- [Announcer] "ncIMPACT" is a PBS North Carolina production in association with the University of North Carolina School of Government.

Funding for "ncIMPACT" is made possible by.

- [Narrator] Changing the course of people's lives, that's the impact UNC Health and the UNC School of Medicine work to deliver every day.

Our 40,000 team members across the state of North Carolina are committed to caring for you, our patients and communities, as well as educating the next generation of healthcare professionals.

Individually, we can do a little, but collectively, we can do a lot to create impact.

[gentle music] - A crisis related to aging looms as a senior population in our state soars.

We'll explore communities coming together to reinvent senior care.

This is "ncIMPACT."

[upbeat music] Welcome to "ncIMPACT."

I'm Anita Brown-Graham.

Across America, families are facing a growing challenge, caring for loved ones with dementia.

Many families find themselves unprepared for bearing the weight of care.

We visit New Hanover County where an innovative program is offering hope and support to caregivers.

[gentle music] - Millions of Americans are living with Alzheimer's and with a generation of Baby Boom seniors coming up, that number is only expected to rise.

So who will take care of these seniors?

Well, in most cases, it's not the healthcare system or trained professionals.

It's family members, unpaid family members.

In North Carolina alone, it took over 360,000 family members to provide care for their loved ones with dementia.

And if we had to put a price tag on that unpaid family labor, it would exceed a staggering $10 billion.

So why are families dealing with this enormous burden and what's being done to help them?

I'm David Hurst.

This is "ncIMPACT."

[upbeat music] For many families, the journey into dementia care begins with uncertainty, a series of small moments that hint at something bigger.

For Mark Wilde-Ramsing, watching his wife Dina's memory gradually slip away would become an 11-year journey.

During the last five years, caring for Dina would be Mark's full-time job.

- It's a daunting task when you're coming into it and you don't know what you're doing.

- [David] Mark's story is becoming increasingly common across America.

Today, nearly 7 million Americans are living with Alzheimer's, and by 2050, that number is expected to double.

So who steps in to provide care for this growing population?

Well, it'll likely be family members, like Mark.

The challenge of caregiving is that it is 24/7.

You're always on call.

- [David] In fact, for those with dementia, 83% of care in the United States is provided by unpaid family members.

That's parents and children taking on rules they never expected.

[dramatic music] But how did we get here?

You see, our system for long-term care hasn't really changed much since Medicare and Medicaid began in 1965.

But America has changed dramatically.

Baby Boomers are now reaching retirement age, creating the largest elderly population in our nation's history, and they're living longer.

Our current system just isn't built for this reality.

Insurance costs are skyrocketing.

There's a shortage of care workers.

And assisted living facilities?

They're becoming too expensive for most middle class families.

The result is a patchwork of services that leaves most families struggling to find and afford the care they need.

Caring for someone with dementia can feel like navigating unchartered waters.

That's where the Caregiver Academy steps in.

The Academy serves the one-stop resource hub in the Wilmington area.

They offer everything from educational programs, to support groups.

[gentle music] - To make anything easier for caregivers, their jobs are already hard enough, and if we can have that central location or that when they call one of our agencies, they get all the resources in one place, instead of having to call a lot of different agencies to get that information.

- [David] One of their most popular programs is the Memory Cafe.

It's a social gathering where caregivers and their loved ones can connect with others facing similar challenges.

For couples like Mike and Bonnie Oliver who have been married for 47 years, they say these programs appeared just when they needed them the most.

After Mike's diagnosis two years ago, Bonnie found herself navigating a brand new role, caregiver to her husband.

- It socializes you- - Mm-hmm.

- And it socializes me too and I'm starting to see faces who may be in another group, but it's just a good thing for everybody.

- What about for you, Mike?

What does getting in a room like this mean to you?

- I agree with Bonnie.

I think it's affirmation that what I see myself doing is not unusual for my disease, my affliction, and I appreciate so much her patience.

I think the first thing about this affliction is accepting it.

- [David] But even with support systems in place, the weight of caregiving takes its toll.

A recent survey found that nearly 60% of those caring for loved ones with Alzheimer's report being under extreme stress.

It's something Mark Wilde-Ramsing learned through experience.

- It's like when you're on the airplane and oxygen goes out, you put your mask on first.

The caregiver has to stay healthy.

- [David] That's where Project CARE comes into play.

It stands for Caregiver Alternatives to Running on Empty, and it's a state-funded program that operates across North Carolina.

The local Area Agency on Aging administers these funds across 12 counties.

They provide family consultants who help caregivers access resources and temporary respite care.

- Caregiving can be a very lonely job, you know, especially if you take it on all yourself.

I find sometimes caregivers have a hard time reaching out and asking for help, so that's where we try to help them when they call us.

- [David] But there's another stressor that could be relieved, and that's the financial burden.

