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Affiliated with the Rhode Island AFL-CIO “Fighting for the future of our members.” “NOW, more than ever!!!” Publication 2018 Issue 19 Published in house by the RI ARA

May 13, 2018 E-Newsletter

All Rights Reserved RI ARA 2018©

Proposed Trump Administration Rescissions Would Be a Disaster for Retirees President Donald Trump plans to submit up to $25 billion in federal spending cuts to Congress later this month. According to administration sources, he will take aim at rolling back parts of the budget enacted in February and mandatory spending items, including Social Security, Medicaid and Medicare. If these so-called “rescissions” are approved by Congress, Republicans will be able to to

renege on elements of their budget deal and take the opportunity to slash “entitlements.” Consumer Financial Protection Bureau Head Mick Mulvaney alr eady confir med as much when he said that “Democrats probably won’t like” the mandatory spending adjustments included in the proposal. This could increase the likelihood of a government shutdown and diminish an already frayed relationship between lawmakers and the

public. Adding insult to injury, nonobligated agency funds from previous years will be the chief source for cuts. This would be particularly devastating for the Social Security Administration, which is already struggling with inadequate funding. “It is absolutely appalling that the Trump administration and GOP leaders Rich Fiesta would pass a tax bill for the one percent and then

try to clean up their fiscal mess by cutting seniors’ hard earned benefits,” said Richard Fiesta, Executive Director of the Alliance. Luckily, the president won’t be able to fast-track the rescissions through Congress because he plans to include “mandatory benefit programs” as part of the package. That’s why we need you to please sign our petition and make your voice heard NOW!

Pension Funds Still Making Promises They Probably Can't Keep The value of investments by public pension funds declined last quarter, widening the gap between what these funds say they will earn and what they actually earn. Pension funds across the U.S. must each year estimate how much they expect to earn on investments—a projection that determines the amount the government that is affiliated with the pension fund must pay into it. Robust returns reduce the need for government support. But forecasts don’t always square with funds’ actual experience. Retirement plans across the country still project their investments will grow at a median rate of 7.25%, according to Wilshire Consulting, an adviser to pension funds. Yearly returns on public pension plans have returned a median 6.79% over the past decade and 6.49%

over the past 20 years, according to Wilshire Trust Universe Comparison Service, a database. Unlike corporations, public pensions have wide latitude in projecting investment returns. In the first quarter, public plans lost a median 0.23%, according to Wilshire Trust Universe Comparison Service. Such a lackluster return will serve as a stark reminder to the public officials who manage billions of dollars in pensions for America’s firefighters, police and other public workers of the daunting shortfalls many funds face. “With all of the major asset classes falling it was pretty tough for investors to have any positive returns. They didn’t have much of a chance to make money,” said Robert J. Waid, managing director at Wilshire Associates. Public retirement systems had an average 72% of assets they need to pay for retirement

promises in 2016, according to the latest data available in the Public Plans Database, which tracks about 170 pension funds. The figure a decade earlier was 85%. Before the first quarter, pension plans had experienced nine quarters of positive returns. That rise had brightened the picture for public retirement systems and closed some of the gap between expectations and reality. These pension funds have also steadily narrowed this gap on their own. Three quarters of the 129 state pension plans monitored by the National Association of State Retirement Administrators have reduced their investment return assumption since fiscal year 2014. But government officials seeking to make their investment targets more conservative have a powerful disincentive: High returns

assumptions appeal to elected leaders because they reduce the amount governments need to set aside to cover pension promises. For some, pensions have already caused budget pressure. Companies don’t have the same flexibility to set return expectations on their pension plans. Pension plans sponsored by S&P 1500 companies have an average 87% of assets needed to cover their pensions promises, according to Mercer, a consultancy….Read More

Study: Pension plans in 'critical' condition for 17 RI cities, towns. PROVIDENCE, R.I. (WPRI) - Rhode Island’s 34 independent municipal pension plans have accumulated a combined shortfall of more than $2.4 billion, led by a billion-dollar gap in the city of Providence, a newly released study shows. ...Read More

