. I mean, there is so much that can be
    done, and absolutely, again, if you have not seen and felt and
    touched loneliness, then absolutely you have been very, very,
    very lucky because it is sadness like you can't imagine, so all
    I would say is just this. My question would be, what can we do?
    What can we do beyond--I mean, I know your answer is going to
    be--you know, it is almost like you go in a restaurant and
    say--you know, the waitress comes over and says, sir, how do
    you like your eggs? Do you like your eggs scrambled or fried?
    And you say, yes, absolutely.
        In this situation, we have got to say yes to all these
    ways, all these ways to make things better. These people have
    given so much, it is off the chart, and so, I want to listen
    real quickly if anybody on the panel wants to take the
    question.
        My question would be just centered around, you know, in
    West Virginia, those values are unbelievable. Tell me anything
    and everything you can possibly tell me in a matter of just a
    few seconds that will make it better. Please, any of you.
        Mr. Balda. Thank you, Senator, for that question and those
    sentiments, and love the idea of pets and just so you know,
    almost all of our communities allow pets. In most cases, either
    the residents have pets or the communities themselves have
    pets, which then become pets for everybody else in the
    building.
        Senator Justice. Babydoll is not a pet.
        Mr. Balda. Well, exactly. Fantastic point.
        Senator Justice. I mean, Babydoll is one of us.
        Mr. Balda. They bring any, any animal, right. It brings
    life to the entire community, and it is things like that, and
    it is things like music therapy, and it is the
    intergenerational, you know, connections that we have been
    talking about, and I think there is not a single solution to
    this crisis.
        I think there is elements of a solution among all of us
    here, all serving sort of different parts of the community, and
    learning from each other on what works and what doesn't, I
    think is a tremendous opportunity, and even before we started,
    we were sort of sharing ways to potentially partner with each
    other on some things.
        Senator Gillibrand, back to your question about falls, you
    know, I think that is a terrible concern for seniors and I see
    it in my loved ones, and I can only tell you, in our
    communities, you know, one of the first things that happens
    when somebody comes in, they go through an assessment.
        Oftentimes we identify that it has been lack of nutrition,
    lack of exercise. Needs some physical therapy. Oftentimes it is
    medication, on too many medications, and having to adjust that
    regimen, but it goes beyond that. It is also the setting in
    which they live, and does it have the right flooring? Does it
    have the appropriate lighting?
        There is a whole host of those, regardless of whether they
    live in our buildings or others, but I think technology is also
    a crucial role in that as well, in terms of being able to
    identify when somebody has fallen if they live on their own.
        I can tell you personally, my mom was an hour away from me,
    and she fell, and she sat there until I could come and pick her
    up because she was too proud to call for help, and so, it is a
    terrible need that we need to fill, and we are part of the
    solution, and I think all of us here are part of the solution.
        I commend you for this hearing and bringing us all together
    to work on it together, so, thank you.
        Ms. McCormick. Senator, I would respond and say, I think
    that you have heard today--you have heard a lot of tactical
    activities, things that we can do to provide, but I think what
    you have said that has touched me is this is about cultural
    recommitment to a belief in our responsibility to seniors.
        At the Y, we have four core values. They are caring,
    honesty, respect, and responsibility, and I think this
    Committee is--has a huge opportunity to continue to elevate the
    responsibility that every American has to every American person
    who happens to be over the age of 55 or 60. I won't say older
    adult or seniors.
        I think it is an opportunity, again, for us to raise
    awareness and recommit to the responsibility that we have for
    those who have lived wonderful lives and still are living
    wonderful lives that we can all learn from.
        Senator Justice. Well, thank you so much for all you do
    every day. Let's just do more.
        The Chairman. All right, I want to thank Ranking Member
    Gillibrand for being here. I want to thank my fellow Senators
    for being here. I thank our witnesses and the audience.
        Yes, I think all of us can picture somebody in our lives
    that, you know, has gone through loneliness, whether it is a
    family member or somebody you have seen along the trail or
    something, and it is tough.
        It is important that we figure out how to recommit to
    figure out how to get this done. There is some things that the
    private sector can do, or families can do, our friends can do,
    and there is some things Government can do. We have got to
    figure out how to do all those things in a manner that has an
    impact.
        Thanks everybody for being here. I look forward to
    continuing to work with members across the aisle and down the
    dais on this very important topic. If any Senators have
    additional questions for the witnesses or statements to be
    added, the hearing record will be open until next Wednesday at
    5.00 p.m..
        I want to thank everybody for being here.
        [Whereupon, at 11:57 a.m., the hearing was adjourned.]

    =======================================================================

                                    APPENDIX

    =======================================================================

                          Prepared Witness Statements

    =======================================================================

                     U.S. Senate Special Committee on Aging

      "Breaking the Cycle of Senior Loneliness: Strengthening Family and
                               Community Support"

                                 March 12, 2025

                          Prepared Witness Statements

                               Andrew MacPherson

        Chairman Scott, Ranking Member Gillibrand, and
    distinguished members of the Aging Committee, thank you for the
    opportunity to testify today on the pressing issue of social
    isolation and loneliness among older adults. My name is Andrew
    MacPherson, and I am the Founder and Chairman of the Foundation
    for Social Connection Action Network (F4SC-AN). Since our
    establishment in 2018, our mission has been to create a diverse
    coalition of national organizations, including consumer groups,
    health plans, health care providers, technology innovators, and
    patient advocates, with the goal of developing and advocating
    for federal policy solutions that address the epidemic of
    social isolation and loneliness. Our efforts encompass a wide
    range of activities, from legislative and programmatic advocacy
    to public awareness campaigns that integrate research and
    evidence.
        The Action Network is honored to have played a role in
    supporting and advising a range of federal policy efforts to
    address the public health crisis of social isolation and
    loneliness, including working directly with members of Congress
    on a bipartisan basis, former U.S. Surgeon General Dr. Vivek
    Murthy, the White House Domestic Policy Council, and leading
    agencies such as the Administration for Community Living as
    well as leading advocates in the field such as the
    Gerontological Society of America and AARP. Over the past seven
    years, we have worked diligently alongside these and other
    influential voices to address loneliness and social isolation,
    striving to make meaningful progress in addressing one of the
    most pressing public health challenges of our time.
        As this Committee knows, this issue is critical. Before
    sharing key statistics and the reasons behind our work, I want
    to acknowledge and thank you for the tremendous efforts and
    progress in the Senate and House to support older Americans.
        We strongly support Chairman Scott and Senator Tina Smith
    in their introduction of the Social Engagement and Network
    Initiatives for Older Relief (SENIOR) Act, which aims to reduce
    loneliness by expanding access to community-based initiatives
    that foster social connection. A key element of this
    legislation is the inclusion of the word "loneliness" in the
    definition of "disease prevention and health promotion
    services" under the Older Americans Act. This inclusion
    underscores the critical role social connection plays in
    helping older adults live healthy, independent lives.
    Additionally, this change would increase funding for vital
    gathering places, like senior centers and libraries, where
    older adults can participate in structured social activities
    that build connections. It also supports transportation
    solutions through subsidized ridesharing and shuttle services
    that help older adults stay active in their communities. It
    expands volunteer and peer-support networks, providing older
    adults with meaningful opportunities for mutual aid,
    mentorship, and community engagement. Importantly, the
    legislation mandates a federal report on the impact of
    loneliness, examining how multigenerational family structures
    influence social connectedness in older adults. We thank the
    Chairman and Senator Smith for their leadership on this
    important legislation.
        In the House, Congressmen Flood and Bera introduced the
    Improving Measurements for Loneliness and Isolation Act. Even
    with increasing recognition of loneliness as a public health
    crisis, the U.S. health care system currently has no
    standardized method for measuring social disconnection,
    loneliness, or social isolation. This bill addresses the gap by
    establishing a federal Working Group composed of experts,
    researchers, and agency representatives to develop uniform
    metrics for assessing loneliness and isolation. These
    standardized tools could be integrated into Medicare wellness
    visits, electronic health records, and public health surveys,
    to ensure early identification of at-risk seniors.
    Additionally, this legislation would provide critical data to
    inform policy decisions, including potential insurance coverage
    for community-based interventions like home-visit programs,
    which have been shown to reduce loneliness and improve overall
    well-being.
        In addition to these two pieces of bipartisan legislation,
    we are pleased to note that a number of other bills that have
    been introduced on this issue in the past several years. We
    commend these members for their bipartisan leadership and their
    commitment to this critical issue.
        Although significant progress has been made, the work is
    far from complete. We must continue to build on these efforts,
    ensuring that we address the full scope of loneliness and
    social isolation with the urgency and dedication it requires.
    This demographic, already dealing with challenges related to
    aging, health, and accessibility, is disproportionately
    impacted by isolation, with consequences extending beyond
    emotional well-being to physical health, cognitive decline, and
    even mortality. The impact of loneliness on older adults is not
    merely a matter of individual suffering but a societal concern
    with costs that merit our collective attention.

    The Crisis of Loneliness Among Older Adults

        Social isolation and loneliness among older adults have
    reached epidemic proportions, with devastating effects on
    public health, health care costs, and overall well-being.
    According to the National Academies of Sciences, Engineering,
    and Medicine (NASEM), nearly one in four adults aged 65 and
    older is considered socially isolated.\1\ The consequences are
    severe: chronic loneliness is linked to a 50% increased risk of
    dementia, a 29% increased risk of heart disease, and a 32%
    increased risk of
    stroke.\2\,\3\,\4\
    Research has also found that prolonged loneliness is as harmful
    to health as smoking 15 cigarettes per day,\5\ making it a
    significant public health crisis that demands urgent action.
    ---------------------------------------------------------------------------
        \1\ National Academies of Sciences, Engineering, and Medicine
    (2020) Social Isolation and Loneliness in Older Adults: Opportunities
    for the Health Care System, The National Academies Press, Washington,
    DC. 10.17226/25663.
        \2\ National Academies of Sciences, Engineering, and Medicine
    (2020) Social Isolation and Loneliness in Older Adults: Opportunities
    for the Health Care System, The National Academies Press, Washington,
    DC. 10.17226/25663.
        \3\ Valtorta NK, Kanaan M, Gilbody S, Ronzi S, Hanratty B.
    Loneliness and social isolation as risk factors for coronary heart
    disease and stroke: systematic review and meta-analysis of longitudinal
    observational studies. Heart. 2016;102(13):1009-1016.
        \4\ Kuiper JS, Zuidersma M, Oude Voshaar RC. Social relationships
    and risk of dementia: a systematic review and meta-analysis of
    longitudinal cohort studies. Ageing Res Rev. 2015;22:39-57. doi:
    10.1016/j.arr.2015.04.006.
        \5\ Our Epidemic of Loneliness and Isolation (2023). Office of the
    U.S. Surgeon General. Department of Health and Human Services. https://
    www.hhs.gov/sites/default/files/surgeon-general-social-connection-
    advisory.pdf.
    ---------------------------------------------------------------------------
        Beyond its impact on health, social isolation among older
    adults carries a substantial economic burden. Estimates show
    that Medicare spends an additional $6.7 billion annually on
    socially isolated older adults due to increased
    hospitalizations, emergency room visits, and nursing home
    admissions.\6\ Loneliness is also associated with higher rates
    of depression and anxiety,\7\ leading to increased prescription
    medication use and mental health service costs. Furthermore,
    socially disconnected older adults are more likely to
    experience functional decline,\8\ increasing reliance on costly
    long-term care services.
    ---------------------------------------------------------------------------
        \6\ Flowers, L., Houser, A., Noel-Miller, C., Shaw, J.,
    Bhattacharya, J., Schoemaker, L. & Farid, M. (2017). Medicare Spends
    More on Socially Isolated Older Adults. AARP. https://www.aarp.org/pri/
    topics/health/coverage-access/medicare-spends-more-on-socially-
    isolated-older-adults/.
        \7\ Our Epidemic of Loneliness and Isolation (2023). Office of the
    U.S. Surgeon General. Department of Health and Human Services. https://
    www.hhs.gov/sites/default/files/surgeon-general-social-connection-
    advisory.pdf.
        \8\ National Academies of Sciences, Engineering, and Medicine
    (2020) Social Isolation and Loneliness in Older Adults: Opportunities
    for the Health Care System, The National Academies Press, Washington,
    DC. 10.17226/25663.
    ---------------------------------------------------------------------------
        The economic impact extends beyond health care
    expenditures. Social isolation reduces workforce participation
    among older adults who might otherwise engage in part-time
    employment, mentorship, or volunteer activities, all of which
    contribute to economic productivity.\9\ It also places a
    financial strain on family caregivers, many of whom must reduce
    their working hours or leave the workforce entirely to provide
    care for an isolated loved one.\10\ Addressing this crisis is
    not just a moral imperative, it is an economic necessity.
    ---------------------------------------------------------------------------
        \9\ National Academies of Sciences, Engineering, and Medicine.
    (2020). Social Isolation and Loneliness in Older Adults: Opportunities
    for the Health Care System. https://www.nap.edu/catalog/25663/social-
    isolation-and-loneliness-in-older-adults-opportunities-for-the-health-
    care-system
        \10\ Committee on Family Caregiving for Older Adults; Board on
    Health Care Services; Health and Medicine Division; National Academies
    of Sciences, Engineering, and Medicine; Schulz R, Eden J, editors.
    Families Caring for an Aging America. Washington (DC): National
    Academies Press (US); 2016 Nov 8. 4, Economic Impact of Family
    Caregiving. https://www.ncbi.nlm.nih.gov/books/NBK396402/.
    ---------------------------------------------------------------------------
        Several structural and societal factors contribute to this
    crisis of social isolation and loneliness among older adults.
    The decline of multi-generational living - a trend driven by
    economic pressures and shifting cultural norms - has reduced
    the built-in support systems that once naturally fostered
    intergenerational connections. According to the Pew Research
    Center, while 57% of older adults worldwide lived in extended
    family houses in 1960, that figure has steadily declined,
    particularly in high-income nations like the United States,
    where only 20% of older adults now reside in such
    arrangements.\11\
    ---------------------------------------------------------------------------
        \11\ Pew Research Center (2010). The Return of the Multi-
    Generational Family Household. https://www.pewresearch.org/social-
    trends/2010/03/18/the-return-of-the-multi-generational-family-
    household/.
    ---------------------------------------------------------------------------
        Simultaneously, shrinking social circles and declining
    participation in community and civic life have further
    exacerbated the problem. Robert Putnam's seminal work Bowling
    Alone (2000) details how social capital has diminished over
    recent decades, with fewer individuals engaging in clubs,
    religious institutions, and volunteerism-key avenues through
    which older adults have historically built and maintained
    relationships.\12\
    ---------------------------------------------------------------------------
        \12\ Putnam, R. (2000). Bowling Alone: The Collapse and Revival of
    American Community. Simon & Schuster.
    ---------------------------------------------------------------------------
        Barriers to mobility-both physical and financial-compound
    these issues. Many older adults face challenges such as
    inaccessible public transportation, unaffordable housing, and
    declining physical health, which can prevent them from engaging
    in the social activities they once enjoyed. Mobility
    limitations have been reported to affect about 35% of adults
    aged 70 and older, and the majority of adults over 85 years,
    making it difficult to visit friends, attend social gatherings,
    or participate in community life.\13\
    ---------------------------------------------------------------------------
        \13\ Freiberger E, Sieber CC, Kob R. Mobility in Older Community-
    Dwelling Persons: A Narrative Review. Front Physiol. 2020 Sep
    15;11:881. doi: 10.3389/fphys.2020.00881. PMID: 33041836; PMCID:
    PMC7522521.
    ---------------------------------------------------------------------------
        At the same time, the increasing reliance on digital
    communication as a primary means of connection has created new
    barriers. While technology has expanded opportunities for
    social engagement, many older adults struggle with digital
    literacy and lack access to high-speed internet, particularly
    in rural and underserved communities.
        Finally, ageism in society discourages many older adults
    from seeking social engagement, exacerbating their isolation.
    Negative stereotypes about aging can lead to self-imposed
    withdrawal, as older adults may feel undervalued or unwelcome
    in spaces dominated by younger generations. Research from the
    World Health Organization (WHO) suggests that ageism is linked
    to poorer physical and mental health outcomes, increased social
    isolation, and even reduced life expectancy.\14\
    ---------------------------------------------------------------------------
        \14\ World Health Organization (2021). Ageism is a global
    challenge: UN. https://www.who.int/news/item/18-03-2021-ageism-is-a-
    global-challenge-un