Think about either the cost of paying for expensive care or even quitting your job to care for one of your parents, because caring for someone with dementia comes with a hefty price tag, nearly $400,000 over their lifetime.

And family caregivers shoulder about 70% of this burden through unpaid care and out-of-pocket costs.

This time the solution is at the federal level.

In the summer of 2025, Medicare is rolling out an eight-year pilot project to directly support dementia caregivers.

It's a first for the federal health insurance program for seniors.

The idea is to invest in caregivers to keep dementia patients healthier and happier at home, while also preventing families from burning out emotionally and financially.

Medicare's betting this approach will pay off in the long run.

[crowd clapping] [gentle music] [shoes tapping] [shoes tapping] Behind all these programs and initiatives are real families facing both heartbreak and hope.

For Mark Wilde-Ramsing, his wife passed away in October of 2023.

Through 11 years of caring for her, he discovered that even in the toughest moments, support could make all the difference.

- There are so many good times and loving moments that I had throughout my wife's illness, even to the very end that just makes my heart sore because we were able to enjoy them and not be so mad and so distraught.

- [David] And as more families face this journey, the hope is that a tapestry of resources woven from local, state and federal initiatives will empower caregivers to navigate this road with greater confidence.

[shoes tapping] [crowd applauding] For "ncIMPACT," I'm David Hurst.

- While dementia presents unique challenges, it's part of a larger trend reshaping our state.

North Carolina is growing older, and quickly.

In just two decades, our senior population will jump by 50%.

We'll travel to Greensboro, where a unique program is helping seniors age safely in their own homes.

- America is aging.

By 2030, all Baby Boomers will be 65 or older, marking a significant demographic shift.

And nearly 90% of seniors today wanna stay in their own homes as they age.

It's a concept known as aging in place.

But most homes aren't designed for aging bodies, steep stairs, high cabinets, and slippery bathrooms can create hazards.

It's estimated that about 10% of American homes are not considered aging ready.

And many seniors simply can't afford to make these costly home modifications.

It forces them to make a tough choice between safety and the comfort of their own homes.

So, a lot of memories here?

- Oh, beautiful memories.

Beautiful.

- But what if they didn't have to choose?

What if we could make homes safer right where they are?

I'm David Hurst.

This is "ncIMPACT."

[upbeat music] [gentle music] [birds chirping] Cornelia Powers has lived in her Greensboro home for 68 years.

So this is your family home.

- Family home, yes.

- What does this home mean to you?

- Everything.

I love this home.

- [David] The family wall in her living room tells the story of generations who have called this place home.

- We had all kinds of gatherings.

My mother was the best cook in the world, and my father was very family-orientated, so we had a good time.

- [David] But as Cornelia aged, daily tasks became challenging, sometimes even dangerous.

It was a chore getting in and out of the shower.

She couldn't reach her washer and dryer and had to get on her tiptoes to get clothes out.

And after being diagnosed with emphysema, these everyday challenges became more than inconvenient.

They became a threat to her breathing.

- That it's here, that it is for me, the better I can breathe.

- [David] Cornelia's story is not unique.

It's playing out across North Carolina where the elderly population is projected to nearly double over the next 20 years.

That means for many seniors, the choice becomes stark.

They can risk their safety in an unsuitable home.

They can go somewhere else and leave behind decades of memories, or pay for expensive home renovations.

But like many seniors on fixed incomes, Cornelia couldn't afford costly home repairs and moving out to live with family or a long-term care facility, in her words, was not an option.

[gentle music] But then she heard about a program that could help, one that brings together an unlikely partnership of healthcare workers and home repair specialists.

It's called Aging Gracefully, and it helps seniors age in place.

Instead of treating home safety as just a construction project, it starts with healthcare.

- One of your goals you have is to make it safer and easier.

- [David] Occupational therapists like Beth and nurses, like Amanda, visit seniors in their homes, assessing their needs through a medical lens.

- We figure out with their functional mobility, their basic daily activities and then advanced activities like bill paying and doing laundry, what activities they feel like they are not as safe with or would like to be more independent with.

- [David] Once these healthcare professionals identify what needs to be done, they write prescriptions in the form of home modifications.

Then, another local nonprofit called Community Housing Solutions steps in to make these improvements.

We're talking about things like adding access ramps, installing grab bars, and raising toilet seats.

- I like to say this program is the intersection of healthcare and housing, where we take the strengths of two fields of study and put 'em together and the outcomes are phenomenal.

- [David] And it doesn't stop at home improvements.

The healthcare team makes regular visits, monitoring how seniors adapt to their modified homes.

- It's making sure that nobody is left behind.

It's making sure that everyone has the opportunity to live at home for as long as possible, to achieve the most optimal health outcomes that they can, and ultimately, not have to spend time in the hospital, not have to experience depression, not have to experience fear being in the home, but we want to equip people to live confidently and boldly at home.

