“Health equity is essential to improving the aging journey for everyone in our community. We must view health holistically, accounting for the social determinants that impact one’s health and working to address each of them with patients so they can flourish,” said Anna Faul, executive director of the . “It felt necessary for health equity to be our theme this year, especially with the growing aging population in the U.S. and the recent challenges to DEI initiatives.”��

The Trager Institute/Optimal Aging Clinic and the Kentucky Association of Gerontology hosted the conference, held in person for the first time since 2019.

As the opening keynote speaker, Kentucky State Director of Faith-Based and Community Initiatives Charles Booker set the tone and mission of the conference, emphasizing the need to listen to the voices of those directly impacted by services and policies and the importance of strengthening community relationships.

Other keynote sessions included an update on Alzheimer’s and dementia research from Gregory Jicha, professor of neurology at the University of Kentucky; a call to action for women’s caregiver roles and health disparities from Sam Cotton, associate professor at the UofL Department of Family and Geriatric Medicine; a panel on health equity and aging policy with Bob Blancato, executive director of the National Association of Nutrition and Aging Services Programs and Sandy Markwood, CEO of the National Association of Area Agencies on Aging; and a panel of six octogenarians and nonagenarians who shared insights on aging optimally.

The nearly 300 attendees also had the opportunity to participate in sessions on animal-assisted therapy, the benefits of adult day care, lifestyle medicine for preventing dementia, ageism, expansion of senior center services, mental health challenges in older adults and other topics.

“The Optimal Aging Conference was an enlightening and rewarding experience. Participants were able to journey through the landscapes of aging and health equity with every keynote and workshop presentation they attended. This conference reinforced my belief that, by embracing inclusivity and understanding, we can make every year of life a rich and fulfilling adventure for everyone,” said Barbara Gordon, director of community engagement for the Trager Institute/Optimal Aging Clinic.�� ��

The annual conference aims to transform preconceptions about aging, hoping to ignite conversations in which aging is viewed as an opportunity rather than a disease. For more details and information about the 2025 event, visit the .

By Samantha Adams, UofL Trager Institute

UofL News: You’ve been involved with the clinic since it began. What keeps you coming back?

LaRosa:�� I am drawn back by the work we are doing and all of the clients I have gotten to meet. The creation of this clinic felt serendipitous; it was exactly what I was looking for. I came into law school knowing I had an interest in estate planning and working with elderly populations. I had resigned myself to the fact that I was probably going to end up working in a general law school clinic that, while a great learning opportunity and benefit to the community, would not be in an area of the law that I had an interest in practicing. Then the Trager-Brandeis Elder Law Clinic was announced as an option for students’ required experiential learning.

Elder law can be such a rewarding field. The documents we are drafting – durable power of attorney, health care surrogate designation, living will directive and last will and testament – are important documents that can ease the burden on the client and their family and friends when it comes to end-of-life care. They are crucial in preserving the wishes of the client for a time when they may not be able to fully communicate those wishes anymore. The clients that come to see us trust us with the task of making sure their wishes are clearly stated and protected in legal documents. Many clients have expressed their gratitude for the services we are offering, and I am just as grateful that they have trusted me with their estate planning needs and the opportunity to learn and grow as a student. My experience in the clinic has been the highlight of my law school education.

UofL News: How has your role in the clinic evolved?

LaRosa: My role has evolved with the growth of the clinic and the growth of my experience in elder law. In January 2022, when we were preparing to open the clinic, we were a much smaller group. There were four students with three attorneys supervising us. We were learning as we went along and had the task of setting the foundation for the clinic. We had to decide everything, from what supplies we needed in the office to what language we wanted to include in our documents. My role was conducting client intake interviews, drafting documents and conducting document executions.

I thoroughly enjoyed the work I did in spring 2022 and reached out to Misty toward the end of that semester about the possibility of doing some work in the clinic over the summer on a volunteer basis. The Trager Institute and the law school approved the idea of a limited summer clinic, and in summer 2022, the clinic offered two mini clinics.

During these mini clinics I had the opportunity to take on a more supervisory and administrative role. There were about 10 law students per session that I, along with attorneys Misty, Sheldon Haden and Chris Brown, trained and supervised. I was the point of contact for all client communication and observed all client meetings. It was a whirlwind experience. Over the course of four days, we served 17 clients and prepared a total of 64 documents.

