Home-based care advocates say they are confident measures outlined in President Joe Biden's now-stalled Build Back Better Act will move forward in some form.

The legislation aims to expand access to services to older adults and people with disabilities, as well as boosting pay for workers who provide home-based care. Currently, more than 3.5 million people rely on Medicaid's Home and Community Based Services (HCBS).

Connie Garner, national policy director for Easterseals, explained demand for home care has outpaced resources, and as a result, more older adults end up in nurse homes.

"That costs more money, that causes more isolation, and that's not what we should have in this country," Garner asserted. "We should have the ability to have people be able to be taken care of correctly at home. And we have to be able to pay and support the providers of that care. They become an essential member of that family."

According to the research firm Paraprofessional Healthcare Institute, more than two million home care workers earn around $16,000 per year, and one in six live below the federal poverty line.

A report by the ICA group found West Virginia is facing a troubling home-caregiver shortage with one caregiver available for roughly every 11 clients.

In Washington, lawmakers say portions of the Build Back Better Act will likely pass this year, but it remains unclear whether the $150 billion earmarked for Medicaid HCBS will remain intact.

According to the Kaiser Family Foundation, in 2020 more than 2.5 million people nationwide received Home and Community Based Services, with hundreds of thousands more on wait lists.

Amber Christ, director of health policy and advocacy for Justice in Aging, said families are forced to make tough choices.

"From an older adult perspective, this lack of investment in home and community-based services in effect pushes older adult into nursing facilities unnecessarily," Christ contended.

A survey by AARP found 76% of Americans age 50 and older say they prefer to remain in their current residence as long as possible, but just 46% anticipate they will be able to stay in their current home.

Monday is the start of Arizona's new legislative session. Advocacy groups such as AARP Arizona are gearing up and say they're ready to work to ensure older Arizonans have the quality of life they deserve.

Brendon Blake, director of advocacy at AARP Arizona, said one of its priorities is a bill sponsored by state Rep. Quang Nguyen, R-Prescott Valley, which would allow family members to install a camera in their loved one's room at a long-term care facility.

Blake said they're eager to get to work with lawmakers, regardless of political party.

"It is meeting new faces, it is getting to have a relationship with members on both sides of the aisle and both chambers, so that way they know what we're all about," he said. "And I would say that is our biggest hurdle, is just getting to an introduction."

Blake said AARP Arizona also sits on the Vulnerable Adult System Study Committee, which will be meeting throughout the year to prepare legislation for 2026 to protect vulnerable adults. He suggested that all Arizonans learn about the legislative process and get involved.

Scammers stole close to $500 million worth of cryptocurrency last year. Blake said cryptocurrency scams are a growing issue in Arizona and around the country, but added that AARP Arizona will work to prevent them by educating folks on the risks of using cryptocurrency ATMs.

"People are putting their money, and in some cases their life savings, into a cryptocurrency ATM," he said, "and that is one thing that was brought to our attention that our national office has gotten behind us on, that we are hoping to work on as well - at the very least, educate legislators on this."

In 2023, the FBI's Internet Crime Complaint Center received more than 69,000 complaints from the public about financial fraud related to cryptocurrency.

Blake said people shouldn't be shy about reaching out to their legislators. He said many times lawmakers are more receptive to constituents than to advocates such as himself.

"Because they see me as someone who is getting paid to do this," he said, "and they see you as somebody who could impact their next election, especially in some of these really swing districts."

With 2025 almost here, Connecticut organizations are preparing for the next legislative session.

The 2025 session will not be as short as the one in 2024 and after some committee shortcomings, there is growing hope more legislation will be passed to help the state's older residents. AARP Connecticut said it will target topics like predatory lending, making utilities more affordable and improving nursing home care.

Nora Duncan, state director of AARP Connecticut, said they want to focus on 'pocketbook issues.'

"We need to fight for the priorities that can impact the most amount of people to help reduce their cost of living to make Connecticut a great place for people to live, age and retire," Duncan contended.

The latest ALICE update found salaries for most Connecticut jobs do not pay enough for monthly expenses like rent and utilities. ALICE stands for "Asset Limited, Income Constrained and Employed," referring to those who are working but still cannot cover their bills.

Electric utility Eversource has announced a 24% rate increase starting in 2025. Federal data show Connecticut has some of the highest energy costs in the country.

As important as cost-saving priorities are to residents, there could be challenges to achieving them. Some of them are political but Duncan acknowledged there will be many others.

"When there's a budgetary impact, the challenge is always what are the priorities of the General Assembly and other advocacy groups? What are the challenges to the state budget?" Duncan explained. "I know this year there'll be a lot of conversation around the fiscal guardrails."

New studies show some of the budget's fiscal guardrails are twice as restrictive as they are meant to be. A Connecticut Voices for Children report concluded the state's volatility cap is not using reasonable metrics, which has led to at least $755 million per year in revenue being restricted, or more than $5 billion between 2018 and 2024.

As winter sets in for Pennsylvania, it is crucial to be cautious of fall hazards, especially for seniors.

The Centers for Disease Control and Prevention reported in one recent year, more than 616,000 older adults took a fall in Pennsylvania.

Gwen Bergen, Safety Promotion Team leader at the CDC, said falls and motor vehicle crashes are the two leading causes of injury and death among seniors. She suggested getting an eye exam and doing strength-building exercises to improve balance and prevent injuries.

"It's very important to get annual vision checks, and make sure that your vision is good, you're wearing the best glasses for each activity you're doing," Bergen recommended. "Vision is very important in allowing you to drive safely and in preventing falls."

Bergen advised consulting with a health care provider about potential side effects of medications, which can affect balance or driving ability. There may be alternatives or adjustments to minimize risks.

Bergen added during the winter months, some older adults may feel especially isolated or disconnected from family or friends. She acknowledged it takes a little more effort to stay engaged when the weather is not cooperating but there are hobbies, classes and physical activities available in every community.

"Visit community areas near you such as parks, places of worship and senior centers, which all give you opportunities to connect with other people," Bergen emphasized. "You can also engage in new activities and hobbies with others. Some of these might include cooking and baking, sports or crafts."

She added it is important for seniors to maintain regular, in-person interactions and when it is not possible, phone calls or video chats are good options.