- So, David, this is in our warehouse, this is our operations central or command control- - Okay.

- Where we do all of our planning for the work that we do out in the field.

- [David] Inside Community Housing Solutions command center, the whiteboards track dozens of ongoing renovation projects.

- You'll also notice the AG on the addresses.

Those are Aging Gracefully homeowners.

So of the 13 addresses we have right there, six of them are Aging Gracefully home repairs that we're currently involved with.

- Is that common?

Is that usually how many there are going on in a week?

- It can vary depending on, as we get the flow of the work write-ups from the occupational therapists, we do about 150 home repairs a year.

So about a third of them are Aging Gracefully.

- It drives home the need for a command center to keep it all organized, right?

- [Gene] Exactly, exactly.

Yep.

- [David] But as I toured the facility, I kept thinking about a question.

With labor and material costs soaring and an aging population that keeps growing, how sustainable really is this approach?

But I was surprised to learn that programs like Aging Gracefully might actually save money in the long run.

So let's break down the numbers.

An Aging Gracefully home modification typically costs about $5,000.

Seems expensive, right?

Well, not when you compare it to the alternatives.

One emergency room visit after a fall, including rehab and medications, costs about $30,000.

But what if they just went into a care facility instead of staying in their home?

Well, a year in a North Carolina Medicaid nursing home runs about $90,000.

- So by doing this $5,000 investment, we can prevent falls and those costs, but we can also hopefully allow them to live longer in their home and prevent them from having to go into a nursing home, which is $90,000 a year.

- [David] And Guilford County isn't alone in recognizing these savings.

Across North Carolina, the Housing Finance Agency is partnering with local governments and nonprofits to provide financing for home repairs and modifications, specifically targeting low-income seniors.

But I've got another question.

What if we're approaching this from the wrong end?

Why retrofit homes when we could build them better from the start?

Well, there's a growing movement in home construction called universal design, building Homes that work for everyone from the beginning.

Wide doorways, single-story layouts, lower countertops, features that make sense for all ages and abilities.

But despite growing awareness, most new homes aren't built this way.

Without enough market demand, builders stick to the more traditional designs.

But some cities are taking action.

San Antonio, for example, now requires all new homes built with city funding to follow universal design principles.

But until more of these types of building codes are in place, or there's more market demand for universal design, programs like Aging Gracefully can bridge the gap.

Today, Cornelia's home works for her, not against her.

A walk-in shower replaced the dangerous bathtub, new grab bars provide stability, and a stackable washer and dryer means no more tiptoeing to reach clothes.

Each modification helping her stay in the home she loves.

- The best thing that can happen is to get someone that advocates for your better life.

- Well, thank you for inviting us into your home.

Maybe next time I visit, Amanda and Beth will be up here on the family wall.

[all laughing] - Thank y'all for coming.

It's been fantastic.

For "ncIMPACT," I'm David Hurst.

- Building ramps and fixing homes helps seniors stay put.

But what about their social wellbeing?

As we age, our social circles often shrink, increasing our risks of isolation.

For this next story, we head across town here in Greensboro.

We'll explore how art just might be the prescription for healthy aging.

- American older adults are experiencing unprecedented levels of loneliness.

And while most adults say they value living near family, about half do not.

You see, the current generation of older adults lived in a time of strong community ties.

Nowadays, we barely know our neighbors and the days of Tupperware parties and bowling leagues, those are pretty much gone.

This shift in social dynamics has left many older adults feeling isolated and disconnected.

One study shows that the health risks of chronic loneliness are comparable to smoking 15 cigarettes daily.

Is there a way to rewrite the story of social isolation into one of a vibrant community?

At least one group here in Greensboro, North Carolina, thinks so.

I'm David Hurst.

This is "ncIMPACT."

[upbeat music] Social isolation isn't just about feeling lonely, it's a silent killer.

During the peak of the pandemic in 2020, this was a huge issue.

More than half of people aged 50 to 80 reported feeling cut off from others.

But while these numbers have improved from the COVID days, it's still higher than before the pandemic.

In a recent, U.S.

Surgeon General called loneliness and isolation and epidemic.

- Here's why this is so concerning.

It's because we've realized that loneliness is more than just a bad feeling.

It has real consequences for our mental and physical health.

- [David] He says the government is spending an extra $6.7 billion on healthcare because of it.

But what if there was an unassuming cure already in our hands?

- I'm so grateful for my first set of crayons that I got when I was probably four of five.

[both laugh] And everybody in my family has nurtured me all along to, you know, to just have fun.

- Jean Muson received that gift 80 years ago when she was living in Jamaica, but she's since been in North Carolina to be closer to her son.

Let me ask, what does art mean to you?

- Hmm, that's a good question.

It means everything.

Art is the soul of a community.

I get goosebumps thinking about it.