This semester I have a combined role. I am meeting with clients and drafting documents as I did in my first semester, while also providing support and advisement to the nine other students in the clinic. I am the first student to return to the clinic for a second semester, so I came in with a wealth of knowledge to share.

UofL News: Why is elder law important?

LaRosa: Elder law is a field of law that encompasses services that benefit everyone as they enter the later stages of life. Aging is a natural part of life, and with it comes new concerns and milestones. It is important to have a sector of the legal field dedicated to the complexities that come with life planning documents. Having a long-term care plan and estate planning documents can relieve some of the stress that clients and their families face when thinking about the future.

UofL News: Students participating in the elder law clinic are required to take part in the Trager Institute’s case conceptualization workshops. What have you learned or gained from these workshops that you can apply to your clinic work?��

LaRosa: The case conceptualization workshops are a really cool way to view a client/patient as a whole and see the way that the various practices at the Trager Institute interact to provide comprehensive care to its clients/patients. It exemplifies the team effort to improve overall quality of life instead of simply issue spotting. When there is a team of doctors, social workers and attorneys coming together for the good of one person, you can ensure that you are addressing care options for physical health, mental health, social relationships and legal security. It provides an expansive view of who we are helping.

UofL News: What impact has this clinic had on the clients that you’ve worked with?

LaRosa: I hope this clinic has helped provide our clients with a sense of peace for the future. Estate planning can feel daunting and scary to many people. Our goal with this clinic is to provide valuable estate planning services to a population that is underserved due to financial limitations. The clients I have served have expressed their gratitude for the help they received through the clinic. I strive to make sure that each person I meet with fully understands the power of the documents we prepare, that they feel confident in the decisions they are making and that they walk away with a sense of relief that they took the initiative to seek out our help. By executing these documents, clients hopefully feel comforted that their wishes have been legally documented.

As of the end of 2022, the clinic had served 76 clients in preparing 305 legal documents.

UofL News: How do you think your experience at the law clinic will influence your future goals and plans after you graduate from Brandeis?

LaRosa: My experience at this clinic has solidified my interest in practicing as an estate planning attorney. Moreover, it has expanded my view of the field of elder law. I now plan to practice as an elder law attorney in Kentucky upon graduating and passing the Kentucky bar exam. I enjoy the work I have done at the clinic. It has provided me with hands-on, practical experience that I never would have fully acquired from a law school classroom. There is nothing more valuable than real client interaction. I want to continue serving the aging populations of Kentucky.

Q&A conducted by Samantha Adams.

Now she is creating a sponsorship program to assist area children with clothing and supplies once they can go back to school.

UofL News talked to Miceli about her efforts, the support she has received and what needs still exist in the flooded communities.

UofL News: How have you been able to help those affected by the July flooding?

Chelsea Miceli: My work has varied greatly from day to day. I have assisted in coordinating hot meals to remote communities. I have prepared meals and delivered them door to door. I have taken up donations and delivered them to homes throughout Knott, Breathitt and Perry Counties. I helped find individuals to sponsor a Perry County High School football player who lost all his sports equipment. I worked with national disaster relief food organizations to create hubs for food pickup for those that still do not have access to roadways. I connected the shelters to resources to get oxygen for those staying in the shelters. I assisted in finding a location for a birthday party for a young girl that lost everything. I assisted in connecting affected individuals with showering and laundry services. The Trager Institute and Republic Bank Foundation Optimal Aging Clinic staff and I worked to coordinate services for the Deaf and Blind community that is being sheltered at Hindman Settlement School.

UofL News: What makes the work personal for you?��

Miceli: As a resident of Whitley County who has family members across Eastern Kentucky, I understand the value of Appalachia and the history surrounding the culture which makes these individuals and their families so strong. When the recent flooding disaster hit in Eastern Kentucky, I knew I could not sit idly and watch those that I have an obligation to serve suffer alone.

When a disaster of this magnitude takes place, it is an immediate call to help your neighbor. Given my connection to this region and these communities, this work is very personal to me as I understand the geographic remoteness of this area of our state. These communities already face structural and systemic inequities such as generational poverty and trauma, oppression and a lack of resources in rural areas, and this disaster will only exacerbate these challenges.