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

Millions Lose Coverage as Affordable Care Act Changes Take Effect May 4th marks the oneyear anniversary of the U.S. House of Representatives passing the American Health Care Act (AHCA), a bill that would have put millions of Americans at risk of losing affordable health care. The bill would have ended Medicaid as we know it, eliminated the insurance

protections of the Affordable Care Act (ACA), raised premiums on older adults, and undermined Medicare. While AHCA ultimately failed to become law, efforts to unravel the ACA have continued. Late last year, Congress passed a tax bill that included a provision eliminating the ACA’s individual mandate, which was widely seen as the linchpin for the ACA’s individual market. In

addition, the Administration has taken several steps to reduce spending to support the ACA, including stopping cost-sharing reduction (CSR) payments that helped reduce premiums for consumers, ending most marketing and advertising for ACA markets, and changing ACA enrollment rules to make plans harder to buy and keep. We are starting to see the impact of these changes. This

week, the Commonwealth Fund’s Affordable Care Act Tracking Survey showed recent coverage declines among 19-to-64-year-olds. The survey’s focus is on adults who gained coverage through the ACA’s marketplaces and Medicaid...Read More

Kaiser Family Foundation Makes Predictions for Future of Medicare Drug Price Negotiation Under current law, Medicare is expressly prohibited from negotiating directly with drug manufacturers to set prescription drug costs for beneficiaries. Instead, each Part D plan must separately negotiate with each drug manufacturer. The belief supporting this scheme was that each plan, though the creation of distinct formulary structures, would have the ability to drive down prices for preferred medications. Then, beneficiaries could choose the plan that had the lowest cost for the drugs that they take. For many drugs, however, this arrangement means that the negotiating power of the Medicare population is diluted, split across different Part D plans that are in competition with each other and have no incentive to work together to

lower prices across the board. The idea of allowing Medicare to negotiate at least some drug prices for all beneficiaries has been promoted as an alternative since the inception of Part D, and enjoys widespread support across the political spectrum. The Kaiser Family Foundation released a new report looking at the history of this concept, including the dramatically different role that the federal government has in securing good prices for Medicare beneficiaries, compared to its active involvement in establishing drug prices for other government health programs, including Medicaid and the Department of Veterans Affairs (VA). The report outlines various bills that have been introduced in Congress since the enactment of the Part D benefit, and discusses how

enthusiasm for making this change tracks closely with the rate of increase in Part D drug costs. The report notes that with prescription drug spending growth on the rise, and strong public support for policymakers to take action to ensure the affordability of medications, interest in giving Medicare negotiating power has spiked in the past couple of years, and is increasingly a focus of this Congress and Administration.

As soon as next week, President Trump is expected to lay out new administrative actions on the issue. Medicare Rights will be monitoring these developments closely, for any implications the policy proposals may have for people with Medicare to limit the growth in drug prices that has moved too many medications out of the reach of average beneficiaries. Read the Kaiser Family Foundation report.

First drug priced at over $1 million may be on the horizon In the paradoxical world of drug pricing, the U.S.'s first price tag exceeding $1 million for a medicine is being contemplated as the nation's agita over the cost of prescription drugs climbs ever higher. New gene therapies that aim to cure hemophilia, a disease affecting the blood's ability to

clot, may carry prices of $1.5 million or more, analysts at Leerink wrote in a research note Monday. Gene therapies deliver a healthy copy of a gene to make up for a defective one that causes disease, aiming to cure — or at least significantly improve — the malady in just one treatment. Such therapies for hemophilia are in development at drugmakers

BioMarin, Spark Therapeutics, and UniQure. They're changing the way we think about delivery — and pricing — of medicine. The first gene therapy was approved in the U.S. in December, and received a price tag of $850,000in January. Called Luxturna, it treats a rare form of blindness and is made by Spark A price of $1.5 million or more

would set a new paradigm in the U.S. "It appears the seemingly impervious million-dollar threshold may be breached with hemophilia gene therapy, which could do so while still creating value for society by reducing the cost of factor replacement therapy," Leerink analysts Joseph Schwartz and Dae Gon Ha wrote in their research note. …...Read More

