Many nursing communities seek to comfort and ease residents with dementia by maintaining the illusion that they are in a familiar place, such as their childhood home, with props and simulations, reports the New Yorker . Such practices are endorsed by people like senior-care administrator Barry B. Zeltzer. "I believe that deep down, they know that it is better to lie," he wrote in the American Journal of Alzheimer's Disease & Other Dementias . "Once the caregiver masters the art of being a good liar and understands that the act of being dishonest is an ethical way of being, he or she can control the person's behaviors in a way that promotes security and peace of mind." Although loved ones and caregivers often lie, many of them are uncomfortable with it. To mitigate this "deception guilt," lying in dementia care has been assigned euphemisms such as "therapeutic fibbing," "brief reassurances," or "stepping into their reality." The earlier practice of reality orientation, in which people with dementia are constantly reminded of their actual situation, is losing adherents. However, ethical lying comes with its own complications, as noted by author Sissela Bok. "You need to be very careful," she advises. "What other kinds of harm might there be in lying? The most important effect is on yourself."

AARP has hired former ad executive Cindy Gallop to lead a campaign to counter the stereotypical portrayal of seniors in U.S. media and advertising, reports the Wall Street Journal . The group aims to reduce ageist-based discrimination that older Americans could face particularly in the workforce. "If you look at stock photos that are used to show the 50 plus, they tend to look confused or are shown as not being able to do something," notes AARP's Karen Chong. She says such images and messaging "reinforce the stereotypes." At the 13th annual Advertising Week event, Gallop will participate in a panel stressing that the ad industry must make a better effort to portray older Americans accurately. Gallop notes ageism is rampant in the workforce, and the U.S. economy "is failing to benefit from the commitment, experience, skills, creativity, and influence of older workers" because they are dismissed and discriminated against. On her agenda is putting pressure on ad agencies to hire more older adults. "When you have older people creating, producing, and approving ads, the problem of ageism is easily solved," Gallop argues. AARP was drawn to Gallop because she operates a startup called MakeLoveNotPorn at the age of 58.

The prolonged lack of overseers for Social Security and Medicare is a dire situation, with Washington insiders saying such advisers help keep annual financial reports sound and unbiased, reports the Associated Press . Public trustees are typically economists or retirement experts, and this year's assessment of Social Security and Medicare found both programs to be ailing. The insolvency date for Medicare's inpatient trust fund moved three years closer, to 2026, while Social Security's insolvency forecast still stands at 2034. However, for the first time in nearly four decades, the cost of the retirement program is projected to top its annual income in 2018, meaning reserves will be tapped to cover benefits. Former Health Secretary Mike Leavitt says the absence of public trustees signals deeper problems with senior programs that Americans are refusing to confront. He notes public trustees fulfill "a piercing and profound purpose" as "knowledgeable private citizens empowered with information to make a declaration to their fellow citizens." Lacking public trustees, Social Security and Medicare officials are reluctant to rethink their assumptions underlying financial estimates, and this means the estimates can get out-of-date, according to former Medicare official Rick Foster. "The closer we get to the cliff with these two programs, the more critical these positions and the integrity of the process become," warns economist Robert Reischauer.

A study published in the International Journal of Geriatric Psychiatry has found arthritis to be more prevalent in older U.S. adults with depression, reports Personnel Today . The investigators examined the physical and mental health of 4,792 people aged 50 or older, 43.7 percent of whom had been formally diagnosed with arthritis. Arthritis rates were lowest in participants with no depression, with only 38.2 percent having received an arthritis diagnosis. Meanwhile, arthritis was diagnosed in 55 percent of those claiming to have "minor" depression, 62.9 percent of those with "moderate" depression, and 67.8 percent reporting "severe" depression. Suggested reasons for the link between arthritis and depression include the likelihood of arthritis being a disabling condition, higher probability of people with arthritis worrying about potential treatment and rehabilitation outcomes, poor coping strategies and reduced physical activity, and a "common biological mechanism" such as a neuroimmune issue, causing inflammation that compounds arthritic symptoms. "Notably, there were significant associations between moderate depression and arthritis, even after adjusting for age, gender, race, education, smoking status, binge drinking, sedentary behavior, obesity, diabetes, hypertension, and heart disease," the researchers concluded. "These findings suggest that moderate depression and arthritis tend to co-occur among older adults, independent of other factors that are known contributors to both depression and arthritis."

A study from the Centers for Disease Control and Prevention (CDC) published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association predicts the prevalence of Alzheimer's disease and related dementias in Black and Hispanic Americans will rise higher than in any other ethnic group between now and 2060, reports MD Magazine . It is thus critical to consider the growing minority groups with dementia when developing and implementing statewide and national plans to prevent and treat the disease. The CDC estimates were based on Medicaid Fee-for-Service data from 2014 and population prediction data from the U.S. Census Bureau. The Medicaid data included about 28 million beneficiaries 65 or older in 2014, comprising some 60 percent of adults in the U.S. who are 65 or older. More than 3.2 million beneficiaries had been diagnosed with Alzheimer's and related dementias in 2014, while that same year, 1.6 percent of the American population was diagnosed with Alzheimer's disease and related dementias; by 2060 this percentage will rise to 3.3 percent, with 13.9 million Americans affected. Although non-Hispanic whites will still have the most cases of Alzheimer's and related dementias, cases among Blacks and Hispanics are expected to experience the largest increase due to population growth. "Culturally competent care for these groups will be of paramount importance," the researchers note. "Thus, our findings highlight the need to monitor and evaluate minority populations to ensure materials and evaluations are culturally sensitive and to define the needs of a diverse group of caregivers and persons with dementia."