These are my people, the people that I want to serve, the people that I feel could most benefit from additional services, the people that I know need advocacy and the people I know that are appreciative of the simplest act of kindness. ��

Living and working in this region, I know that the communities of Eastern Kentucky are tough and resilient people, yet we all need help from time to time. I have delivered supplies and food to homes where people have said, ‘I hate to take it if someone else could use it more than us.’ The culture of wanting to work for what you have and always lending a helping hand is something that is instilled in our communities from birth. ��

UofL News: What specific skills and experiences have helped you in this work?

Miceli: As a recent graduate from the Kent School and now a Trager Institute and Republic Bank Foundation Optimal Aging Clinic employee, my educational and professional background has instilled in me the value of taking action. During my time in the MSSW program and as an intern, I learned the importance of trauma-informed care and the long-term implications that you can have on someone’s life through acknowledging what they endured.

Throughout my time helping in Eastern Kentucky, my main goal has been to offer dignity and worth to individuals who have lost everything. Taking the time to stop and hear their stories and let them know that someone is there for them and is working with them is the best service anyone can offer. ��

UofL News: How has your position at UofL and hat connection been helpful?

Miceli: As a program coordinator with the Trager Institute and Republic Bank Foundation Optimal Aging Clinic, I develop and facilitate services, provide education, training and supervision to our student interns and facilitate collaboration and services with partnering sites across Eastern Kentucky for our projects funded by Health Resources & Services Administration grants. One of the core missions of these projects is to provide workforce development and services to rural communities across the state. ��

The team has been instrumental to my flood relief work. I have reached out numerous times needing assistance in identifying contacts and resources to provide services to these individuals. Without hesitation, they connected me to individuals and organizations that could assist with high priority needs of the communities including oxygen, hearing aids and sign language interpreters.

The staff has gone above and beyond to help me serve these individuals, most of whom they will never see nor meet. Without their help I don’t know if my work in Eastern Kentucky would have been as fruitful.

Our partner sites across Eastern Kentucky have faced many challenges during this time as well, primarily Mountain Comprehensive Health Corporation. However, any time I picked up the phone and explained a need they were quick to act and put me in contact with individuals and resources to resolve the issue. ��

UofL News: Tell us about your project to gather supplies for students as they go back to school.

Miceli: I am working to create an ‘Adopt-a-Student’ sponsorship program. We will ask sponsors to purchase a backpack, clothing essentials (e.g., socks, shoes, underwear and two outfits), along with basic school supplies to be distributed to students in Knott County when they are able to return to school. With so much uncertainty surrounding when school will begin, this gives us time to begin gathering items in hopes that as students return, they will not have to worry about having school clothes and supplies. Given the financial hardship the parents are already facing, between clean-up costs and restarting their lives, the goal is to relieve some of the burden on them as well. This program’s goal is to let the students and parents start this school year without additional stressors during this trying and difficult time.

An has been created for school supplies for the students. To contribute to the Adopt-a-Student program, contact Miceli.

“It is so exciting that the Republic Bank Foundation Optimal Aging Clinic received the Age-Friendly recognition so shortly after celebrating our one-year anniversary,” said Anna Faul, executive director of the UofL Trager Institute and the Optimal Aging Clinic. “This recognition serves as a testament to . We strive to be on the forefront of patient care for older adults and we look forward to continuing to provide every older adult with the best care possible as part of the Age-Friendly Health Systems initiative.”

As part of the�� initiative,��The John A. Hartford Foundation and the��Institute��for Healthcare Improvement, in partnership with the American Hospital Association and the��Catholic��Health Association of the United States, are helping hospitals, clinics and other care settings��implement evidence-based interventions��specifically designed to improve care for older adults.��

The interventions are tested and adapted through participation in Age-Friendly Health��Systems Action Communities. These collaborative entities are comprised of health care teams from across the country that are committed to sharing data and learning together. The teams work��to��implement best��practices across emergency departments, intensive care units, medical-surgical��units, general wards and primary and specialty care settings.

