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

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

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                                                                   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

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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/.
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    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
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    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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