    ---------------------------------------------------------------------------
    Evidence-Based Policy Solutions to Address Loneliness

        In light of these statistics, I would like to highlight
    five key areas where public policy can play a transformative
    role in addressing and mitigating this crisis. These areas
    present tangible opportunities for a response rooted in
    collaboration and innovation to ensure our most vulnerable
    populations receive support and connection. I want to express
    my gratitude once again for the committee's focus on this
    critical matter, and I look forward to exploring these
    solutions together.

    Strengthen Federal Programs to Address Loneliness Among Older
    Adults

        The Older Americans Act (OAA) serves as a vital cornerstone
    for aging services, but current demand far exceeds available
    resources. While an increase in funding is needed, it can
    result in cost savings in other areas. By enhancing funding for
    OAA nutrition programs, we can ensure that congregate meal
    sites not only provide nourishment to maintain physical health
    but also serve as vital social hubs that promote engagement and
    connection among older adults. In alignment with the
    committee's jurisdiction, addressing issues of health
    maintenance, securing adequate income, and engaging in
    productive activities, further investments in senior centers,
    libraries, and multi-use community spaces will offer structured
    opportunities for socialization, supporting overall well-being.
        Additionally, targeted funding for rural aging
    interventions is essential to address isolation in areas with
    limited transportation and resources. The Administration for
    Community Living (ACL) has taken an important leadership role
    in developing evidence-based models to integrate social
    engagement into health policy. Expanding funding for ACL's
    Commit to Connect initiative would enable a more comprehensive
    evaluation of interventions that address loneliness, including
    technological solutions, intergenerational programming, and
    cognitive health initiatives. We also recommend that
    policymakers prioritize funding for peer support programs,
    volunteer-based companionship models, and faith-based
    mentorship initiatives, which are instrumental in strengthening
    community-driven approaches to social connection. This broader
    approach will not only enhance quality of life but also ensure
    that older adults receive the full spectrum of support they
    need to thrive in all areas of life.

        Expand Intergenerational Programs

        Intergenerational initiatives-such as shared housing
    programs, mentorship opportunities, and community volunteer
    projects-have proven to significantly reduce loneliness among
    both older and younger generations. A recent study by
    Generations United found that 92% of Americans believe that
    participation in intergenerational programs improves feelings
    of loneliness across age groups.\15\ Fortunately, many
    evidence-based strategies can be implemented to strengthen
    these bonds, including designing built environments that
    encourage social interaction,\16\ establishing and scaling
    community connection programs that unite diverse age groups,
    and strategically investing in local institutions that serve as
    intergenerational community hubs.
    ---------------------------------------------------------------------------
        \15\ Generations United and The Eisner Foundation (2018). All in
    together: Creating places where young and old thrive. https://
    www.gu.org/app/uploads/2018/06/SignatureReport-Eisner-All-In-
    Together.pdf.
        \16\ Jennings, Viniece & Browning, Matthew & Rigolon, Alessandro.
    (2019). Planning Urban Green Spaces in Their Communities:
    Intersectional Approaches for Health Equity and Sustainability.
    10.1007/978-3-030-10469-6--5.
    ---------------------------------------------------------------------------
        Increasing funding for these programs is essential to
    deepen community cohesion and enhance mental well-being,
    aligning with the Committee's focus on promoting health, income
    security, and access to productive activity for older adults.
    Furthermore, the development of intergenerational and age-
    friendly communities creates opportunities for social
    engagement, reduces feelings of loneliness, and fosters empathy
    across generations. Such initiatives not only strengthen
    individual well-being but also contribute to a more inclusive
    and supportive society.

    Promote Digital Inclusion and Technology Access

        While technology holds significant potential to mitigate
    social isolation, its adoption among older adults remains
    limited. Pew Research Center data indicates that 55% of
    Americans aged 65 and older do not use social media,\17\ and
    nearly 22 million older adults lack broadband access.\18\ To
    address these challenges, prioritizing digital literacy
    training and ensuring affordable broadband access, particularly
    in rural and underserved communities, is crucial. Despite the
    overall increase in technology adoption, digital disparities
    persist, especially among individuals with disabilities, lower-
    income adults, and rural residents. A Gallup study highlights
    that older adults who use technology for support are more
    likely to seek in-person assistance, underscoring the
    complementary relationship between digital and physical
    connection.
    ---------------------------------------------------------------------------
        \17\ Faverio, M. (2022). Share of those 65 and older who are tech
    users has grown in the past decade. Pew Research Center. https://
    www.pewresearch.org/short-reads/2022/01/13/share-of-those-65-and-older-
    who-are-tech-users-has-grown-in-the-past-decade/.
        \18\ Older Adults Technology Services (OATS) (2021). Report: 22
    Million U.S. Seniors Lack Broadband Internet Access; First Time Study
    Quantifies Digital Isolation of Older Americans as Pandemic Continues
    to Ravage Nation [Press Release]. AARP. https://oats.org/aging-
    connected-press-release/.
    ---------------------------------------------------------------------------
        To bridge this gap, leveraging telehealth, assistive
    devices, online support groups, and expanded broadband access
    can significantly enhance social connectivity among older
    Americans. These interventions not only increase access to
    social support beyond in-person interactions but also improve
    patient-doctor relationships and foster community cohesion.
        In addition, updating the 2010 National Broadband Plan to
    focus on low-income, rural, underrepresented, and socially
    isolated populations will ensure a more inclusive digital
    landscape. Federal digital literacy programs should also be
    expanded to include cybersecurity education, specifically
    targeting older adults to ensure they can navigate online
    spaces safely. By addressing digital literacy, expanding
    broadband access, and continuing to innovate in the development
    and implementation of technology, we can effectively combat
    social isolation and foster meaningful connections across
    generations.

    Enhance Medicare's Role in Addressing Loneliness

        Medicare plays a crucial role in supporting the health and
    well-being of older adults, and it is poised to do more to
    address the growing crisis of loneliness and social isolation.
    One effective strategy would be to require Medicare Annual
    Wellness Visits to include routine screenings for social
    isolation and loneliness, enabling providers to identify at-
    risk individuals and connect them with appropriate
    interventions. It is also important to ensure that Medicare
    Advantage plans maintain access to sufficient rebate dollars to
    offer and tailor supplemental benefits that directly address
    these issues, such as social engagement programs and
    transportation assistance. Expanding Medicare's coverage to
    include interventions for loneliness, such as counseling and
    peer support services, would provide this at-risk population
    with a critical avenue for emotional and social care.
    Furthermore, expanding coverage for hearing aids-through
    improved private insurance and Medicare benefits-would remove a
    significant barrier to communication and socialization for
    older adults, helping to reduce the isolation often caused by
    hearing loss. These steps would strengthen Medicare as a more
    comprehensive solution for addressing loneliness, ensuring that
    older adults receive not just physical care but also the social
    and emotional support they need to thrive.

    Improve Transportation Access

        Reliable transportation acts as a crucial bridge to social
    connection, directly combating feelings of loneliness. Access
    to transportation enables individuals, especially those with
    mobility limitations or living in rural or isolated areas, to
    engage in social life by connecting them to parks, green
    spaces, community activities, cultural institutions, social
    events, and visits with loved ones. For individuals with lower
    socioeconomic status, access to affordable transportation can
    alleviate the psychological burden of prioritizing basic needs
    over social activities. Overall, access to transportation is
    vital for reducing social isolation and loneliness in these
    vulnerable populations who may otherwise find themselves cut
    off from essential support networks.
        Studies consistently demonstrate that increased use of
    public transportation, especially among seniors, correlates
    with a reduction in feelings of loneliness and
    depression.\19\,\20\ Increasing access to
    affordable, reliable public transportation can improve
    opportunities for social connection and recreation, build
    social capital, and increase social ties. Therefore, we urge
    transportation planners and decision-makers to adopt a "people
    first" mentality by prioritizing movability through walking and
    bicycling networks, accessible and affordable transit services,
    lower traffic speeds, and better air quality control.
    ---------------------------------------------------------------------------
        \19\ Henning-Smith, C., Evenson, A., Kozhimannil, K. B., &
    Moscovice, I. (2018). Geographic variation in transportation concerns
    and adaptations to travel-limiting health conditions in the United
    States. Journal of Transport & Health (Print), 8, 137-145. doi.org/
    10.1016/j.jth.2017.11.146.
        \20\ Mattson, J. W., & Peterson, D. (2021). Measuring benefits of
    rural and small urban transit in Greater Minnesota. Transportation
    Research Record, 036119812199001. https://doi.org/10.1177/
    0361198121990014
    ---------------------------------------------------------------------------
        Additionally, policymakers should develop a Senior Mobility
    Program under the Federal Transit Administration (FTA) to
    incentivize cities to improve public transportation options,
    such as subsidized ride-sharing services and accessible bus
    routes for older adults. Addressing transportation insecurity
    by improving access to non-emergency medical transportation and
    non-medical transportation programs also provides social
    interaction opportunities, connects individuals to healthcare
    services, and improves quality of life. Ultimately,
    transportation transcends its function as a means of travel and
    is a fundamental tool for fostering social inclusion and
    bolstering overall well-being.

    A Bold Agenda for the Future: F4SC-AN's Policy Priorities

        Today, I am honored to announce the launch of the
    Foundation for Social Connection Action Network's Policy
    Priorities for Social Connection, which includes these and
    other focus areas. It is a groundbreaking framework comprised
    of over 130 strategic policy solutions designed to foster
    genuine social connection. Based on a thorough review of
    existing research, including leading scientist Dr. Julianne
    Holt-Lunstad's SOCIAL Framework (Systems Approach of Cross-
    Sector Integration and Action Across the Lifespan),\21\ our
    framework prioritizes seven key areas for action: Health;
    Education; Work, Employment & Labor; Built Environment; Arts,
    Culture, and Leisure; Food & Nutrition; and Research and
    Measurement, most of which I've discussed with you today.
    ---------------------------------------------------------------------------
        \21\ Holt-Lunstad J. Social Connection as a Public Health Issue:
    The Evidence and a Systemic Framework for Prioritizing the "Social" in
    Social Determinants of Health. Annu Rev Public Health. 2022 Apr
    5;43:193-213. doi: 10.1146/annurev-publhealth-052020-110732. Epub 2022
    Jan 12. PMID: 35021021.
    ---------------------------------------------------------------------------
        This ambitious agenda calls for a united effort across all
    levels of government while also recognizing the crucial role
    communities play in strengthening social bonds. At its core,
    our policy agenda aims to create sustainable, inclusive
    solutions that promote meaningful connections for individuals
    at every stage of life. Grounded in rigorous scientific
    evidence highlighting the devastating effects of social
    isolation and loneliness, this agenda aligns promising policies
    with the transformative potential to enhance public health,
    drive economic prosperity, uplift community well-being, and
    elevate the overall quality of life for all Americans.
    Together, we can build a future where connection, not
    isolation, defines the American experience.