The Optimal Aging Clinic now joins more than 450 health systems working to make care for older��adults even more��tailored to patients’ goals and preferences and consistently of high-quality as part of the initiative, which is based on a series of practices focused on addressing four��essential elements��of care for��older patients known as the 4Ms:

• What Matters: Know and align care with each older adult’s specific health outcome goals and care��preferences including, but not limited to, end-of-life care, and across settings of care.
• Medication: If medication is necessary, use age-friendly medications that do not interfere with What��Matters to the older adult, Mobility, or Mentation across settings of care.
• Mentation: Prevent, identify, treat and manage dementia, depression and delirium across settings��of care.
• Mobility: Ensure that older adults move safely every day in order to maintain function and do What��Matters.

Joe D’Ambrosio, director of behavioral health at the UofL Trager Institute and Republic Bank Foundation Optimal Aging Clinic, says the Age-Friendly initiative also is infused in the organization’s Behavioral Health Services Organization.

“We are so happy to include this initiative in the work we do with our therapy patients,” D’Ambrosio said. “The 4Ms of the initiative align perfectly with the behavioral health interventions we share with patients in their efforts to age optimally and we are excited to build upon the progress we have made in our first year to continue to help older adults thrive as they age.”

Learn more about the Republic Bank Optimal Aging Clinic in a .

“The UofL Trager Institute is thrilled to offer this new acupuncture set of services to our community,” said Anna Faul, executive director of the UofL Trager Institute. “These new services available at our Republic Bank Foundation Optimal Aging Clinic are part of a broader effort to provide a one-stop shop of comprehensive services that support long-term wellbeing.”

Acupuncture is the anchor of traditional Chinese medicine that involves the placement of fine, sterile needles into specific points on the body to heal disease, restore balance and promote health. AcuBalance providers say the services offered at the UofL Trager Institute can help address a wide range of both neuromusculoskeletal and internal/mental-emotional including:

• acute and chronic pain
• arthritis
• fibromyalgia
• addiction and recovery
• autoimmune issues
• cardiovascular health
• indigestion and digestive health
• cognition and brain health
• reproductive and sexual health
• hormone and thyroid health

These services are known as integrative treatments because they are to be used in conjunction with a primary care physician.

Colby Helton and Andrea Helton, offering services at the UofL Trager Institute, are fully licensed to practice acupuncture and traditional Chinese medicine in Kentucky, having passed four National Board Exams through the . The providers have completed a four-year master’s degree in acupuncture and TCM that included over 3,000 hours of didactic education as well as 1,000-hour clinical residency programs. Colby Helton holds a doctorate in TCM, which required an additional 1,200 hours of didactic education, including additional training in gerontological acupuncture, clinical experience and a doctoral capstone project.

“We are elated to offer acupuncture services in partnership with the UofL Trager Institute at the Republic Bank Foundation Optimal Aging Clinic,” Helton said. “We bring a unique approach to our acupuncture and body therapies as we have extensive training specifically in providing acupuncture to older adults. Our services also will be a great resource for individuals needing pain management support and those looking for anxiety and stress relief. Utilizing an integrative approach and in collaboration with primary care, we can help patients with nearly any condition, from chronic pain and inflammatory conditions to hormonal and emotional imbalances.”

In addition to offering integrative services designed to help individuals achieve optimal health as they age, the new acupuncture services at the UofL Trager Institute may provide anxiety and stress relief specifically related to COVID-19.

“Over the past few months, we’ve seen a dramatic increase in anxiety, depression and stress among health care providers and caregivers, especially our frontline and long-term care workers. Without proper self-care, health care workers face a burnout like we’ve never seen before, which can turn into varying degrees of psychological crises and PTSD,” Helton said. “Integrative therapies like acupuncture help offer significant relief and reprieve by addressing the biological, mental and emotional components of stress and burnout. Specifically, we work to increase parasympathetic tone and reduce stress reactivity, which can balance the mood, sleep cycles, energy, cognition, digestion, cardiovascular health and even immunity. Essentially, we can help our fellow health care workers navigate the COVID landscape with a bit more ease and grace.”

Acupuncture services are available to any member of the community, with appointments available Tuesdays and Thursdays from 1to 6 p.m. To make an appointment, visit the , or call 502-588-4340. Services are provided on a private payment structure.