Two studies seek to prevent Alzheimer's via treatments that target early brain changes early on when memory and thinking skills are still unaffected, reports the Associated Press . "If we really want to come up with therapies that will modify the disease, we need to start very, very, very early," says the National Institute on Aging's Eliezer Masliah. The studies will attempt to impede the earliest steps of plaque formation in asymptomatic people who are at higher risk for dementia due to age and possession of the APOE4 gene. Participants must join GeneMatch, a confidential registry of people who want to volunteer for various Alzheimer's studies, are aged 55 to 75 years old, and have not been diagnosed with any cognitive decline. To be eligible, applicants must agree to learn their APOE4 status and have at least one copy of the gene. Participants undergo periodic brain scans and memory and thinking tests every six months, then receive experimental drugs or placebos for several years. One study is enrolling people with two copies of APOE4, who are either administered shots of a drug every few months to help the immune system clear plaque from the brain, daily pills of a medication to prevent initial steps of plaque formation, or placebos. For the other study, participants either must have two copies of APOE4 or one copy of the gene plus evidence on brain scans of plaque accrual, and they get one of two doses of the drug to prevent plaque formation or placebos.

Clover Health's annual Flu Shot Monitor survey found 63 percent of Americans older than 60 intend to get a flu shot this season, reports Becker's Hospital Review . The poll also learned that 35 percent of seniors did not get a flu shot in the 2017-18 season, and 8 percent of those who caught the flu last year have no plans of getting vaccinated this year. Of those, 43 percent are worried the shot will make them sick, 35 percent doubt flu shots are effective, 35 percent consider the shot unnecessary, and 22 percent do not like shots. About 64 percent of Caucasian respondents plan on getting a flu shot, versus 56 percent of nonwhite respondents. Meanwhile, about 74 percent of seniors with a household income of $75,000 or more plan on getting a shot, followed by 65 percent from a household earning $35,000 to $74,000 and 54 percent who earn less than $35,000. Furthermore, about 60 percent of seniors lacking an undergraduate degree plan on getting the vaccine, compared to 70 percent of respondents who graduated from college. Finally, respondents 80 years old and over are most likely to get a flu shot this year. "It's concerning to see that so many people in this at-risk demographic do not intend to get vaccinated," notes Clover Health's Kumar Dharmarajan. "Not only are these older adults putting themselves at risk, but also their friends and family members."

As part of a large appropriations bill, Congress has allocated $300,000 to establish the first U.S. family caregiving advisory council, with the measure slated to go to President Trump this week, reports the Minneapolis Star Tribune . The advisory council is key to deploying the bipartisan RAISE Family Caregivers Act to address the growing burden on families and businesses as the population ages. AARP estimates that informal caregivers contribute an estimated $470 million in unpaid care for America's older adults annually. The RAISE Act urges the Department of Health and Human Services to propose an initial strategy to Congress within 18 months. Sen. Tammy Baldwin (D-Wis.) notes implementation has been sluggish, and she lauds the "critical funding" needed to take the next step. The council will convene informal caregivers and older adults along with employers, healthcare providers, senior housing representatives, community leaders, nonprofits, and all levels of government. Its objective is to address a wide scope of social, cultural, and policy solutions. The American economy loses $33.6 billion each year in productivity as working caregivers help out their loved ones. The physical and mental toll correlates with higher healthcare costs for caregivers, even as their work has been shown to save taxpayers money by preventing or delaying costs of care paid by ­Medicare and Medicaid.

A new study from the Centers for Disease Control and Prevention (CDC) published in the Morbidity and Mortality Weekly Report estimated that flu vaccination rates among healthcare professionals (HCPs) have stagnated at about 74 percent since 2014, reports Medscape . The rate was particularly low among those working in long-term care settings and settings where vaccination was not required, promoted, or offered on-site. Vaccination rates were highest in workplaces with vaccination requirements, and they can be improved by offering worksite vaccination at low or no cost for one day or by actively promoting vaccination. "Influenza vaccination coverage among healthcare personnel working in long-term care settings ... continues to be consistently lower than that among healthcare personnel working in all other healthcare settings," the authors write. "Influenza vaccination among healthcare personnel in long-term care settings is especially important because influenza vaccine efficacy is generally lowest among seniors, who are at increased risk for severe disease." The researchers suggest deploying workplace vaccination programs that have been successful in increasing coverage in hospital settings, such as vaccination requirements. They also believe use of the CDC's digital campaign and long-term care employers' toolkits could boost influenza vaccine coverage among HCPs.

State and national studies indicate that later-in-life marriages and older people living as couples are becoming more common, reports the Associated Press . Pennsylvania's Department of Health estimated that although marriages in the state decreased slightly over 15 years, the number of people 50 and older who got married rose more than 60 percent in that time period. In Westmoreland County, 1,763 couples got married in 2017, including 201 women and 273 men 50 and older. Allegheny County marriages increased from 6,003 in 2002 to 6,699 in 2017, while the number of women older than 50 who married nearly doubled over that span, from 343 to 636, and the number of men gained more than 60 percent, from 508 to 822. Moreover, studies in 2014 found remarriage was on the rise for Americans 55 and older, and the number of older adults living with an unmarried partner is growing. The Pew Research Center calculated that about two-thirds of previously-married people between 55 and 64 had remarried in 2013, up from 55 percent in 1960. In addition, one-half of people 65 and older had remarried in 2013, versus one-third in 1960. Researchers think a rise in life expectancy may contribute to older adults seeking fulfillment in their senior years.