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Comment Letter on Ways and Means Committee Request Around Rural Health Care In October 2023, AGS submitted recommendations in response to a request from the House Committee on Ways and Means on a legislative framework for improving access to health care in rural and underserved areas (Smith, 2023). Re: Medicare and Medicaid Programs; CY 2024 payment policies under the Physician Fee Schedule and other changes to PartBpayment and coverage policies; Medicare Shared Savings Program requirements; Medicare Advantage; Medicare and Medicaid provider and supplier enrollment policies; basic health program(CMS-1784-P)[Letter]. https://www.americangeriatrics.org/sites/default/files/inline-files/AGS%20Comment%20CY%202024%20MPFS%20and%20QPP%20Proposed%20Rule%20FINAL%20%289%2011%2023%29.pdf American Geriatrics Society. U.S. House of Representatives Committee on Ways and Means. https://waysandmeans.house.gov/wp-content/uploads/2023/09/WM-Rural-Health-Care-RFI.pdf Disclosure: The author has disclosed no potential conflicts of interest, financial or otherwise.

Themes of the first conference included underlying contributors to resilience, the dynamic nature of resilience throughout the life span, and the role of resilience in health equity. The first conference led to multiple recommendations, including new longitudinal studies of the impact of exposures to stressors on resilience in older adults, preclinical models for resilience research, translational research to bring findings on resilience to patient care, and others. The most wonderful thing about these conferences for me is participating in round table discussions and mentoring breakfasts with future scholars who will carry this research forward (and perhaps at times return to their own earlier iterations of life to find their fire)—rising stars across all disciplines, junior faculty, and clinicians interacting with more senior researchers and NIH staff—all filled with passion for this work.

Given that >88% of older people use at least one prescription and >66% use three or more prescriptions in any given month (National Center for Health Statistics, 2019), I believe the AGS Beers Criteria® is a vital resource for clinicians and older adults as they develop individualized treatment plans. A modified version of the AGS Beers Criteria® had already been adopted as a quality metric by the Centers for Medicare & Medicaid Services (CMS) when AGS took over stewardship of the list following Mark's death in 2009. Advance online publication. https://doi.org/10.1111/jgs.18372 PMID: 37139824 National Center for Health Statistics(US).

AGS appreciates the comprehensive, global approach that the WFG Task Force took when drafting this new set of recommendations (Montero-Odasso et al., 2022) and the global perspective it offers. Exercise Interventions People at low fall risk should be counseled on physical activity, encouraged to have a daily activity goal, and referred to local community health promotion programs where available. Table A Considerations from the American Geriatrics Society (AGS) Expert Panel for Implementation of the World Falls Guidelines (WFG) in the United States Summary of WFG Recommendation AGS Response Considerations for Implementation in the United States Cognition and Falls Assessment of cognition, especially of executive function, should be included as part of a multifactorial fall risk assessment in older adults at high risk of falls. Include an evaluation of concern about falling in a multi-factorial falls risk assessment of older adults.

The first is a four-part series called Living with Dementia, and the other is an ECHO® series on caring for persons with dementia and their caregivers for primary care physicians and health care professionals. In terms of efficacy for MCI and mild AD, respectively, differences of 0.98 and 1.63 points for CDR-SB are considered minimally clinically important differences (MCID) (Andrews et al., 2019). [...]the between-group difference of 0.45 does not meet MCID (Liu et al., 2021). Inform Black people about the lack of specific meaningful data and what that means for them. Because risk and progression of AD may be influenced by ancestry and social determinants of health, there is insufficient data to inform how a Black person will do if prescribed this drug. Discuss How Lecanemab is Administered and the Need for Ongoing Monitoring Alert patients that biweekly infusions (approximately 1 hour in length) will be needed (Eisai Inc. & Biogen, 2023) and tell them where they will receive treatment (e.g., provider's office, health care center, another location).