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

Home Health Care Information The Center has been hearing from people unable to access Medicare-covered home health care, or the appropriate amount of care, despite meeting Medicare coverage criteria. In particular, people living with long-term and debilitating conditions find themselves facing significant access problems. For example, patients have been told Medicare will only cover one to five hours per week of home health aide services, or only one bath per week, or that they aren’t homebound (because they roam outside due to dementia), or that they must first decline before therapy can commence (or recommence). Consequently, these individuals and their families are struggling with too

Home Health Coverage & Jimmo v. Sebelius.

little care, or no care at all. Home health access problems have ebbed and flowed over the years, depending on the reigning payment mechanisms, systemic pressures, and misinformation about Medicare home health coverage. Regrettably, if recent policies and proposed rules are fully implemented, it appears these access problems will only get worse. To respond to this crisis, the Center is building a coalition to support a Home Health Access Initiative. This Initiative is working to oppose inappropriate restrictions on Medicare to open

More Information  When does Medicare cover home health care?

doors to Medicare-covered, necessary home care, but we  What services are covered? need your help. If you or someone you know  What if I attend religious has experienced home health services once a week; am I care access issues, submit the still considered story today. "homebound" for the In addition, it is important for purpose of Medicare beneficiaries and advocates to coverage? know what Medicare home health coverage should be under the law, especially for those with  The home health agency told me my aide services would long term, chronic, and be reduced. My doctor debilitating conditions. See our hasn’t given me this detailed information below, and download our Infographic, Fact information. What are my rights? Sheet, and Toolkit: Medicare ….Read More

Why are One out of 10 Social Security Offices Closing??? One out of 10 Social Security offices has closed since 2000. Seniors and politicians want to know why. The Social Security Administration plans to close its Arlington field office and one of its Baltimore locations in June, part of a series of shutdowns across the country that activists and political leaders say is causing major difficulties for the elderly, people with disabilities and other beneficiaries. The agency has closed about 125 of its approximately 1,250 offices since 2000 — a 10 percent reduction, part of what officials describe as a shift to greater use of online services in an era of budget constraints and a growing population of senior citizens. In addition, all 533 Social Security Administration “contact sites” — locations that serve remote, rural populations on a weekly or monthly basis — have closed, said leaders of the union that represents Social

Security employees. The most recent closures, which have not been publicly announced, come on the heels of the shutdown of offices in Milwaukee and Chicago in the past year, which elected officials also protested to no avail. An SSA spokeswoman attributed the Arlington closure to an expiring lease and an inability to find space nearby — an explanation that elected officials in Virginia dispute. “Closing the Arlington office is a shortsighted way to cut costs, and will inflict hardship on people least able to cope with it,” Rep. Don Beyer (D-Va.) said. He said he is asking the Social Security Administration’s inspector general to investigate whether the agency complied with requirements for public notice and community feedback

before field offices were shuttered. At a noisy rally Thursday under a hot noontime sun, about four dozen people — including Arlington County Board member Christian Dorsey (D) — protested the impending closure outside the office at 1401 Wilson Blvd., which is an easy walk from the Rosslyn Metro station. “I don’t have a car,” said Arlington resident Susan Landfield, 65. “I use public transit and it’s about two hours” to get to the next-nearest office, on Edsall Road in the Alexandria area of Fairfax County. Cecile Heatley, 75, warned Landfield that the commute may not be the worst of it. Heatley said she went to the Edsall Road office in 2014, after her husband died, and had to wait three hours

— standing the whole time because all the waiting room chairs were occupied. “I’m very, very upset that they are closing this office. It’s an imposition,” said the McLean resident. “That drive to Edsall is a long drive for me — I don’t drive that much anymore.” Social Security Administration spokeswoman Nicole Tiggemann said the General Services Administration, which handles federal office leases, has been “unable to find suitable replacement space” in Arlington and will have to close the office because of an expiring lease. The block where the office building is located is slated for redevelopment, but plans are on hold for the next two years, according to what the owners, Monday Properties, told the Arlington County Board a year ago. A spokeswoman for the company would not comment about its plans Friday….Read More