    Conclusion: A Call to Action

        Chairman Scott, Ranking Member Gillibrand, and esteemed
    members of the Committee, as this hearing instructs us,
    addressing the epidemic of loneliness among older adults is not
    only a moral imperative but also a critical public health
    necessity. The time for decisive action is now. We urge
    Congress to increase funding for proven programs, advocate for
    innovative legislative solutions, and prioritize social
    connection as a national objective.
        Tackling this issue offers us an opportunity to unite in a
    time of increasing polarization. By fostering social
    connection, we can bridge divides, rebuild trust, and
    strengthen the fabric of our communities. This issue transcends
    political affiliation and speaks to our shared humanity.
    Together, we can build a future where connection, not
    isolation, defines the American experience. Thank you for the
    opportunity to testify today.

                     U.S. Senate Special Committee on Aging

      "Breaking the Cycle of Senior Loneliness: Strengthening Family and
                               Community Support"

                                 March 12, 2025

                          Prepared Witness Statements

                                  James Balda

        Chairman Scott, Ranking Member Gillibrand, and members of
    the committee, thank you for this opportunity. I am James
    Balda, President and CEO of Argentum, the leading national
    association serving senior living communities, including
    independent living, assisted living and memory care communities
    across the nation. More than 2 million seniors call our
    communities home. Argentum commends you, Senator Smith (D-MN)
    and Senator Warnock (D-GA) on the introduction of the SENIOR
    Act and for holding this important hearing.
        Socialization is a crucial aspect of healthy aging.
    Socialization promotes a sense of purpose and connection with
    others. It significantly improves the mental health, cognitive
    function, and physical health of seniors.
        We see this firsthand every day in our communities. Our
    assisted living model of care was created to allow seniors to
    thrive - to provide seniors with a sense of dignity,
    independence and community - to keep seniors living as
    independently as possible, to prolong the quality of life, and
    delay for as long as possible the need for costlier care. The
    structure of our communities' social activities specifically
    fosters a sense of community and belonging while simultaneously
    providing 24-hour care -- assisting our residents with a
    multitude of ADLs, or activities of daily living, such as
    bathing, dressing, toileting, eating and mobility. Our care
    also includes medication management, providing nutritious meals
    and crucial socialization.
        I believe we do our job well. According to multiple
    national surveys, our residents are thriving. Ninety-four
    percent of senior residents said they were happy with their
    choice of community and had made friends; 99% said they felt
    safe; 75% responded that their quality of life improved; and
    according to a poll of more than 130,000 assisted living
    residents, loneliness levels were reduced dramatically when
    residents, who formerly lived alone, moved into our
    communities.
        Lillian, an 85-year-old assisted living resident in
    California, lived alone and suffered mobility issues and
    depression. Shortly after she moved into an assisted living
    community, Lillian filled her day with art classes, exercise
    classes, and prayer groups and stated she now has a "wonderful
    group of friends, many who are lifelong."
        An assisted living community provides a wide range of
    social and interactive activities tailored to different
    abilities and interests. Seniors can enjoy gardening, dancing,
    educational seminars, exercise classes, concerts, book clubs,
    religious services, arts and crafts, and game nights, to name
    just a few. Regardless of the activity, each is designed to
    create a sense of purpose and community, and to combat
    isolation, depression and loneliness. Equally importantly,
    because assisted living communities are the homes of seniors,
    pets are welcome at most communities, and pet therapy is often
    available for those who are not capable of caring for a pet.

    The Health Impact of Social Isolation

        Loneliness and social isolation in older adults are serious
    public health risks, affecting millions of seniors. According
    to a study in JAMA Internal Medicine, up to 50% of those 60 and
    older are at risk of social isolation, and nearly one-fourth of
    adults aged 65 and older are socially isolated. Factors such as
    living alone, the loss of family or friends, chronic illness,
    and hearing loss are all contributing factors to social
    isolation and loneliness.
        The consequences of social isolation cannot be overstated.
    The former U.S. Surgeon General, Dr. Vivek Murthy, called
    loneliness "America's invisible epidemic," noting that "The
    physical health consequences of poor or insufficient connection
    include a 29% increased risk of heart disease, a 32% increased
    risk of stroke, a 50% increased risk of developing dementia for
    older adults, and a 60% increased risk of premature death." An
    AARP report estimates that the adverse health effects of
    loneliness equal that of smoking 15 cigarettes per day.
        The Alzheimer's Association reports that social isolation
    increases dementia risk by more than 50%. What's more, it found
    that a strong connection exists between high social contact
    later in life and memory and thinking skills.

    The Cost of Social Isolation

        The costs of loneliness are significant. According to a
    Harvard-Stanford-AARP study measuring the impact of social
    isolation on the healthcare system, Medicare spent an estimated
    $1,608 annually for each socially-isolated older adult than it
    did for those who had more social contacts, concluding that "a
    lack of social contacts among older adults is associated with
    an estimated $6.7 billion in additional federal spending each
    year." Additionally, a recent study in JAMA Internal Medicine
    determined that social isolation among seniors can increase the
    chances of admission to nursing homes and recommended that
    programs to increase their socialization could reduce
    healthcare spending.
        As this committee well knows, the prevalence and cost of
    dementias is escalating, with some projections stating the
    number of people living with dementia is projected to roughly
    double every twenty years. The health care costs of Alzheimer's
    and other dementias to Medicare and Medicaid are approximately
    $231 billion annually, and is projected increase of over 200%
    by 2050.

    The Benefits of Communal Living

        Assisted living communities strengthen social connections
    for our residents and therefore play an important role in
    reducing social isolation and supporting the overall health and
    well-being of seniors. A national study by the University of
    Michigan found that adults aged 50 to 80 who live alone report
    higher rates of social isolation than those who live with
    others. The social and communal atmosphere of assisted living
    changes that dynamic. As stated above, a national survey of
    more than 130,000 assisted living residents by Activated
    Insights, found that just 14.3% of senior living residents
    reported being lonely, compared to 29.9% of seniors who live
    alone. Many of our communities have reported even lower
    loneliness scores.
        The communal yet home-like nature of assisted living
    fosters independence and socialization to help seniors thrive
    while preventing mental and physical decline. "A community is a
    group of people who care about one another, and that's what we
    are here," said Eilean of her community in upstate New York.
    Resident satisfaction in assisted living remains extremely high
    because communities are able to not only offer high quality of
    personal care but also improve the quality of life of
    residents. National surveys have found that 90% of assisted
    living residents report high satisfaction with their care and
    communities.
        When 95-year-old James' wife died and it wasn't safe for
    him to remain at home alone, he reluctantly moved into an
    assisted living community. His granddaughter said that the move
    "literally saved his life" and that her grandfather "blossomed
    due to his many new friendships." His caregivers managed his
    chronic conditions, medications and psychosocial needs. She
    stated, "I am a firm believer that without assisted living we
    would have lost my grandpa quickly after the death of my
    grandmother. To see a light in his eyes again and to hear that
    he feels he has purpose has been the greatest gift."
        A 2024 U.S. News & World Report survey of older Americans
    and their families found that nearly all the respondents (99%)
    said they felt safe at their senior living community, further,
    nearly all respondents (98%) said they trusted the staff at
    their senior living community to care for their well-being.
    Social connections made in assisted living communities are
    important -- 93% of residents reported that they are pleased
    with the social opportunities within their communities, and 75%
    say assisted living has demonstrably improved their quality of
    life. According to the 2024 J.D. Power Senior Living
    Satisfaction Survey, assisted living communities received a
    satisfaction score of 855 (on a 1,000-point scale), up 18
    points from the prior year, and higher than industries like
    travel and hospitality.
        "A laugh a day keeps the doctor away, and that's what we do
    here," said Bob, an 84-year-old resident, in a Florida
    community. Perhaps Bob is on to something. In a review of
    Medicare claims of residents from more than 14,000 senior
    living communities, and using the Harvard Claims-Based Frailty
    Index to assess vulnerability, researchers found that residents
    experienced a 10% decline in frailty levels one year after
    moving in. Through care coordination and managing chronic
    conditions, assisted living communities improve the health and
    wellbeing of their residents while decreasing the financial
    strain on the healthcare system. A 2018 Washington University
    study found that living in a senior community can lead to lower
    levels of hospitalization for vulnerable seniors-including
    those with chronic health conditions. Utilizing data from a
    decade-long study, the report concludes that the services
    offered by many senior living communities encourage residents
    to seek treatment sooner for pressing issues, leading to fewer
    trips to the hospital. The "findings suggest that the positive
    effects from the various support services available in the
    senior housing environment accrue over time in helping
    vulnerable elders better manage their health conditions."

    Two Testimonials:

        "About three years ago my neighbor started to decline in
    his physical abilities. He was a veteran and would go to the VA
    regularly for help with different issues he was experiencing.
    He loved walking and tried as hard as he could to keep moving
    so he would not lose his ability to walk. Despite his efforts
    he continued to decline. In the winter, my friend could not
    walk safely outside. He had a hard time with some stairs in his
    house and the sloped driveway and in the winter, he lost much
    leg strength. He cooked for himself and did not always want to
    take the time to eat properly. He became very skinny and frail.
    He was a very social person, but he continued to become more
    isolated. Family and neighbors tried to keep him company as
    best as they could, but no one could provide him with the
    social aspects of his life as he needed.
        I used to pick him up every Sunday for church services, but
    it became harder and harder for him to get himself ready.
    Sometimes it would take him three hours to get ready. It became
    hard for him to shower and to dress. Eventually he finally gave
    up on trying to come to church with us, which was a big part of
    his life -- not just spiritually but also socially. As time
    went on, the decision was made to move him into an assisted
    living community. Immediately he loved it! It met his needs in
    so many ways. He could walk the building without fear of what
    he used to worry about. He could use the fitness room every
    day, which he loved to do. He ate three meals daily in the
    dining room and started to put back the weight he had lost.
    Socially he integrated very quickly, and he told me recently
    that he considers the people living there to be a part of his
    family. He truly loves it, and it made such a difference in his
    quality of life.
        I had spoken to his daughter about her dad many times on
    the phone. She lived in a different city and didn't get to see
    him too often. One day after he moved into the community, his
    daughter gave me a big hug and thanked me for all the talks and
    discussions that helped to lead her dad to moving into an
    assisted living community. She said the people that work there
    are her heroes. She then said that her dad was happier than he
    had ever been in his entire life. She said her entire family
    was grateful for the community that gave her dad renewed hope
    and happiness and a better life than he had in a very long
    time."

    -Holladay, Utah, January 2024

        Meet Zelma Bennett, one of our newest residents at
    Commonwealth Senior Living at Stratford House. Zelma moved into
    our community on January 29th, after spending the past year
    living with a friend. Zelma, who had previously run a group
    home for adults, enjoyed maintaining a vibrant social life with
    assistance, but her memory loss prompted her to seek a
    community where she could continue engaging socially while
    receiving the support she needed. From the moment she arrived,
    Zelma embraced every opportunity for socialization,
    participating in nearly every activity offered. She uses her
    calendar so frequently to keep track of events that she wears
    it out and needs to replace it before the month's end! Her
    enthusiasm has been contagious, and she has made many new
    friends in a short time. Zelma's story is just one example of
    how socialization in our communities has dramatically improved
    the quality of life for seniors. The friendships and activities
    she's engaged in have helped alleviate her feelings of
    loneliness and have given her a renewed sense of purpose and
    joy. We are so grateful she chose to join our community.

    -Resident Program Director, Danville, Virginia, March 2025

        As we look back five years from the start of the pandemic,
    it is important to note how our residents faired during those
    times of intense isolation. A 2022 joint report from the ATI
    Advisory and the American Senior Housing Association found that
    senior living communities improved quality of life during the
    pandemic through cohesive social environments and encouragement
    of residents to participate in social activities. Residents,
    the study found, were more likely to have greater social,
    physical and intellectual wellness than their counterparts
    living in the greater community.

