Stories from the Field: Carmel Roques

What inspired you to frame your work through the lens of helping Marylanders become "longevity ready"? What observations, gaps, and/or opportunities influenced this direction?

When Governor Wes Moore asked me to take this role, I had already been thinking differently about serving older people, their families, and caregivers. I came in with the idea that we must reframe aging to include the aging of our entire population. We need a broader narrative about how older people live and contribute, beyond simply equating age with being frail or a burden. “Longevity ready” is about broadening the lens; it is the idea that aging happens across the entire life course. We are living longer, and we must evolve to live better. In four years, nearly 22 percent of Marylanders will be over 65. Yet, we are still operating as if it were 1965, when today’s seniors were in kindergarten. To bridge that 60-year gap, we successfully passed the Longevity Ready Maryland (LRM) Act into law. Maryland is now the first state in the nation to enact legislation that specifically addresses longevity, ensuring we support our residents at every stage of life.

Please share an example of an innovative program or practice you are implementing, or plan to implement, that focuses on improving healthspan for older adults.

We just launched a program in partnership with Johns Hopkins—a Caregiver Checklist to support families caring for people with dementia. It's free and easy to use. The checklist guides caregivers through a series of questions, generates a personalized care plan, and connects them to resources. We’ve also hired a cognitive and behavioral health specialist to look at ways we can influence navigation of resources for family caregivers and better educate providers of services. We recognize that by the time we're trying to help people deal with multiple chronic illnesses, we've missed an opportunity to intervene further upstream. Children who have a good, healthy start in life have a better chance of achieving a healthy late life. So we've focused our efforts alongside the Enough Act, a Maryland initiative focused on communities where a disproportionate percentage of children are living in poverty, many in households where grandparents are raising them. We can strengthen that family by helping that grandparent raise that child, making sure they benefit from community resources. We’re also actively engaged in the Maryland rural health initiative and promoting nutrition stability and a food-is-medicine approach in these communities. 

Is the Maryland Department of Aging considering any of the strategies highlighted in the Milken Institute's report, Longevity Ready: A Systems Approach to Aging Well at Home

I'll start with the idea of a trusted resource hub. The Maryland Access Point (MAP) is the front door for services for older people. Part of what we've done is to train other agencies, like the Department of Human Services and the Department of Housing, so they know how to connect older Marylanders with MAP. We're also doing a lot of work with the 211 system. We realized that when people call 211, a lot of times they just never made it over to MAP. Now those two entry systems are integrated, and we have a way to do a warm handoff between systems. We are also using AI to triage needs, so the people who really need hands-on, high-touch navigation through a very complicated situation get the appropriate level of support. We're also looking at financial longevity and how individuals can become better informed about how to plan for 20 to 30 years beyond retirement. For example, we're looking at how we can leverage the State Health Insurance Assistance Program dollars we receive to fund education around Medicare enrollment and to make sure people are better informed about their long-term care coverage earlier in their planning.

What advice would you give to colleagues in the public sector working to help their constituents become "longevity ready"? Where should they start?

I’d say try to do this work with an “all of government” approach. Find the places where you can influence other agencies using population disruption as a policy lever. It might be the education system, housing, or health. We're not starting with “do these 78 LRM recommendations.” We're simply saying, use the lens of longer lives when you're thinking about your policies and programs. The other thing I would say is you have to be willing to step out and challenge ageist ideas. Think about how you can be part of changing the narrative. We worked closely with the National Center to Reframe Aging to educate about 600 people in various sectors in Maryland. Lastly, we need to modernize through system changes, structural changes, and programmatic changes to get us beyond being reactive to the crisis de jour. And remember that, like all true transformation, it takes time, and it’s incremental.