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

Big Pharma is poised to reap huge rewards from the GOP tax bill

Following the lead of big banks and other corporations, none of their tax savings are going to workers. Ever since Republicans passed the biggest overhaul of the United States tax code in over three decades, there have been a flurry of reports detailing just how much corporations and the ultra-wealthy will benefit from the GOP tax law. The Senate Finance Committee even held hearings last week on the initial impacts Tax Cuts and Jobs Act, with Democrat lawmakers raising fears the legislation is too skewed toward corporate America. Americans For Tax Fairness, a political advocacy group devoted to tax reform, released a report last week analyzing the tax bill’s effect on the pharmaceutical industry. Big Pharma stands to reap billions of dollars from the tax bill, and not a penny of that will “trickle down” to American workers, according to the report. Tax cut estimates have only been released for five of the ten largest pharmaceutical companies in the United States, but when it comes to those five, a savings of $6.3 billion dollars is potentially in their future. Pfizer predicts the company will receive a tax cut of over $1 billion in 2018 alone, for instance, and that it will pay a tax rate of just 17 percent — much lower than what many working families pay. AbbVie could pay just a 9 percent income tax rate this year. Its tax savings in 2018 could reach $1.3 billion. Merck will likely receive a tax

cut of over $2.7 billion in 2018, while increasing its stock buyback program by $10 billion. Only two companies in the “Pharma Big 10” — Pfizer and Merck — have announced any plans to share their tax savings with their existing employees in the form of bonuses, wage hikes, or an expansion of benefits. And the two companies chose the most common route among corporations profiting from the tax overhaul: a one-time bonus. Only two companies in the “Pharma Big 10” — Pfizer and Merck — have announced any plans to share their tax savings with their existing employees in the form of bonuses, wage hikes, or an expansion of benefits. And

are choosing to give their workers. Big Pharma CEOs, meanwhile, are making 94 to 452 times more than their typical worker, according to the report. This disparity between corporations’ tax savings and employees bonuses is reflected in other industries. A ThinkProgress analysis of a list of companies offering tax bill bonuses in January 2018 found that out of the $1 trillion dollars it costs to permanently lower the corporate tax rate to 21 percent, corporations were only spending .13 percent of that amount on bonuses for their workers. Like most other corporations, big pharmaceutical companies believe their tax savings are better spent on their shareholders. Five of the Pharma Big 10 — AbbVie, Amgen, Celgene, Merck and Pfizer — have announced increased stock buybacks since the tax bill was in the early stages of negotiations. Stock buybacks are an ineffective way to get wealth to middle-class workers, given that the rich own the most corporate the two companies chose the stock. While about half of U.S. most common route among adults own stock in any form, corporations profiting from the the wealthiest 10 percent of tax overhaul: a one-time bonus. households own 84 percent of One-time bonuses are a cheap shares and the top 1 percent way to ensure free positive owns more than 40 percent. publicity among the public and Corporations and big banks the company’s employees, but have also gone the buyback effectively do very little for route, with a majority of Fortune workers in the long run. 500 companies spending a total Bonuses also represent just a of roughly $238,244,348,330 in tiny portion of what the industry stock buybacks since GOP tax is expected to gain in tax bill was passed in December. savings. The one-time bonuses Overall, just 2 percent of doled out by Pfizer and Merck Americans have reported are worth a total of just $169 getting a raise or bonus as a million dollars — which means result of the tax bill, according the pharmaceutical industry’s to a Reuters/Ipsos survey estimated $6.3 billion in 2018 conducted a month after its tax cuts amounts to 37 times passage. more than what drug companies

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

Coalition for Equal Access (CC=A) As President of the Rhode Island Alliance for Retired Americans, along with the President of the Connecticut Alliance for Retired Americans, and as person with disabilities, I’ve been asked to participate and support an initiative CC=A is undertaking, I’ve also asked our Congressional members to participate in this CC=A imitative. I would like to introduce you to the Citizens Coalition for Equal Access (CC=A). The CC=A Mission Statement is to promote awareness and dignity of persons living with disabilities by removing physical and social barriers at all levels of society. CC=A Objectives  ¨ To improve understanding of the barriers faced by people living with disabilities.  To ensure that this improved understanding leads to action to remove barriers to educational, governmental, and social systems.  To ensure comprehensive, dignified, safe, and self-reliant access to both private and public buildings that provide services to the general public.  To achieve improvements in meeting the basic human needs of people living with disabilities.  To ensure inclusion of all people, including those with severe disabilities, in all aspects of society.  To help people living with disabilities to learn strategies that advance their cause, including the importance of voting. Universal Design and Infrastructure Investment