    The Benefits of Pet Therapy

        The powerful bond between humans and animals has been
    proven to benefit physical, mental, and emotional well-being.
    For this reason, most assisted living communities allow pets.
    Pets can provide unconditional love and support, encourage
    socialization, reduce stress levels, and foster a sense of
    belonging - all of which can curb loneliness and bring about
    physical and mental healing.
        Pets have an incredible capacity to bring joy and
    companionship into our lives. Joanie and her rescued black cat,
    "Baby Boy," often serve as the "greeters" to visitors of their
    assisted living community. And Jean, a resident of a community
    in Florida, has Gretta Garbo, a 9-year-old Miniature Poodle, as
    her steadfast companion. Gretta Garbo is every bit the starlet
    of the community as her namesake suggests -- the poodle dresses
    for all types of occasions and provides the normally
    introverted Jean with the motivation to socialize and
    participate in communal activities.
        For those who are unable to have their own pet, many
    communities utilize pet therapy which can play a crucial role
    in curbing negative behaviors associated with dementia and
    other cognitive impairments. By providing companionship and
    emotional support, pet therapy can help seniors feel more
    connected and less isolated, leading to a reduction in negative
    behaviors. Furthermore, the soothing presence of therapy
    animals can help calm seniors with cognitive impairments,
    promoting a more stable emotional state and overall well-being.
        Buttercup and Sugarplum, two Golden Retrievers, are regular
    visitors to a memory care community in Maryland. When they
    arrive during circle time, there isn't a resident who doesn't
    want to see an affectionate tail wag and maybe receive a
    friendly lick on their hands. A room, once quiet, can transform
    into laughter and perhaps even unlock precious memories of
    long-forgotten childhood pets or spark the recollection of the
    name of their children's first puppy.

    Directed Socialization Critical in Caring for Seniors with
    Dementia

        Research links dementia-associated apathy to accelerated
    decline in all physical and mental areas. When cognitive
    changes start, withdrawal and isolation are common. Memory care
    communities often have programs to encourage residents to
    consistently socialize and participate in therapeutic
    activities to reduce apathy and build cognitive reserve.
        A national senior living provider headquartered in Texas
    recently evaluated its memory care socialization program known
    as the Circle of Friends program and compared two cognitively
    similar groups of their assisted living residents. One group
    was enrolled in Circle of Friends. The second group was not,
    but chose from a similar menu of activities to attend on their
    own. The participation standard for both groups was four hours
    a day. What was learned was that approximately 75% of the
    residents in the Circle of Friends group spent a minimum of
    four hours per day engaged in purposeful activities, with less
    than one-fourth exhibiting apathy. However, less than a third
    of the group of self-directed participants met the study's
    minimum participation standard and nearly two-thirds exhibited
    apathy. For residents who are beginning to experience cognitive
    decline, the benefits of a guided program can be significant in
    helping to maintain engagement and function.

    Whisper Words of Wisdom - Music Therapy and Cognitive Decline

        Directed socialization with music therapy is also effective
    when dementia residents become socially withdrawn and can
    encourage engagement and improve verbal abilities. Mary, a 73-
    year-old memory care resident suffering from vascular dementia,
    can become non-verbal and withdrawn as her disease progresses.
    To help abate this, a record player in her apartment becomes an
    important tool. For Mary, a lifelong Beatles fan (she has a
    framed $5 ticket stub from a 1965 Beatles concert she attended
    in Portland, Oregon in 1965), directed music therapy is
    effective. Let it Be is often the song of choice. Mary remains
    silent at the beginning of the song but soon is swaying to the
    music and when the phrase "whisper words of wisdom" is sung,
    Mary is inevitably singing along. It's common for fellow
    residents to join in for an impromptu sing-a long.

    The Aging Crisis and Long-Term Care Solutions

        By 2030, all baby boomers will be at least age 65, and in
    that same year for the first time in our nation's history,
    there will be more individuals over the age of 65 than under
    the age of 18. The most rapidly growing segment of the
    population are those 85 and older. As this Committee continues
    to provide guidance to Congress on how to prepare for the
    nation's aging crisis, is it important to note that assisted
    living is the most cost-effective form of long-term care.
        To stretch limited federal long-term care dollars, "right-
    sizing" long-term care needs is critical. A 2021 report by the
    U.S. Department of Veterans Affairs found that if veterans did
    not need the high level of care of skilled nursing, the federal
    government could save an average of $69,000 per year per
    veteran by providing care in assisted living communities.
    Ensuring that veterans and seniors are in their appropriate
    level of care can provide significant financial savings, both
    to the individual and to taxpayer-funded public programs.
        Additionally, the need for investment in our nation's long-
    term care is long overdue, with a rapidly aging population and
    need for long-term care projected to explode in the coming
    years. Every day, more than 10,000 Americans turn 65, and the
    85 and older population (average age of an assisted living
    resident) is projected to more than double from 6.6 million in
    2019 to 14.4 million in 2040 (a 118% increase). By 2030, all
    baby boomers will have reached 65 years old and for the first
    time in history, older adults will outnumber children in the
    United States. Federal data shows that someone turning age 65
    today has a 70% chance of needing some type of long-term care
    in their lifetime, 50% will need more extensive care in a
    skilled nursing facility or assisted living community, and 20%
    will need it for five years or more.
        Despite this projected explosion in demand, there is not
    nearly enough supply of senior housing to meet these care
    needs. The National Investment Center for Seniors Housing and
    Care (NIC) estimates that approximately 881,000 additional
    units of assisted living inventory will be needed to serve
    seniors by 2030. Estimates suggest that the development cost
    associated with needed production of assisted living will
    exceed $1 trillion by 2050. Insufficient investment will
    dramatically limit housing access and options for seniors.

    The Importance of the SENIOR Act and the Care Across
    Generations Act

        Mr. Chairman, we believe our communities offer many
    opportunities for seniors to combat loneliness, but we know
    more can be done and believe seniors should be able to choose
    where and how they live. That is why Argentum commends you on
    taking the important step of introducing the SENIOR Act. The
    important bill will take critical steps to address the epidemic
    of senior loneliness by promoting key programs specifically
    designed to reduce loneliness for all seniors in the broader
    community. Additionally, the requirement to direct the
    Secretary of HHS to report to Congress on the importance of
    multigeneration relationships to mental health and loneliness
    is significant.
        According to studies by the National Institute of Health,
    both older and younger people experience a significant
    reduction in loneliness through interactions with individuals
    from different generations. Therefore, Argentum is also pleased
    to support H.R. 1812, the Care Across Generations Act, a
    bipartisan bill which will create opportunities for
    intergenerational connection through the establishment of a
    grant program for assisted living and all long-term care
    settings to co-locate a childcare facility near or within a
    long-term care community. We believe the benefits to both the
    seniors and the children will be enormous.
        Mr. Chairman, thank you again for holding this important
    hearing. Argentum looks forward to working with you and the
    Committee on this and other critical issues impacting our
    nation's seniors.

                     U.S. Senate Special Committee on Aging

      "Breaking the Cycle of Senior Loneliness: Strengthening Family and
                               Community Support"

                                 March 12, 2025

                          Prepared Witness Statements

                               Suzanne McCormick

        Chairman Scott and Ranking Member Gillibrand: I want to
    thank you for inviting me today.
        I am here representing the nation's 2,600 YMCAs, which
    serve 10,000 communities across our country. I am grateful for
    the opportunity to share the story of how they connect and
    support our older adults every day.
        At the Y, we are committed to strengthening communities by
    connecting people of all ages, abilities and backgrounds to
    their potential, their purpose and each other.
        This has been at the core of who we are for 175 years in
    the U.S. But today, we know that people are struggling to make
    these connections.
        Forty percent of adults say they feel lonely sometimes or
    even more often than that.
        The mortality rate of being socially disconnected is
    similar to the impact of smoking 15 cigarettes a day, and
    greater than the impact associated with obesity and inactivity.
        The health risks for our older adults are heightened,
    because they are more likely to feel isolated and disconnected
    than younger Americans.
        But at the Y, older adults find the support and meaningful
    relationships they need to feel connected and be healthy.
        YMCAs engage 17 million Americans annually, and nearly 4
    million are over age 55. Almost 2.5 million are over 65.
    Seniors make up nearly one-quarter of our members.
        A few years ago, the Y partnered with NORC at the
    University of Chicago to find out whether older adults report
    better quality of life and social connectedness when they visit
    our facilities or participate in our programs.
        Results of this study showed significant increases in
    overall well-being and social connectedness, a decrease in
    loneliness, and observed improvements in social well-being,
    spiritual well-being, physical health and mental health.
        The results were even better for older adults who were able
    to engage more frequently with their YMCA.
        Our programs not only help participants build friendships
    and connections that we all need to thrive, but they also can
    help prevent, delay or control chronic disease.
        Thanks to a 20-year partnership with CDC, the Y is the
    leading in-person provider of evidence-based chronic disease
    prevention and management programs, which address issues like
    diabetes, hypertension, arthritis, falls and cancer.
        These programs have been proven to improve health outcomes
    and quality of life, and they often save health care dollars.
        In fact, the Y is recognized for its work with the Centers
    for Medicare and Medicaid Innovation. During a national study
    of 8,000 Medicare recipients, the YMCA's Diabetes Prevention
    Program saved $2,650 per participant while preventing or
    delaying diabetes among the majority of recipients.
        The Y is also the leading provider of the Medicare
    Advantage fitness benefit -- larger than the next seven
    providers combined.
        But for as much as we are able to accomplish on our own due
    to our national scale and community-level credibility, the Y is
    always looking to maximize our impact through partnerships.
        So, in communities across the country, YMCAs collaborate
    with partners like senior centers, libraries and places of
    worship to reach and engage more older adults.
        The Y looks forward to also partnering with the Select
    Committee on Aging to improve both the physical and emotional
    health of our nation's older adults.
        We urge Congress to continue supporting the highest level
    of funding for the CDC to help the Y innovate our evidence-
    based chronic disease prevention and control programs, uphold
    Medicare Advantage's ability to offer supplemental benefits
    like fitness and socialization opportunities, and enable
    Medicaid to help low-income seniors improve their physical and
    mental health.
        Every dollar invested in community-based organizations like
    YMCAs - organizations with trusted relationships and on-the-
    ground credibility - pays a dividend in the form of improved
    health and wellness, especially for our older adults.
        Again, thank you for this opportunity today, and thank you
    for your leadership.

                     U.S. Senate Special Committee on Aging

      "Breaking the Cycle of Senior Loneliness: Strengthening Family and
                               Community Support"

                                 March 12, 2025

                          Prepared Witness Statements

                              Tori Strawter-Tanks

        Thank you for the opportunity to speak before you today. My
    name is Tori Strawter-Tanks, and I have the privilege of
    serving as the Director of Senior Services in Clayton County,
    Georgia, and the President and Founder of the Georgia
    Association of Senior Centers (GASC). I am honored to be here
    today to discuss a critical issue facing older adults across
    the country-social isolation and the vital role senior centers
    and other aging programs play in combatting it.
        Senior centers are hubs of high-impact exercise, cultural
    engagement, physical wellness, and lifelong learning. The Older
    Americans Act contributes to funding senior centers and other
    important aging services, and protecting that funding is
    critical to ensuring older adults continue to have access to
    the services I have spent my life carrying out.
        Across Georgia, and throughout the nation, senior centers
    provide vital programs that enhance the lives of older adults,
    keep them socially engaged, and support their overall well-
    being. These include:
          Health, wellness, aquatic, technology, and fitness
    classes, theatrical productions, cultural arts programs, trips,
    and evidence-based programs. This programming plays a vital
    role in improving seniors' physical health, reducing fall
    risks, preventing chronic disease, enhancing mental well-being,
    fostering creativity, promoting social engagement,
    strengthening community connections, and bridging the
    generational digital divide.
        At Frank Bailey Senior Center in Riverdale, Georgia, we saw
    firsthand the extraordinary potential of older adults when Ms.
    Dorothy Steel, who started her acting career at age 80, took
    her first acting class at our center. She went on to become a
    Hollywood sensation, starring as a tribal elder in Marvel's
    Black Panther and Black Panther: Wakanda Forever, proving that
    dreams don't have expiration dates.
        Ms. Steel's appeared in several other films. Her story is a
    testament to the power of senior centers to unlock potential
    and rewrite the narrative of aging.
        Another essential service that senior centers provide is
    congregate meals. For many older adults, these meals aren't
    just about food; they are about connection, dignity, and
    community.

           Congregate meals ensure that seniors receive balanced,
    nutritious food, reducing the risk of malnutrition and diet-
    related illnesses.
          They combat isolation by providing opportunities for
    older adults to gather, talk, and form meaningful
    relationships.
          For some seniors, this may be the only hot meal they
    receive in a day.

        Without adequate funding for congregate meal programs, like
    those provided through the Older Americans Act, too many older
    adults risk going hungry or becoming further isolated.
        Along the same line, home-delivered meals also provide
    nutritious food, social interaction, and wellness checks for
    older adults who may not be able to leave their homes. These
    services are especially critical for those who are aging alone,
    without family or other community support.
        Additionally, transportation services provided through
    assistance from federal funding help seniors get to their
    medical appointments, buy fresh and healthy food at the grocery
    store, and see their friends-rather than being isolated at home
    because they are not able to drive.
        Beyond their social and emotional benefits, senior centers
    and other aging programs save our economy billions of dollars
    annually. Research has shown that healthy, active seniors who
    participate in community-based programs reduce healthcare costs
    significantly-both for themselves and for taxpayers.
        We cannot overlook the sandwich generation, those caring
    for aging parents while supporting their children. As the
    senior population grows, working caregivers face mounting
    financial, emotional, and logistical challenges.
        When older adults stay active, healthy, and engaged, it
    eases the burden on their families. Without proper investment
    in senior centers and community-based services, caregiving
    falls heavily on adult children already juggling careers,
    finances, and family life.
        Access to social engagement, nutritious meals, health
    programs, and transportation supports not just seniors, but
    their families, workforce retention, and the economy. Yet,
    despite their proven benefits, senior centers remain
    underfunded, leaving many older adults struggling with barriers
    like transportation, awareness, and lack of investment.
        If we are serious about combatting senior isolation and
    improving public health, we must:

          1. Expand funding for senior centers and other aging
    services
          2. Improve transportation access, especially in rural
    areas so that older adults can actively participate in
    community life
          3. Strengthen digital inclusion for seniors so they can
    stay connected in a technology-driven world
          4. Recognize senior centers as essential infrastructure
    to support aging in place, health, and well-being
          5. Invest in meal programs to fight food insecurity,
    combat isolation, and promote nutrition for older adults
          6. Support caregivers by ensuring seniors have access to
    services that promote independence.