Art just oozes out of everything.

- That belief in art's power to build community led Jean to the Creative Aging Network.

It's a 10-acre site where older adults can be in a creative environment.

But this isn't your typical art studio.

It's part of a healthcare approach called Arts on Prescription.

It's a healthcare approach where providers can prescribe arts, cultural, or nature experiences to improve patients' health and their wellbeing.

While Jean's enthusiasm for art's healing power might seem unusual, the idea itself isn't new.

It's part of a broader approach called social prescribing.

First popularized in Britain, it aims to improve health by connecting people with non-medical activities.

It's now being adopted in more than 20 other countries, including the U.S. where communities are launching their own pilot programs.

But this all raises an important question.

In an era of advanced technology and medicine, can something as simple as art really make a difference?

The Creative Aging Network thinks so, and they're finding that the power of art lies not only in the creating, but also in the connecting.

And so how much of this is art as having the power to heal versus art being a vehicle to get people connected, to get them into community?

- Right, so creative aging in and of itself is partly that, you know, creating a product that you're happy with.

But the other part of it is more therapeutic.

It is more about bringing people together to connect socially, having people have that vehicle to express their feelings in a healthy way.

- [David] At first glance, the Creative Aging Network might seem to just be for seniors, but their approach to aging is different.

- Well, we're all aging from the time we're born, every day we're getting older.

- [David] But I've got another question here.

How do you convince doctors to embrace this non-traditional approach?

Especially since prescribing art isn't exactly part of standard medical training?

Well, at Mustard Seed Community Health, providers are testing this new approach.

They found that traditional medical appointments often don't address underlying issues affecting their patients' health.

- I just think it's important that more and more people realize healthcare can't just be 15 minutes in a doctor in a pill.

That really, if you're gonna impact somebody's life, you gotta go deeper.

[gentle music] - [David] This is the Cottage Grove neighborhood in Southeast Greensboro.

It's here where Mustard Seed Community Health serves primarily low-income populations.

Their experience highlights both the potential and the challenges of art prescription programs.

- It always comes down to trust.

Especially, you know, I don't know you, I'll feel uncomfortable, I'm not really an artist.

What if people make fun of me?

So the hardest part is getting 'em out the door and getting them here.

And then once they come once, usually they're gonna stay 'cause they have a good time.

When you see somebody smiling who for the first six months you met 'em, never smiled.

And if you see them smiling, holding something they made, proud, it just, oh, it gives me chills.

- [David] But access to these programs remains a challenge, particularly for certain populations.

You see, Guilford County has one of the highest number of foreign-born residents in North Carolina.

Research indicates that immigrants experience higher rates of social isolation and depression, especially after leaving established social networks in their country of origin.

That's where faith communities like this one can play a part.

FaithAction International House partners with the Creative Aging Network and connects these vulnerable populations with a program that brings them out of isolation.

[Lidia speaking Spanish] [Lidia speaking Spanish] [Lidia speaking Spanish] [Lidia speaking Spanish] - [David] And as both an immigrant and an artist, Jean Muson has used her creative expression to build community.

- But it gives us a stronghold, you know, a root in this beautiful garden.

We can take root and blossom.

This is what I'm doing.

I'm blossoming in my mature years.

[both laugh] - And you still got a lot left, right?

[laughs] - I hope so.

I have a lot of work to do.

For "ncIMPACT," I'm David Hurst.

[light music] - We're trying something new this season.

We're focusing more on the experts on the ground.

I wanna thank those experts, the local leaders featured in this episode who so generously allowed us to share the inspirational stories of their collaborative work.

And of course, thank you to you, our amazing audience, for watching and engaging at such high levels.

Let me know what you think about the new format.

I also always love hearing about the solutions you know of out there.

When we do, what we do best as North Carolinians, we work together.

[upbeat music] [upbeat music] [upbeat music] [upbeat music] [upbeat music] [upbeat music] [upbeat music] Tell us what your community is doing or how we can help you.

Email us at ncIMPACT@unc.edu or message us on Facebook or LinkedIn.

And be sure to join us every Friday night at 7:30 on PBS North Carolina for new episodes of "ncIMPACT."

[intriguing music] Coming up on "ncIMPACT."

While some places in North Carolina post really strong economies, others have experienced significant declines.

We'll discover how three communities are fighting back to rebuild their local economies.

- [Announcer] "ncIMPACT" is a PBS North Carolina production in association with the University of North Carolina School of Government.

Funding for "ncIMPACT" is made possible by.

- [Narrator] Changing the course of people's lives, that's the impact UNC Health and the UNC School of Medicine work to deliver every day.

Our 40,000 team members across the state of North Carolina are committed to caring for you, our patients and communities, as well as educating the next generation of healthcare professionals.

Individually, we can do a little, but collectively, we can do a lot to create impact.