CC=A (Citizens Coalition for Equal Access) believes that the concept of Universal Design should be core to all building codes, policies and regulations, including those governing pedestrian rightsof-way, transit facilities, and any other projects related to the nation’s infrastructure. CC=A is concerned that no agency of the federal government charged with enforcement of the ADA has adopted as policy the 2011 US Access Board Guidelines for Pedestrian Rights-of-Way. Universal Design Universal Design is the design and composition of an environment so that it can be accessed, understood and used to the greatest extent possible by all people, regardless of their age, size or disability. This includes public places in the built environment such as buildings, streets or spaces that the public has access to; products and services provided in those places; and systems that are available including information and communications technology (ICT). (Disability Act, 2005) The Universal Design concept, originally developed with the disabled in mind, should be looked on as the norm unless, and with no possible alternatives, structural integrity is compromised. Global Universal Design Commission The Centre for Excellence in Universal Design (CEUD) was established by the National Disability Authority (NDA) in January 2007 under the Disability Act 2005. http:// , http:// gudc-action Infrastructure Investment The President and members of Congress have all spoken to the

urgency of using government funding to upgrade and reinvest in the nation’s infrastructure. All federal funding toward relevant infrastructure projects should be contingent upon use of the 2011 US Access Board Guidelines for Pedestrian Rightsof-Way: What is universal design… inclusive design…design for all? …a framework for the design of places, things, information, communication, and policy that focuses on the user, on the widest range of people operating in the widest range of situations without special or separate design. Or, more simply: HumanCentered design of everything with everyone in mind. UNIVERSAL DESIGN PRINCIPLES (Developed by a group of US designers and design educators from five organizations in 1997. Principles are copyrighted to the Center for Universal Design, the State University of North Carolina at Raleigh. The principles are in use internationally.) Equitable use: The design does not disadvantage any group. Flexibility in use: The design accommodates a wide range of individual preferences and abilities Simple, intuitive use: Use of the design is easy to understand, regardless of the user’s experience, knowledge, language skills, or current concentration level Perceptible information: The design communicates necessary information effectively to the user regardless of the user’s sensory abilities Tolerance for Error: The design minimizes hazards and the adverse consequences of accidental or unintended actions. Low physical effort: The

design can be used efficiently and comfortably, with a minimum of fatigue Size and Space for Approach & Use: Appr opr iate size and space is provided for approach, reach, manipulation, and use, regardless of the user’s body size, posture, or mobility What is the relationship between Universal Design and legally mandated accessibility such as the ADA? Legally mandated requirements for accessible design provide a vital basis for autonomy and equal opportunity for people with disabilities. To be effective, legal mandates require an infrastructure of information and enforcement in order to ensure meaningful compliance. The legal mandates establish a set of MINIMUM standards for SOME built, information, and communication environments, and they address the needs of people with SOME types of functional limitations, particularly people in wheelchairs and blind people.In contrast, Universal Design principles are aimed at MAXIMUM accessibility in ALL environments for ALL people. Accessibility laws and state codes are a limited indicator of the potential of design to facilitate independence, participation, and wellbeing for a growing proportion of people. In a world in which we live 30 years longer than people did 100 years ago and survive illness and injury at record rates, most of us will experience at least periods of functional limitation in the course of our lives. It is not about “special” any more. Universal or inclusive or human -centered design starts with accessible design and calls for a more creative and imaginative education and engagement of designers to design places, products, and technology that will work seamlessly for the widest possible group of potential users. To succeed, we must reframe an agenda for inclusion and embed this vision of universal design into public policy at every level.