        Social isolation is not just an individual problem, it's a
    public health crisis with consequences as severe as smoking or
    obesity. But, senior centers and programs like congregate and
    home-delivered meals offer a proven solution, helping older
    adults not only stay socially engaged but thrive in ways they
    never imagined.
        When we invest in senior centers, we are not just enriching
    lives, we are saving money, strengthening families, supporting
    working caregivers, and ensuring a better future for
    generations to come.
        Thank you for your time and commitment to this issue. I
    look forward to your questions and to working together to build
    a stronger, more connected future for our nation's seniors.

    =======================================================================

                            Questions for the Record

    =======================================================================

                     U.S. Senate Special Committee on Aging

      "Breaking the Cycle of Senior Loneliness: Strengthening Family and
                               Community Support"

                                 March 12, 2025

                            Questions for the Record

                               Suzanne McCormick

                            Senator Raphael Warnock

        Question:

        The Centers for Disease Control and Prevention (CDC)
    maintains key community partnerships to address complex public
    health issues, including chronic disease. For example, the
    Diabetes Prevention Program, in partnership with the YMCA and
    CDC, supports evidence-based lifestyle change programs to
    prevent type 2 diabetes.\1\
    ---------------------------------------------------------------------------
        \1\ What is the National DPP?, Centers for Disease Control and
    Prevention (May 15, 2024), https://www.cdc.gov/diabetes-prevention/
    programs/what-is-the-national-dpp.html.
    ---------------------------------------------------------------------------
        Why are strong investments in federal health agencies,
    including the CDC, important for maintaining community
    partnerships and support programs that address chronic disease
    prevention?

        Response:

        CDC is the nation's leading science-based, data-driven
    organization that protects public health through health
    promotion and disease prevention. CDC's National Center on
    Chronic Disease Prevention and Health Promotion and National
    Center on Injury Prevention and Control have invested in the Y
    to pilot and scale evidence-based programs that prevent and
    control chronic diseases and prevent childhood drownings.
        Health care costs in the United States are among the
    highest in the world, but Americans often face worse health
    outcomes than their peers in other high-income countries.
    According to CDC:

          An estimated 129 million people in the U.S. have at
    least one major chronic disease (heart disease, cancer,
    diabetes, obesity, hypertension, etc.).
          Over the past two decades, the prevalence of chronic
    diseases has increased steadily, and this trend is expected to
    continue.
        Strong federal investments in the CDC will:

          Help our Ys scale proven programs and strategies that
    address the nation's leading causes of death and disability,
    which include heart disease, cancer, obesity, stroke,
    arthritis, and diabetes.
          Address chronic diseases, which impact 6 in 10
    Americans.
          Help the nation save money-90% of health care spending
    goes to treating chronic disease as opposed to preventing these
    conditions.
        The public health programs and prevention activities
    conducted by the CDC-in partnerships with organizations like
    the Y-have been proven to be effective. They are crucial to
    reducing health care costs and improving health outcomes. The Y
    offers a variety of evidence-based programs to address chronic
    disease and prevent drownings and, with modest funding from CDC
    and the help of private philanthropy, has scaled these programs
    in communities across the country (see below for examples).
        CDC's National Diabetes Prevention Program (NDPP) helps
    some of the 98 million adults living with prediabetes reduce
    their risk for developing the disease by taking steps that will
    improve their overall health and well-being. Consider that
    Research has shown that programs like the National Diabetes
    Prevention Program can reduce the number of new cases of type 2
    diabetes by 58%, and by 71% for adults over the age of 60.e
    YMCA's Diabetes Prevention Program (DPP) has helped the average
    participant lose 5% of their body weight and helped Medicare
    save $2,650 per participant over 15 months. In April 2018,
    Medicare began covering DPP. The Y is delivering the NDPP in 41
    states and has served 80,842 participants at 1,159 sites.
        CDC's Arthritis Program helps helps the Y expand it's
    EnhancerFitness program to more people. EnhancerFitness is a
    proven community-based senior fitness and arthritis management
    program that helps some of the 54 million adults living with
    arthritis become more active, energized, and independent. Were
    you aware that EnhancerFitness program participants were found
    to have fewer hospitalizations and spend $945 less in health
    care per year than non-participants. Now offered at 258 Ys in
    634 sites in 45 states, the program has reached 42,584
    individuals living with arthritis.
        CDC's Heart Disease and Stroke Program supports the Y's
    Blood Pressure Self-Monitoring Program, which helps some of the
    116 million Americans living with hypertension prevent heart
    disease and stroke by getting their condition under control
    through tracking their blood pressure and receiving nutrition
    education. Importantly, today, three in four people living with
    hypertension do not have their condition under control. As of
    2024, there were 13,718 participants across 41 states who
    experienced an average reduction of 8.6% in systolic blood
    pressure and 4.8% in diastolic blood pressure through the Y's
    program.
        CDC's Comprehensive Cancer Program supports the LIVESTRONGr
    at the YMCA program, which helps some of the 18 million
    Americans who are living with, though, or beyond cancer to
    strengthen their spirit, mind, and body with physical activity
    programs. Recent clinical trials from the Yale Cancer Center
    and Dana-Farber/Harvard Cancer Institute confirmed that
    LIVESTRONGr at the YMCA participants experienced improved
    fitness and quality of life as well as significant decreases in
    cancer-related fatigue. Ys have served more than 85,477 cancer
    survivors in 42 states.
        CDC's Nutrition, Physical Activity and Obesity Programs
    help evaluate and scale Family-based weight management programs
    like the Y's Healthy Weight and Your Child, an evidence-based
    program that equips 7- to 13-year-olds and their families with
    the knowledge and skills to live a healthier lifestyle.
    Research showed a statistically significant reduction in body
    mass index, sedentary activities and improvements in physical
    activity and self-esteem at 6 and 12 months. The program is
    being delivered in 31 states across the country. Strategies
    that increase community access to safe places to walk and bike.
        In closing, the Y supports the highest level of funding
    possible for the CDC's programs that prevent and control
    chronic disease in order to scale programs that work in
    partnership with states and community-based organizations.
    Thank you.

                     U.S. Senate Special Committee on Aging

      "Breaking the Cycle of Senior Loneliness: Strengthening Family and
                               Community Support"

                                 March 12, 2025

                            Questions for the Record

                              Tori Strawter-Tanks

                            Senator Raphael Warnock

        Question:

        As Director of Clayton County Senior Services, you have
    witnessed firsthand how senior and intergenerational centers
    positively affect the lives of older adults, families, and
    entire communities across the state of Georgia.
        Can you share specific challenges that older adults and
    families across Georgia might face should federal funding for
    senior programs be reduced or limited?

        Response:

        1. Service Reductions or Eliminations
          Fewer people served: Programs may have to prioritize the
    most at-risk clients, leaving many without services.
          Waitlists would grow: Individuals who previously
    received help may be put on indefinite waitlists.
          Program closures: Some services (like congregate meals
    at senior centers) might be shut down entirely in some areas.
        2. Increased Risk for Older Adults
          Malnutrition: Loss of meals (home-delivered or
    congregate) can lead to poor nutrition and worsening health.
          Increased isolation: Reduced transportation or closure
    of senior centers limits social interaction, increasing
    depression and cognitive decline.
          Unmet healthcare needs: Without transportation or case
    management, seniors may miss critical medical appointments or
    medication pickups.
          Safety risks: Without home repairs or in-home care,
    falls and hospitalizations may rise.
        3. Greater Long-Term Costs
          More emergency room visits and hospitalizations: When
    basic needs aren't met, healthcare costs rise significantly.
          Earlier nursing home placement: Seniors without
    caregiver or in-home support may be institutionalized
    prematurely, which is more costly for both families and the
    state.
        4. Job Loss and Local Economic Impact
          Fewer staff positions: Reductions in funding may lead to
    layoffs of drivers, case managers, and program coordinators.
          Strain on caregivers: Family members may have to leave
    work or reduce hours to care for loved ones, affecting
    household incomes and overall productivity.
        5. Pressure on State and Local Governments
          Without federal support, state and local governments
    would face pressure to fill the funding gap , often without
    sufficient resources.
          Counties with fewer tax dollars (especially rural ones)
    would be disproportionately affected.

        Question:

        Why is predictable funding important for the operations of
    senior centers?

        Response:

        Predictable funding is critical for the successful
    operation of senior centers because it provides the stability
    and security needed to plan, operate, and grow programs that
    directly support older adults.
        1. Stability for Essential Services
          Senior centers provide vital daily services, like meals,
    transportation, fitness, education, and socialization.
    Predictable funding ensures these can continue without
    interruption.
          Older adults rely on consistent access, and gaps in
    funding could cause programs to shut down temporarily or
    permanently.
        2. Long-Term Planning and Program Development
          Predictable funding allows staff to strategically plan
    for:
              New programs
              Seasonal events
              Community partnerships
              Facility improvements
          Without reliable funding, long-term planning is replaced
    by crisis management and uncertainty.
        3. Staffing and Retention
          With steady funding, senior centers can hire and retain
    qualified staff, including social workers, drivers, program
    coordinators, and health educators.
          Frequent funding fluctuations can lead to layoffs, low
    morale, and high turnover.
        4. Consistent Vendor & Supply Relationships
          Many centers rely on external vendors for meals,
    supplies, transportation services, and programming.
          Predictable funding ensures timely payments and helps
    maintain strong vendor relationships, which can result in
    better pricing and service.
        5. Community Trust and Engagement
          When the community sees reliable services and
    programming, it builds trust and participation.
          Older adults feel safe and supported when they know the
    center will be there for them tomorrow, next month, and next
    year.
        6. Stronger Grant Writing & Fundraising
          Consistent funding provides a foundation that can be
    built upon with private donations, sponsorships, and
    competitive grants.
          Grantmakers and donors are more likely to contribute to
    centers that show financial stability and sustainability.

    =======================================================================

                           Statements for the Record

    =======================================================================

                     U.S. Senate Special Committee on Aging

      "Breaking the Cycle of Senior Loneliness: Strengthening Family and
                               Community Support"

                                 March 12, 2025

                           Statements for the Record

       The Alzheimer's Association and Alzheimer's Impact Movement (AIM)
                                   Statement

        The Alzheimer's Association and Alzheimer's Impact Movement
    (AIM) thank the Committee for its continued leadership on
    issues crucial to individuals living with Alzheimer's and other
    dementias. We appreciate the opportunity to submit this
    statement for the record for the Senate Special Committee on
    Aging hearing on "Breaking the Cycle of Senior Loneliness:
    Strengthening Family and Community Support." This statement
    highlights the profound impact of senior loneliness and social
    isolation on our nation's aging population, particularly those
    at risk of developing or who are living with Alzheimer's or
    another dementia.
        Founded in 1980, the Alzheimer's Association is the world's
    leading voluntary health organization in Alzheimer's care,
    support, and research. Our mission is to eliminate Alzheimer's
    disease and other dementias through the advancement of
    research, to provide and enhance care and support for all
    affected, and to reduce the risk of dementia through the
    promotion of brain health. AIM is the Association's advocacy
    affiliate, working in a strategic partnership to make
    Alzheimer's a national priority. Together, the Alzheimer's
    Association and AIM advocate for policies to fight Alzheimer's
    disease, including increased investment in research, improved
    care and support, and the development of approaches to reduce
    the risk of developing dementia.

    The Critical Role of Family Caregivers

        People living with Alzheimer's disease may experience
    changes in the ability to hold or follow a conversation. As a
    result, they may withdraw from hobbies, social activities, or
    other engagements. Caregivers of individuals living with
    Alzheimer's or another dementia play an essential role in
    combating this, maintaining the quality of life for their loved
    ones, and helping them live independently in their homes and
    communities for as long as possible. They are the backbone of
    our nation's health care system. However, the immense physical,
    emotional, and financial toll of caregiving often leaves them
    socially isolated themselves. In fact, 41 percent of dementia
    caregivers report having no additional unpaid assistance,
    highlighting the urgent need for stronger support systems. In
    2023 alone, more than 11 million caregivers provided 18.4
    billion hours of unpaid care - valued at nearly $350 billion -
    underscoring their indispensable role in our health care
    system.There are several types of caregiver interventions
    designed to assist caregivers of individuals with Alzheimer's
    or another dementia, such as support groups, which provide
    caregivers the opportunity to share personal feelings and
    concerns to overcome feelings of isolation in a community-based
    setting.
        It is evident that Alzheimer's takes a devastating toll on
    caregivers, from facing social isolation to battling the
    financial strain associated with caregiving. Amid these
    challenges, there is an urgent need to alleviate the
    overwhelming costs faced by caregivers. We strongly support the
    bipartisan Credit for Caring Act (S. 925/H.R. 2036), which
    would create a new, nonrefundable federal tax credit of up to
    $5,000 for eligible working family caregivers of individuals,
    regardless of age, with certain functional or cognitive
    limitations. The tax credit would help alleviate some of the
    financial strain on these selfless caregivers nationwide and
    could be used to offset some of the costs of caregiving,
    including the costs of respite care, transportation, lost
    wages, and more. We look forward to working with Congress and
    members of the Committee to advance the bipartisan Credit for
    Caring Act and other legislation to support caregivers, as they
    enhance the longevity and quality of life for our aging
    population.