May 7–8), is the place to be for geriatrics professionals, including nurses, physicians, pharmacists, physician associates, social workers, health care administrators, and other health-related professionals from different settings, to convene and participate in the state-of-the-art educational sessions and ground-breaking research presentations that the AGS is known for. Below are just a few highlights from #AGS24's program schedule that you won't want to miss (note all times are Eastern Standard Time): AGS CoCare®: HELP (Hospital Elder Life Program) Pre-Conference Session (5/7; 10:00 a.m.–3:30 p.m.) (additional fee session)—The AGS CoCare®: HELP program, formerly known as The Hospital Elder Life Program, originally created by Dr. Sharon Inouye, is a well-studied, effective, and innovative model of hospital care designed to prevent delirium and functional decline. Preoperative Management of Older Adults Undergoing Noncardiac Surgery (5/9; 1:15–2:15 p.m.)— Despite advances in surgery and anesthesiology, older adults remain at increased risk for postoperative complications, which in turn contribute to increased length of stay, functional decline, reduced quality of life, and increased cost. Session topics include opportunities to integrate brief discussion of nutrition and dietary choices into clinical practice; validated tools to assess and guide intervention for nutrition, malnutrition, and food insecurity; strategies and available resources to support healthier food choices and improve access to nutritious foods, particularly in lower socioeconomic status areas, while also addressing the needs of older adults with food insecurity; and social media and web-based approaches to engage older adults in healthy eating.

Areas of particular interest include the burden of anticholinergic drugs, dementia, the practice of deprescribing, and adverse drug reactions. From my perspective, what is likely to matter most to people living with AD, their families, and other care partners is whether a proposed new treatment provides clear clinical benefits to cognitive and functional performance and other key outcomes that improve their quality of life and align with their goals and priorities. (2023) provide more evidence and guidance on this issue by proposing a model for assessing clinical benefit in AD and dementia studies by incorporating clinically meaningful and relevant data, including patient and caregiver perspectives.

In a classic longitudinal experiment, The Harvard Study of Adult Development followed 724 men beginning in 1938 when they were only teenagers, and the most crucial factor in happiness and cognitive health was close relationships with spouses, family, friends, and within social circles (Solan, 2017). In another study of women and men who volunteer, when factoring in age, a positive association between volunteering and mental health and emotional well-being became apparent around age 40 years and continued well past age 80 years (Tabassum et al., 2016). The report made several recommendations we as nurses and other health care team members can implement, including strengthening ties between the health care system and community-based resources. [...]please take the time to read the feature articles in this month's issue of the Journal of Gerontological Nursing (JGN), many of which address what matters and connecting with older adults, including an article on connecting caregivers to services and support online (Gaugler et al., 2023) and the impact of COVID-19 on relationships (Doyle et al., 2023).

[...]I was delighted when I learned that the American Geriatrics Society (AGS) was going to begin managing the Hospital Elder Life Program (HELP) in 2019 given the Society's strong track record of creating and diffusing educational products and clinical tools. HELP has been clinically studied and proven to reduce delirium, prevent functional disease, improve the overall quality of hospital care and satisfaction for older patients, and provide cost-effective care with reduced overall hospital costs (Inouye et al., 2000; Inouye et al., 1999; Leslie et al., 2005; Rizzo et al., 2001; Rubin et al., 2018; Rubin et al., 2006). AGS launched AGS CoCare®: HELP just as the coronavirus disease 2019 pandemic was starting and was quickly able to pivot its support for health systems, implementing the program to our new virtual reality. Because of this, programs were able to brainstorm how to modify HELP so it could still be offered during the pandemic, and we were also able to continue learning together as a community.

Purpose: To explore family care partners' (FCPs) experiences with delirium superimposed on dementia (DSD) and identify their needs and preferences for education, support, and resources. Method: A qualitative descriptive design was used. Data from 16 FCPs were collected using demographic surveys and semi-structured interviews, which were conducted via telephone and/or Zoom video conference. Thematic analysis identified key patterns and themes. Results: Five key themes were identified: (1) Caught Off Guard: Emotional Strain and Sudden Shifts in DSD; (2) No Two Days the Same: Adapting to the Shifting Demands of DSD Care; (3) Bridging the Gaps: Navigating Support, Advocacy, and Communication in DSD Care; (4) Stabilizing Strategies: Reassuring Presence, Comfort, and Mobility in DSD Care; and (5) Wanting to Help, Not Knowing How. Conclusion: Findings emphasize the need to educate and support FCPs through clinician-led training and community resources to improve caregiving confidence, effectiveness, and dyadic well-being.