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

RI ARA HealthLink Wellness News


Study: Many Adults Ages 65 to 80 Continue to Be Sexually Active FORTY PERCENT OF ADULTS aged 65 to 80 are sexually active, and more than half, 54 percent, say sex is important to their quality of life. RELATED CONTENT According to the National Poll On Healthy Aging by the University of Michigan, romantic relationships and sex are important even later in life. Sixty-five percent of people in this age group describe themselves as still being interested in sex. "While sex is an integral part of the lives of many older adults, this topic remains understudied and infrequently discussed," the

study states. The study, published Thursday, asked 1,002 adults aged 65 to 80 a variety of questions regarding relationship status, interest in sex and level of sexual activity. Sixty-six percent of respondents were married or partnered, 15 percent were divorced or separated, 12 percent were widowed and 7 percent had never married. Fifty-four percent of those in a romantic relationship reported they were currently sexually active. Seven percent of single respondents reported the same. Overall, 74 percent of respondents said sex is an important aspect of a romantic relationship at any age, according to the study.

An increase in age led to a decrease in sexual activity. Forty-six percent of 65- to 70year-olds reported being sexually active, compared to 39 percent of 71- to 75-year-olds and 25 percent of 76- to 80-yearolds. Men were more likely to be sexually active than women: 51 percent versus 31 percent. Almost three-quarters, 73 percent, reported being satisfied with their sex life. Men were also more likely to report they were interested in sex. Fifty percent of men reported being extremely or very interested in sex, compared to 12 percent of women. A divide existed among people with different health statuses. Those who reported their

health was excellent, very good or good were more likely to be sexually active than those who reported their health was fair or poor – 45 percent versus 22 percent. If a problem concerning sexual health arose, 62 percent of respondents said they would speak with their health care provider about it. Thirty-six percent said they would discuss the issue with their spouse or partner, 17 percent said they wouldn't discuss the problem with anyone, and 10 percent said they would talk about it to a family member or friend. ….Read More

Depression May Dampen Memory Depression may do more than darken your mood, with new research suggesting it might also sap your memory. "Since symptoms of depression can be treated, it may be possible that treatment may also reduce thinking and memory problems," said study author Adina Zeki Al Hazzouri, from the University of Miami's Miller School of Medicine. The scientists also found that the brain structure of seniors with more severe symptoms of depression differed from those without depression.

The study included more than 1,100 people, average age 71, with no history of stroke. They underwent brain scans, a mental health assessment, and took memory and thinking skills tests at the start of the study. Their memory and thinking skills were tested again roughly five years later. At the start of the study, 22 percent of the participants had greater symptoms of depression, and they scored lower on tests of episodic memory, which is the ability to remember specific experiences and events. But the

study did not prove that depression actually caused memory problems. Those with greater symptoms of depression also had smaller brain volume and were 55 percent more likely to have small vascular lesions in the brain. There was no evidence of a link seen between greater symptoms of depression and changes in thinking skills over five years. The study was published online May 9 in the journal Neurology. "With as many as 25 percent

of older adults experiencing symptoms of depression, it's important to better understand the relationship between depression and memory problems," Zeki Al Hazzouri noted in a journal news release. More information Mental Health America has more on depression and older adults..

New dementia risk factors uncovered Using a large and comprehensive database, researchers unearth new combinations of factors that increase the risk of dementia later in life. The findings could help clinicians to spot at-risk people. Advanced statistical methods

give new insight into dementia risk factors. Dementia is a growing concern. Because the population is aging and living longer lives is starting to become the norm, the race to understand why dementia occurs is on. Worldwide, dementia is the leading cause of disability and dependence in older adults.