    Expanding Capacity for Health Outcomes (Project ECHO)

        Technology-enabled learning models, such as Project ECHO,
    are also transforming the way health care providers support
    individuals with Alzheimer's-especially in rural areas. These
    education models, often referred to as Project ECHO, can
    improve the capacity of providers, especially those in rural
    and underserved areas, on how to best meet the needs of people
    living with Alzheimer's. Project ECHO helps primary care
    physicians in real-time understand how to use validated
    assessment tools appropriate for virtual use to make early and
    accurate diagnoses, educate families about the diagnosis and
    home management strategies, and help caregivers understand the
    behavioral changes associated with Alzheimer's, which can be
    heightened during isolation. We ask that Congress continues to
    support provisions expanding the use of technology-enabled
    collaborative learning models. Expanding these programs will
    not only improve dementia care but also strengthen the support
    networks that help individuals with Alzheimer's and their
    caregivers feel less alone.

    Social Isolation as a Dementia Risk Factor

        As of 2024, nearly 7 million Americans are living with
    Alzheimer's, a number expected to rise to nearly 13 million by
    2050. Some researchers have surmised that factors such as
    social isolation from COVID-19 lockdowns, for example, no-
    visitor policies in long-term care facilities, and increased
    intensive hospitalizations may increase dementia risk at the
    population level, but research in coming years will be
    necessary to confirm this and examine whether the impact is
    time-limited or long term. With many more at risk of developing
    the disease or another form of dementia, the need for effective
    dementia risk reduction strategies that help all communities
    increases by the day. Two-thirds of Americans have at least one
    major potential risk factor for dementia. As the prevalence of
    dementia continues to rise, addressing modifiable risk factors
    - such as staying mentally and socially active and physical
    activity - is essential not only to reduce the number of new
    cases but also to prevent current projections from worsening.
        Population-based and epidemiologic studies show that
    certain modifiable risk factors can increase the risk of
    cognitive decline and possibly dementia. A growing body of
    evidence shows that healthy behaviors can protect and promote
    brain health. Given the growing evidence that lifestyle factors
    play a significant role in cognitive health, larger studies are
    essential to further understand how we can effectively reduce
    the risk of cognitive decline and help individuals live longer,
    happier lives. The Alzheimer's Association U.S. Study to
    Protect Brain Health Through Lifestyle Intervention to Reduce
    Risk (U.S. POINTER) is a two-year clinical trial to evaluate
    whether lifestyle interventions that simultaneously target many
    risk factors protect cognitive function in older adults with an
    increased risk for cognitive decline. U.S. POINTER is the first
    such study conducted on a large group of Americans across the
    United States. Approximately 2,000 volunteer older adults who
    are at increased risk for dementia have been enrolled and will
    be followed for two years. Two lifestyle interventions will be
    compared, which vary in intensity and format. Eligible
    volunteers are randomly assigned to these interventions to
    evaluate whether cognitive benefits from a structured program
    differ from a self-guided program. Lifestyle interventions
    combining multiple behavior components show promise as a
    therapeutic strategy to protect brain health. We look forward
    to sharing the results of this groundbreaking study soon.

    Conclusion

        By prioritizing policies supporting caregivers and
    combating social isolation and senior loneliness, we can help
    the aging population live longer, healthier lives. The
    Alzheimer's Association and AIM deeply appreciate the
    Committee's continued commitment to advancing issues vital to
    the millions of families affected by Alzheimer's disease and
    other dementias. We look forward to working with the Committee
    in a bipartisan way to combat senior loneliness and improve
    quality of life for those impacted by dementia.

                     U.S. Senate Special Committee on Aging

      "Breaking the Cycle of Senior Loneliness: Strengthening Family and
                               Community Support"

                                 March 12, 2025

                           Statements for the Record

                                 ASHA Statement

        The American Seniors Housing Association (ASHA) appreciates
    the opportunity to submit this statement for the record
    regarding the March 12, 2025, Senate Aging Committee hearing,
    Breaking the Cycle of Senior Loneliness: Strengthening Family
    and Community Support.
        ASHA is a national organization of over 500 senior living
    companies that own, operate, or provide services to
    approximately 7,000 senior living communities across the U.S.,
    including independent living, assisted living, memory care and
    life plan/continuing care retirement communities. The
    Association's programs are focused on promoting quality and
    innovation, advancing research, exchanging strategic business
    information, and educating seniors and their families about the
    benefits of senior living communities.
        As such, we have a keen interest in the policy agenda of
    the Senate Aging Committee and encourage the committee to look
    to ASHA as a resource for timely and relevant research on
    issues that impact seniors relative to their housing options
    and long-term care needs.
        We appreciate the Committee addressing what has been
    described as an epidemic of loneliness. While the harmful
    effects of loneliness are currently receiving much needed
    attention, it has long been a top-of-mind issue for our members
    who prioritize social engagement as a core benefit of seniors'
    housing. The industry welcomes the opportunity to create more
    awareness about what it is achieving to combat this serious
    public health issue through the hard work and dedication of
    senior living professionals, compassionate caregivers and other
    essential team members.

        Our comments focus on the following:

          The epidemic of loneliness and its harmful health
    impacts
          How senior living communities promote social engagement
    in creative and innovative ways
          Important policies to address loneliness should be
    advanced in Congress and Agencies

    The Epidemic of Loneliness and Harmful Health Impacts is Well
    Documented

        As the population ages, it is critical that our nation
    adequately meets the demands of providing quality long-term
    care, especially given the significant and growing numbers of
    seniors who are lonely, isolated and socially disconnected.
    According to Johns Hopkins, nearly 25% of adults aged 65 and
    older are considered socially isolated-as they're more likely
    to live alone or experience the loss of family members and
    friends. Facilitating opportunities for connection for older
    adults is one way to address the heightened risk of loneliness.
        In a report by the National Academies of Sciences,
    Engineering, and Medicine (NASEM), findings on loneliness and
    social isolation in older adults conclude that social isolation
    significantly increases an individual's risk of premature death
    from all causes, rivaling the risks associated with smoking,
    obesity, and physical inactivity. Social isolation was
    associated with a 50 percent increased risk of dementia, a 29
    percent increased risk of heart disease, and a 32 percent
    increased risk of stroke. These are stunning outcomes that
    should prompt action to address ways to mitigate the source of
    these harms.
        We are grateful your committee is raising the visibility of
    this epidemic among seniors, and we look forward to assisting
    with your efforts.

    Senior Living Promotes Socialization and Engagement as a Core
    Benefit to Residents

        There are approximately two million older adults who call
    senior living "home", and numerous reasons why they move into a
    community. In addition to the myriad services offered, the
    added benefit of promoting social engagement with others in the
    community ranks among the most important aspects of senior
    living for residents and family members.
        The average assisted living resident is an 84-year-old
    woman who is widowed, has multiple chronic and functional
    limitations, requires assistance with her activities of daily
    living such as, bathing, eating, and dressing. She and her
    family are looking for quality care, safe housing and balanced
    nutrition in an environment that allows for independence (with
    assistance, as needed) and the ability to age in place with
    dignity. These services are the core characteristics of senior
    living, but creating opportunities for engagement and personal
    connection is intrinsic to everything offered in a community.
        Life in a community means always having something to do -
    and people to enjoy life with, creating a meaningful lifestyle.
    We know the role that social, economic and physical living
    conditions play in achieving good health, well-being, and
    quality of life. These non-medical factors (the "social
    determinants of health") that influence health care outcomes
    are at the heart of senior living. This doesn't just happen; it
    is purposeful in design with the goal of creating environments
    where residents have the opportunity to thrive.
        Given the high priority senior living providers place on
    the benefits of socialization, ASHA sponsored a research report
    to focus on this topic. We are pleased to share with the
    Committee,: Senior Living Communities: Uniquely Positioned to
    Reduce Social Isolation and Promote Social Connection in Older
    Adults. This brief was prepared for ASHA by ATI Advisory and
    included a literature review, senior living company surveys and
    individual case studies that highlight the impact of social
    opportunities on residents' wellbeing.

        The goals of this report were twofold:

          (1) to explore the relationship of social isolation to
    physical and mental health outcomes and utilization of health
    care services and;
          (2) to highlight approaches that senior living
    communities are taking to reduce social isolation and promote
    social connection among their residents.

        I hope you will find this full report of value to your
    efforts in further addressing this issue. For purposes of the
    statement, I want to highlight a few key observations in the
    report.

    Key Observations:

          Senior living plays a critical role in reducing social
    isolation among older adult residents, limiting the risk of
    negative health effects and promoting critical social
    connections. Many residents move into a community and become
    more active than when they lived in their former home.
          Senior living improves quality of life by fostering a
    cohesive social environment and encouraging participation in
    social activities. The authors highlight a recent study which
    found that senior living residents had increased resilience,
    mood, optimism and satisfaction with their lives compared to
    their counterparts in the general population.
          Senior living offers diverse activities to meet the
    needs, desires, and interests of their varied community base.
    Quality of life is improved by offering opportunities that
    promote resident and community connection.
          Case studies demonstrate that while no two senior living
    communities are the same, they offer innovative approaches to
    promoting social engagement. See more below.
          Senior living socialization efforts, enhanced during the
    COVID pandemic, continued, albeit with a twist. While
    interaction with friends and family decreased during the
    pandemic, virtual interaction dramatically increased. Staff
    were on hand to navigate new technologies, thus uncovering new
    ways senior living communities allowed for greater access to
    social, physical and intellectual wellness than their
    counterparts living in the greater community.
        Figure 1: Senior Living Communities Offer Diverse
    Opportunities for Social Connection

    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

    Other Studies/Reports:

        NORC/University of Chicago: Findings demonstrate that upon
    moving into senior housing, vulnerability increases for a short
    period as residents settle into their new community before
    leveling off and showing improvement. "Non-medical care and
    services like socialization, transportation, exercise, balanced
    nutrition, medication management, and others have a positive
    impact on a resident's health," said Dianne Munevar, lead
    researcher at NORC.
        US News and World Report: Released new findings from their
    survey of residents who had recently moved into senior living
    communities and their families about their experiences with
    loneliness, the health impacts of social isolation and how
    moving into a senior living community positively changed that
    experience. (How Senior Living Communities Reduce Loneliness
    and Improve Senior Health: 2025 U.S. News Survey Report)

    Important Policies to Address Loneliness Should be Advanced in
    Congress and Agencies

        There are many opportunities Congress can take to enact
    policies and programs and raise general awareness about and
    enhance what is already available. The Senate Special Committee
    on Aging is positioned to do this by promoting policies to call
    more attention to the harms of loneliness and incentivizing
    creative programing to enhance social engagement in senior
    living communities

          The Social Engagement and Network Initiatives for Older
    Relief (SENIOR) Act (Senior Act) creates a meaningful approach
    to initiating the broader conversation on loneliness among
    older adults. Adding loneliness to the definition of disease
    prevention and health promotion services under the Older
    Americans Act, requiring the Department of Health and Human
    Services to create a report on the effects of loneliness on
    older adults, and recommending solutions and analyzing the
    relationships between multigenerational family units, has the
    ability to place this health crisis front and center in the
    minds of policymakers, health care providers and systems,
    academics, research institutions and the entire long term care
    industry.
          The Care Across Generations Act. There is much evidence
    to date to indicate that fostering relationships between young
    and old are beneficial to both in terms of increased
    socialization and overall wellbeing. Taking action to increase
    such arrangements is encouraged. ASHA supports additional
    voluntary programs that encourage these relationships. The Care
    Across Generations Act is a worthy program to encourage these
    relationships. We need to promote intergenerational care, such
    as encouraging child-care and early-learning programs to be
    established in relation to senior living communities.

    Other Areas for Consideration:

        Workforce Shortage in Senior Living: Given the importance
    of senior living as a positive factor in addressing the crisis
    of loneliness, it is important that the industry continue to
    meet the current and future needs of the aging population. To
    do so, it is important that policymakers understand the
    workforce challenges we are facing in the caregiver, nurse
    assistant, housekeeper, and dining staff positions.
        ASHA supports an "all of the above" solution that creates a
    pipeline of caregivers in a number of ways including 1) through
    workforce training and development programs, specifically
    targeted for long term care positions; and, 2) the advancement
    of proposals to enact legal immigration reform for worker
    visas, to allow foreign workers to work in the senior living
    industry to help meet the growing needs.
        There are simply not enough native-born workers to meet the
    current and future demand for long-term care. Left unresolved,
    it will ultimately impact the ability to care for older adults.
    As the aging population grows exponentially, organic workforce
    growth in the country is expected to stagnate. We understand
    the need to address border security, but we also need to create
    a legal immigration process where visas are made available to
    caregivers and other essential workers in long term care. We
    support efforts to address both challenges.
        Costs of Long-Term Care: In addition to sharing and
    promoting these favorable studies and reports about the
    benefits of senior living in reducing the level of loneliness
    for older adults, it is also important to recognize the cost
    effectiveness of senior living relative to other settings.
        Specifically, as explained in the ASHA sponsored report,
    The Surprising Price of Staying in a House, Cost Comparisons
    Often Favor Senior Living, the emphasis on keeping people in
    their homes at all costs may be shortsighted. While we
    understand most people do not want to leave their homes given
    their personal attachment, the decision should not be based on
    cost alone, without further examination of what it takes
    financially to remain in the home.
        A recent analysis challenges the cost assumptions. The math
    most seniors and families use does not capture all of the costs
    associated with living in a house, such as taxes, insurance,
    HOA fees, maintenance, system failures, etc. or enjoying meals
    and transportation to appointments, grocery store, movies, etc.
    When all of these factors are considered, the costs tell a
    different story. This information should be made widely
    available to older adults in all public service information
    sharing efforts to ensure they have important facts to make an
    informed decision. NOTE: The figures below under Home Health
    Care, do not reflect a 24/7 care environment as included in
    assisted living. Therefore, as more hours are needed, the costs
    grow exponentially.

    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

        ASHA welcomes the opportunity to create more awareness
    among the Senate Aging Committee about what the industry is
    achieving in senior care for residents, caregivers, families,
    and the broader healthcare system. As noted above, the senior
    living industry's work to promote social engagement and thus
    reduce the associated health risks is especially relevant to
    the current inquiry by the Committee. The hard work and
    dedication of senior living professionals and the overwhelming
    resident and family satisfaction deserves to be recognized.
        The aging population and booming demand for long-term care
    in the very near future requires policy makers to give serious
    thought to innovative approaches to create more options for
    older adults who need care and housing. We look forward to
    working with the Committee to advance opportunities to meet
    this critical need.

        Sincerely,

        /s/
        David Schless
        President and CEO

                     U.S. Senate Special Committee on Aging

      "Breaking the Cycle of Senior Loneliness: Strengthening Family and
                               Community Support"

                                 March 12, 2025

                           Statements for the Record

                     ASHA: Senior Living Communities Report

    [GRAPHICS NOT AVAILABLE IN TIFF FORMAT]

                     U.S. Senate Special Committee on Aging

      "Breaking the Cycle of Senior Loneliness: Strengthening Family and
                               Community Support"

                                 March 12, 2025

                           Statements for the Record

            ASHA: The Surpassing Price of Staying in a House Report

    [GRAPHICS NOT AVAILABLE IN TIFF FORMAT]

                     U.S. Senate Special Committee on Aging

      "Breaking the Cycle of Senior Loneliness: Strengthening Family and
                               Community Support"

                                 March 12, 2025

                           Statements for the Record

                             James Balda Statement

        ADDENDUM: Testimonials from senior living stakeholders on
    importance of socialization in senior living communities.

                                      ***

        Helen, a 97-year-old woman from the Bay Area, had been
    struggling at home with loneliness and feeling particularly
    isolated, especially since she had lost her husband. Feeling
    resigned to leave her home behind, which for her symbolized
    leaving her entire life behind, she reluctantly made the
    decision to move into one of our Bay Area Assisted Living
    communities. To her surprise, she found renewal when she met
    Barbara, another resident in her nineties, and today the two
    are inseparable. As Helen told us in an interview with the
    pair, "We just have a very close friendship. Barbara has a
    heart of gold, and I just love her. I never thought I would
    find my best friend at age 97."

                                      ***

        George and Mary have led a full life together - raising
    their children, traveling the world, and enjoying virtually
    every outdoor pursuit one can imagine. When George was
    diagnosed with Lewy body dementia with Parkinsonism, Mary
    stoically took on the role of caregiver. But within weeks, she
    began experiencing extreme symptoms of stress and anxiety. "I
    wound up in the hospital. I was ignoring my best friend's needs
    over some misconception of mine that I had to do it," she
    shares in this documentary video. She and her family made the
    decision to bring George into one of our communities, and it
    has been transformative for them. Today, Mary continues to live
    at home just a few miles from the community. One might think
    she would be lonely living alone, but she's not. She still
    spends much of each day with George, engaging in life in the
    community alongside him and the other residents and associates
    in our Prema Memory Support neighborhood. "George is doing so
    much better," says Mary. "The Nayas here love their work, they
    love being with the residents. George has made friends with the
    Nayas. They are able to be with one another as family."
    (Watermark's Nayas, which is a Sanskrit word for "guide," are
    more than caregivers - they participate in daily life alongside
    our memory care residents.) In many ways, the decision to move
    George into our community enabled them both to regain strength
    and find new modes of engagement, while avoiding loneliness.
    "We've always had a very adventuresome life," says Mary. "And
    it's continuing."

                                      ***

        The health and well-being benefits of socialization at our
    communities are enjoyed not just among people, but also between
    people and animals. Every Watermark community is pet-friendly.
    And among Watermark's award-winning signature programs is In
    the Presence of Horses, which brings equine therapy into the
    community, enabling residents and horses to interact in ways
    that benefit both. Janet, a resident in Memory Care in one of
    our Tucson communities who came to us at age 93 with late-stage
    dementia, had not spoken a word in nearly a year. Her daughter,
    who visited her regularly at the community, was bereft at
    seeing her mom slip away. But in her first week at the
    community, Janet met Brown, one of the program's horses, and
    there was an instant connection. "It was as if this horse knew
    her, and she knew him," said the equine program director. At
    another session just a few weeks later, Janet greeted Brown
    with a "Hello." And from that day forward she was speaking
    again, which also enabled her to reconnect with her daughter.

                                      ***

        Panelists share how they use content as a versatile and
    scalable tool to deliver outstanding resident engagement
    programs for veterans and memory care groups; session includes
    stories about the importance of enriching versus entertaining
    and their strategies for implementing technology to help your
    community flourish.

          https://lifeloop.com/flourishing-communities-sitter-
    barfoot-veterans-care-center-on-demand-webinar-ty

                                      ***

    Breaking the Cycle of Senior Isolation: A Community Story

        When Hurricane Helene tore through Western North Carolina,
    it didn't just damage homes-it cut off the most vulnerable. In
    the rural townships of Ramsay Creek and Bernardsville, seniors
    were already struggling with isolation, living miles apart with
    limited transportation and spotty phone service. Many relied on
    neighbors, local groups, or a rare internet connection for
    help. But when the storm hit, those lifelines disappeared.

    From Isolation to Connection

        With power and communication down, many seniors were left
    alone, unable to call for help or even know when it might come.
    For those with mobility issues, getting food or medicine became
    impossible. Roads were flooded, homes were unreachable, and
    fear set in.
        In Bernardsville, the community supply center became a
    beacon of hope. What had once been a quiet space turned into an
    emergency hub. Volunteers worked tirelessly, delivering food,
    water, and medication to those who had no way to get to safety.
    For many seniors, it was the first human contact they had in
    days.

    More Than a Roof Over Their Heads

        For some, the storm took everything. Their homes, already
    fragile, were now unsafe-waterlogged, crumbling, and unlivable.
    The reality of displacement hit hard, especially for those who
    had lived in the same place for decades. Losing their homes
    meant losing familiarity, routine, and a sense of security.
        A church in Spruce Pine opened its doors, turning its
    sanctuary into a temporary shelter. Volunteers set up cots,
    cooked meals, and offered comfort to those who had nowhere else
    to go. But as days turned to weeks, it became clear that this
    wasn't a permanent solution. These seniors needed real, stable
    housing-something ALG immediately began working on with local
    leaders and families to make happen. Through these efforts, we
    were able to house around 25 seniors.

    Beyond the Storm: Building a Future of Connection

        Hurricane Helene was more than a disaster-it was a wake-up
    call. It exposed how fragile the support system for seniors in
    rural areas really is. It showed how critical human connection
    is, not just in emergencies, but every day.
        Since the storm, communities have stepped up. Volunteer
    programs now pair seniors with regular check-ins. Local
    organizations are improving transportation access. Plans are in
    motion to strengthen emergency networks so no senior is left
    alone in a crisis.
        Isolation doesn't have to be a way of life. Through
    connection, compassion, and proactive support, these
    communities are proving that seniors can do more than just
    survive-they can thrive.

                                      ***

        Meet Zelma Bennett, one of our newest residents at
    Commonwealth Senior Living at Stratford House. Zelma moved into
    our community on January 29th, after spending the past year
    living with a friend. Zelma, who had previously run a group
    home for adults, enjoyed maintaining a vibrant social life with
    assistance, but her memory loss prompted her to seek a
    community where she could continue engaging socially while
    receiving the support she needed. From the moment she arrived,
    Zelma embraced every opportunity for socialization,
    participating in nearly every activity offered. She uses her
    calendar so frequently to keep track of events that she wears
    it out and needs to replace it before the month's end! Her
    enthusiasm has been contagious, and she has made many new
    friends in a short time. Zelma's story is just one example of
    how socialization in our communities has dramatically improved
    the quality of life for seniors. The friendships and activities
    she's engaged in have helped alleviate her feelings of
    loneliness and have given her a renewed sense of purpose and
    joy. We are so grateful she chose to join our community.
        -Dale Smith, Resident Program Director, Commonwealth Senior
    Living at Stratford House

                                      ***

    Testimonials from Brookdale Residents:
        One of my biggest fears is being all alone in the world. We
    just enjoy doing things together and talking and it just works.
    We are a group.

                                      ***

        I think it just enriches your life. It gets rid of that
    loneliness that so many people at this stage in their life
    experience.

                                      ***

        Not only do you have somebody else that you feel like you
    can talk to, but it's also supporting that somebody else and
    knowing that they're going to support you.

                                      ***

        To me, Friends for Life means that the people that you meet
    here are going to be your friends for life because no matter
    where you go, these people have impacted your life. They've
    enriched your life. Hopefully you've enriched theirs.

                                      ***

        The closeness that is offered to making yourself feel at
    home is to have that beautiful relationship with all of these
    people. Friendships are very, very important. I feel that being
    a friend means being there through the good times as well as
    the bad. Just being with people has taught me so much about the
    healing power of friendship.

                                      ***

        I must tell you, I didn't know I was lonely until I moved
    into Brookdale. And to this day, I have wonderful friends that
    I luncheon with. And it's just a privilege. I found my people
    at Brookdale. It's the people I break bread with. We care for
    each other. And it's wonderful. It's like an extended family,
    really and truly.

                                      ***

        We all talk and we all laugh. And that's good for
    everybody. It is certainly good to live here and do it all.

                                      ***

        I told my kids, I want to move where there'll be friends
    and social things because I needed it. And it's been absolutely
    marvelous. So I'm really glad. And the people I met, I felt
    closer to because this gives us a chance to kind of live again.

                                      ***

        And now you can't be lonesome because there's somebody on
    the elevator. There's somebody sitting with you at a meal.
    There's people all around you. All you have to do is reach out.
    I don't know what I would do without these people.

                                      ***

        We have a nice bunch of friends. And you know what? We
    confide in each other. We tell each other things. We sit and we
    talk to each other and we hug each other. You know, this is
    part of our everyday routine.

                                      ***

        I noticed these ladies sitting at a table in the lounge and
    they seem to be having fun and they're chattering away. So I
    said, "May I join you?" And they said, "Yes." And the rest is
    history. I love them all dearly and they're fun to be with.

                                      ***

        Nolan is a native Oregonian, born in Bend in May of 1938.
    When he was seven, he and his family moved Eugene, OR where
    Nolan lived until about ten years ago, moving to Gresham, OR.
        Sadly, when Nolan's wife passed away, he began experiencing
    some health concerns, landing him in the hospital. Nolan's
    family reached out to Merrill Gardens at Sheldon Park for an
    evaluation. At that time our Senior Health Services Director,
    Kellie Williams, drove from Eugene to Mt. Hood to meet Nolan.
        After meeting Nolan, it was an easy YES from Kellie as
    Nolan wasn't a hard sell with his giant grin and kind heart. He
    was soon to be part of the Sheldon Park family.
        Now, here's the most heartfelt part! Nolan recently called
    Kellie over to his table and stated, "You saved my life!" When
    Kellie asked what Nolan was speaking of, he shared a story of
    what he calls a heroic act.
        Nolan's water heater at his home in Mt. Hood was found to
    be leaking natural gas (carbon monoxide) for quite some time.
    Nolan was unknowingly being poisoned in his home. Nolan stated,
    "I was sitting in a time bomb and didn't even know it. It may
    have killed me if you had not got me moved here."
        Nolan expresses deep gratitude to the Merrill Gardens team
    for "saving" him. We are all so thankful Nolan is safe, happy
    and healthy. He is a true delight and brings so much joy to our
    community.
        Thank you, Nolan, for letting us be part of your family.