In the United States, 5.7 million people are living with Alzheimer's, which is the most common form of dementia. By 2050, this figure is predicted to rise to 14 million. Using a large and comprehensive database, researchers unearth new combinations of factors that increase the risk of dementia

later in life. The findings could help clinicians to spot at-risk people. Dementia is a growing concern. Because the population is aging and living longer lives is starting to become the norm, the race to understand why dementia occurs is on….Read More

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

Things you didn’t know about stroke that may save a life help save a life.  F.A.S.T. is an acronym used to teach the most common warning signs and sudden symptoms of stroke. F.A.S.T. stands for (F) face drooping, (A) arm weakness, (S) speech difficulty, (T) time to call 9-1-1. Less than half of the population is aware of the signs.  Stroke symptoms can also include sudden numbness, sudden trouble seeing in one or both eyes, sudden severe headache with no known cause and sudden trouble walking.  Calling 9-1-1 and arriving at the hospital in an ambulance is the fastest way to get treated quickly during a stroke emergency. Driving to the hospital is a common mistake people make, that can result in longer wait times before the patient receives medical care.  Patients who have an ischemic stroke, may have a treatment window for mechanical clot removal within six hours to up to 24 hours in certain patients with clots in large vessels.  Alteplase (also known as tPA) is a drug used to dissolve a blood clot that causes stroke. Stroke patients who arrive at a hospital within 90 minutes of

symptom onset and qualify to receive tPA are almost 3 times more likely to recover with little or no disability.  TeleStroke is videoconferencing, similar to Facetime and Skype, connecting patients with neurological experts separated by distance. TeleStroke Units are increasing access to acute stroke care in rural areas and improving patient outcomes.  Having a stroke increases the risk of a second one (1 in 4 survivors have another stroke). Prevention is crucial because second strokes can be more debilitating than first strokes.  In some ischemic stroke cases, the cause is unknown (cryptogenic stroke). It’s a challenge to prevent a second stroke, when the cause of the first one is unknown. The patient should work with their healthcare team to find the root cause.  Stroke survivors stopping their aspirin regimen can up their risk of having another stroke, possibly due to increased clotting levels from the loss of aspirin’s bloodthinning effects. Following an aspirin regimen can help prevent stroke in some survivors.  First-ever ASA

rehabilitation guidelines call for intensive, team approach. For the first three months after a stroke, the brain is ready to learn. This ability for our brains to adjust is known as May is American Stroke neuroplasticity and it plays a Month and the American Stroke crucial role in recovery. Association’s 20th anniversary  Get With The Guidelines®Stroke is a leading cause Stroke is an inof preventable death, but lack hospital program that of awareness - even among promotes adherence to the vulnerable older people, latest scientific guidelines to education and resources are improve quality of stroke care. major barriers to stopping it. The program has expanded During May, American Stroke from 24 hospitals in 2003 to Month, the American Stroke more than 2,000 hospitals toAssociation, the world’s leading date. voluntary organization devoted  In the Stroke Belt, an 11to saving people from stroke, state region in southeast U.S., reveals 20 important things you the risk of stroke is 34 probably didn’t know about percent higher for the general stroke, in recognition of its population. 20th Anniversary:  More strokes are happening  There are different types to people in their 30s and 40s. of strokes: ischemic,  High blood pressure is the hemorrhagic and transient most ischemic attack (TIA). An common controllable cause ischemic stroke is a clotof stroke. caused blockage in an artery Recent guidelines redefined to the brain, while a high blood pressure as a hemorrhagic stroke occurs reading of 130/80 mm Hg or when an artery ruptures in the higher. A normal reading brain. A TIA or “mini stroke” would be any blood pressure is caused by a temporary below 120/80 mm Hg and blockage. Eighty-seven above 90/60 mm Hg in an percent of all strokes are adult. ischemic.  Nearly half of all adults in the  During a stroke, nearly 120 U.S. (an estimated 103 million brain cells die every million) have high blood hour. Compared with the pressure. normal rate of cell loss in  Other stroke risk factors: brain aging, the brain ages (See chart below of high blood pressure numbers for this news report.) obesity, diabetes, 3.6 years each hour cholesterol, smoking without treatment. and family history. The sooner the  Eighty percent of patient gets medical strokes are care, the better their preventable. Eating chances of recovery. healthfully, being  3About 66 percent of physically active and the time, someone controlling risk other than the patient factors are important makes the decision to lifestyle changes that seek treatment – can help prevent and recognizing the beat it. warning signs and sudden symptoms of stroke to receive treatment fast, could Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

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RI ARA May 13, 2018 E-Newsletter Happy Mothers Day


RI ARA May 13, 2018 E-Newsletter Happy Mothers Day

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