                                      ***

    Truewood by Merrill, Keller, Texas

        When Mr. Jerry first arrived in our memory care unit he was
    faced with a whirlwind of life changes. Having just lost his
    wife and relocated from California to Texas, he understandably
    felt scared, withdrawn, and overwhelmed by the unknown. The
    adjustment to such significant changes in his life wasn't easy,
    and it took time for him to trust us.
        However, through consistent, one-on-one interactions and
    building a relationship based on sharing our personal stories
    and experiences, we were able to earn his trust. Over time, Mr.
    Jerry began to let his guard down, allowing us to become a part
    of his journey. He found comfort in our steady presence, and it
    wasn't long before he became an ambassador for our community.
        Now, Mr. Jerry is an integral part of our family here. He
    regularly expresses his gratitude for the staff and shares how
    much he loves living here. You can often find him participating
    in bingo games, solving crossword puzzles under our reading
    tree, or most joyfully, spending time with his daughter and
    grandchildren around the community. His joy is contagious, and
    it brings so much warmth to all of us.
        Mr. Jerry holds a special place in our hearts, and we are
    honored to be a part of his extended family. His transformation
    from a scared, withdrawn newcomer to a vibrant, engaged member
    of our community is a testament to the strength of his
    character and the bond we share with him. We are truly grateful
    to have him here with us.

                                      ***

        Just four short months ago, a sweet and gentle woman joined
    our memory care unit. At first, she was very shy and quiet, and
    her husband, deeply devoted to her, would come in several times
    a day to check on her. He shared that his wife wouldn't eat
    unless he was there with her, and she would be hesitant to
    participate in activities unless he was present. She also
    didn't like noise, having lived a quiet, settled life at home.
        For the first few weeks, her husband kept to his routine,
    sitting in on meals, participating in activities, and ensuring
    she was away from any noise. It was clear how much he cared for
    her, and we respected their need for comfort and familiarity.
    However, on one particular day, he had a doctor's appointment,
    and we decided to gently test the waters by bringing her out
    for some musical entertainment. We knew that music was
    something she enjoyed, as we often heard her husband sing songs
    to her during their walks through the unit.
        Sure enough, the music was just what she needed. She began
    to relax, her smile brightening with each note. One song even
    got her up out of her seat, and before we knew it, she was
    clapping and dancing-something we had never seen before. We
    managed to capture the moment on video, and when we showed it
    to her husband, his face lit up with surprise and joy. His
    gratitude was overwhelming, and he couldn't thank us enough for
    taking the chance and helping her break free from her shell.
        That moment marked a turning point. From that day forward,
    her husband knew he could trust us to do what was best for his
    wife. He no longer felt the weight of needing to be present for
    every meal or activity, knowing she was in good hands. She had
    found her comfort, and he shares with us often how much she's
    growing. Not only was she comfortable without him, but he began
    participating in activities as well, knowing that she was safe
    and content.
        The progress we've seen in her has been truly remarkable.
    What started as a quiet, reserved woman has blossomed into
    someone who now enjoys the company of others, embraces
    activities, and even dances to her favorite songs. This
    transformation wouldn't have been possible without the trust,
    patience, and understanding of both her and her husband-and we
    are grateful of having the privilege of supporting them on
    their journey.

                                      ***

    Merrill Gardens at Sheldon Park, Eugene, OR

        When Shirley moved in with us, she was very quiet, reserved
    and preferred to stay in her apartment. After a short
    adjustment period she felt comfortable with joining in
    conversations in the dining room and became fast friends with
    Donna. The two of them are now darn near inseparable and
    Shirley is out socializing more often than not.
        Frieda moved in with Bill and his care was her singular
    focus. After he passed, she enjoyed the sense of community and
    her neighbors made her want to stay. She is often found with
    Weezy and laughing and joking. She tells everyone she meets how
    much she loves it here and often says "I can't imagine going
    home to that empty house and having no one to talk to. You all
    have provided that sense of community that I didn't know I
    needed.

                                      ***

    Merrill Gardens at The University, Seattle WA

        We have a resident who moved into our community in his 70s,
    initially planning to stay only for six months. He loved it
    here so much that he's been with us for almost four years and
    doesn't plan to leave. He fell in love with the sense of
    community. When he walks out of his apartment every morning, he
    greets our receptionist and says hello to those in the bistro,
    reading their morning paper with a cup of coffee. He has
    considered moving to a regular apartment building, but he
    wouldn't want to be anywhere else because you don't get the
    sense of community elsewhere. This resident spends most of his
    time out and about during the day but loves coming home to his
    own apartment in the community he loves and has now called home
    for the past four years.

                                      ***

    Merrill Gardens at Kirkland, Kirkland, WA

        Prior to moving into a Merrill Gardens at Kirkland Senior
    Living , Joann M, age 88, a widow of 18 years, lived alone
    independently in her own home. The isolation took a toll on
    both her physical health as well as her cognitive health.
    Because of the social isolation, she spent most of her time
    sitting in her chair, reading or watching movies on her IPAD.
    Family noticed that she started to become withdrawn and showed
    a lack of interest with most things. She also became less
    sturdy on her feet and at times they would notice bruises on
    her face and body, as well as watching her walk in pain
    concealing that she had fallen. She finally made the decision
    that she had been putting off and agreed that it was time to
    move into a community to make new friends and to start getting
    active again. Within a few short months of embracing the new
    community, her strength and balance came back. She started
    going on all the outing, participated in all the social
    activities, and never missed a meal with her new friends.
    Family reported that all cognitive concerns had gone away since
    she moved in, and this resident never had a fall during the two
    years she moved to this senior living community. The community
    described her as a resident that was aging backwards in real
    time. When we talked to this resident and asked if she had any
    regrets about leaving her home and moving to the community, she
    told us bluntly, YES, I regret not moving in five years sooner.
    This was the best decision she had made in the last 20 years,
    and she was having the time of her life.
        This resident is my own mother who just recently passed
    away. She absolutely loved living at Merrill Gardens at
    Kirkland
        -Brian Madgett, General Manager

                                      ***

    Merrill Gardens at Burien, Burien, WA

        The community had a resident who was never married, was
    scared, living alone in her own home, failing mentally and
    physically. Was fiercely independent, however friends noticed
    she needed help and was able to have her move to our community.
    She has since regained weight, is very active within the
    community and now has a fellow resident as her "boyfriend" and
    living her best life.
        A family from California toured with us months back wanting
    to move to Washington to be with local family in a year or so.
    Unhappily, the husband was diagnosed with terminal cancer. It
    was so very important for the children to get Mom & Dad up to
    WA and in our community - knowing that when Dad passed if Mom
    was not already living in a senior community their fear was Mom
    would follow Dad soon after. The family was able to move them
    in, Dad on hospice and passing soon after their arrival. The
    community of residents and staff wrapped their arms around her,
    and she is thriving; active and engaged.

                                      ***

    Merrill Gardens at Renton Centre, Renton, WA

        When we first met her, Maureen refused to get out of bed.
    Her apartment was dark at 3:00 in the afternoon and she was
    still in bed. She hadn't eaten, showered, or dressed for the
    day. I began seeing her on a regular basis and talking with her
    daughter, who lives out of state. I started to accompany her on
    medical appointments. Because of her memory impairment, she
    couldn't ever recall what was said at prior appointments. I
    took notes, which I shared with our staff and her daughter.
        A number of things resulted from the initial visit. The
    doctor prescribed antidepressants. Our nurse scheduled a
    virtual care conference with her daughter. All agreed that
    Maureen needed more care than she was currently receiving. With
    constant encouragement, she began to take baby steps toward a
    more fulfilling life. She started dressing up and having all of
    her meals in the dining room. We connected her with in-house
    therapists and she began receiving both physical and
    occupational therapy. Maureen began to thrive in our community.
    She missed entertaining her friends for tea in her home. I
    helped her to reconnect with those friends and invited them to
    her apartment for high tea, complete with scones, finger
    sandwiches, and petit fours (thanks to our chef). She also made
    new friends in the community. Thanks to these interventions,
    Maureen developed a brighter outlook and "a new lease on life"
    (her words) at age 91.

                                      ***

        Patricia Will, Founder and CEO of Belmont Village Senior
    Living, moderated a webinar entitled "Resilience and Wisdom in
    Senior Housing Communities" presented by Dr. Dilip V. Jeste,
    M.D., a renowned geriatric neuro-psychiatrist and Director of
    the Sam and Rose Stein Institute for Research on Aging at the
    University of California San Diego. . In the webinar, Dr. Jeste
    addressed conditions experienced by aging seniors, such as
    loneliness and isolation, and how a senior's quality of life
    can be improved by promoting the inherent resilience and wisdom
    of seniors when living in an engaging, communal environment
    among peers. . Dr. Jeste explained that older adults are at
    increased risk for loneliness and social isolation because they
    are more likely to face difficulties in living alone, the loss
    of family or friends, chronic illness, and hearing loss.
    Loneliness is described as the distress caused by a feeling of
    being alone, while social isolation is the inadequacy and
    infrequency of engaging social relationships. Loneliness can
    increase the risk of major diseases, such as heart disease,
    diabetes, obesity, depression, substance abuse and Alzheimer's
    and other forms of dementia.
          -Belmont Village Senior Living and Dilip Jeste, MD,
    Present "Resilience and Wisdom in Senior Housing Communities,"
    a Webinar on the Benefits of Community Living Ahead of New La
    Jolla Community Opening.
        Belmont Blooms Fashion Show (Video)

                                      ***

        Testimonial: Kay Allen, Belmont Village Fort Lauderdale
    (Video)

                                      ***

        Finding Friendship at Belmont Village (Video)

                     U.S. Senate Special Committee on Aging

      "Breaking the Cycle of Senior Loneliness: Strengthening Family and
                               Community Support"

                                 March 12, 2025

                           Statements for the Record

                                NANASP Statement

        The National Association of Nutrition and Aging Services
    Programs commends the committee for convening the hearing on
    "Breaking the Cycle of Senior Loneliness: Strengthening Family
    and Community Support."
        ANASP is an association of over 1,000 members across the
    country who form a vital lifeline through senior centers, dine-
    in and congregate meal sites, and home-delivered-meal services.
    These essential providers reach into every corner of America,
    from rural small towns to bustling urban hubs. Almost 60% of
    our older adult participants live alone, making our programs
    one of their few daily social connections.
        Older adults are at higher risk for socially isolation due
    to factors like mobility limitations, health issues, lack of
    transportation, loss of loved ones, and financial constraints.
    In 2024, one in three older Americans reported feeling lonely.
    Social isolation not only creates health problems -it amplifies
    them, increasing the risk of premature death for older adults
    managing chronic conditions and increasing avoidable admissions
    to a hospital or nursing home. Those experiencing isolation and
    loneliness are more vulnerable to falls and depression,
    threatening their independence and self-reliance.
        An effective answer to this silent epidemic already exists
    in a landmark program, the Older Americans Act (OAA). OAA
    programs offer vital nutrition and supportive services,
    breaking the cycle of isolation while improving health
    outcomes. A recent survey found 61% of home-delivered meal
    participants noted the daily meals helped reduce feelings of
    social isolation and nearly three-quarters of participants
    believe the program helps them to continue to live
    independently and improve their health. As Mr. MacPherson,
    Founder and Chairman of the Foundation for Social Connection
    Action Network, stated in his testimony, addressing this
    epidemic is not only a moral imperative, but also a critical
    public health necessity.
        This year, the OAA will celebrate 60 years of success of
    delivering services and programs that create connections.
    Despite bipartisan support, the OAA wasn't reauthorized in
    2024. We encourage the committee to work in a bipartisan
    fashion to reauthorize the OAA to ensure these essential
    services can reach even more older adults facing social
    isolation and loneliness.
        Sincerely,
        /s/
        Bob Blancato
        Executive Director
        NANASP

                     U.S. Senate Special Committee on Aging

      "Breaking the Cycle of Senior Loneliness: Strengthening Family and
                               Community Support"

                                 March 12, 2025

                           Statements for the Record

                        Oshkosh Community YMCA Statement

    [GRAPHICS NOT AVAILABLE IN TIFF FORMAT]

                     U.S. Senate Special Committee on Aging

      "Breaking the Cycle of Senior Loneliness: Strengthening Family and
                               Community Support"

                                 March 12, 2025

                           Statements for the Record

                                 YMCA Statement

      Social Connection & Fall Prevention - A Winning Combination at NYS
                                     YMCAs

        Studies show that participation in group-based exercise
    programs designed for fall prevention can effectively reduce
    social isolation among seniors by fostering social connections
    and a sense of community.
        In New York State, falls are the leading cause of injury
    and death in New York State, accounting for $1.7 billion in
    annual hospitalization charges. New York State YMCAs are rising
    to meet this challenge by expanding capacity in statewide fall
    prevention programs.

          YMCAs are engaged in a 4-year plan to enroll over 2,500
    New Yorkers in fall prevention programs, expanding access to
    life-saving resources and promoting social connection.
          40 new instructors have been trained in the last six
    months, enabling evidence-based falls prevention programs to
    expand to new YMCA locations as well as senior centers,
    churches, and other community locations, making fall prevention
    more accessible than ever.
          NYS YMCAs are preparing to launch a statewide, virtual,
    small-group based fall prevention program to reach those facing
    mobility challenges or lack access to transportation.

    [GRAPHIC] [TIFF OMITTED] T0186.047

                     U.S. Senate Special Committee on Aging

      "Breaking the Cycle of Senior Loneliness: Strengthening Family and
                               Community Support"

                                 March 12, 2025

                           Statements for the Record

                            YMCA Florida Statistics

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