Author Archives: Nancy Lundebjerg

Responding to Harvey: What We Can Do

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Nancy Lundebjerg
Chief Executive Officer
American Geriatrics Society

Here at the AGS and Health in Aging Foundation offices, we’ve been closely following Hurricane Harvey and its impacts on the Gulf Coast. Many of the images circulating on social media and in the news have been heart-breaking. At the same time, it’s been inspiring to see the general outpouring of support and the many volunteers who have turned out to assist neighbors, friends, and strangers.

The AGS and the Health in Aging Foundation have a history of doing what we can to help smaller, sometimes overlooked organizations working on the ground in response to national emergencies like Hurricane Harvey. Earlier this week, in fact, we reached out to AGS members and leaders in storm-hit communities to check in on how they were doing and to ask how we could help. They recommended donating to Jewish Family Services (a Houston-based organization working with a host of faith-based and nondenominational partners on short-term and long-term recovery) and BakerRipley (a 110-year-old community development organization tasked with running one of Houston’s largest hurricane recovery shelters).Based on their advice, the AGS Health in Aging Foundation made donations to both organizations to assist with recovery efforts.

Like the staff here, you likely have been tracking the ways you can help those in need. Here are some suggestions:

  • If you’d like to volunteer in a storm-hit community, register through a volunteer organization or disaster recovery group. Two organizations that are coordinating volunteers in Houston, for example, are Volunteer Houston and All Hands Volunteers. Remember: It’s best not to contact local law enforcement or emergency medical services directly to offer your services. Try to keep their lines open for emergency calls.
  • For those of you who may not be in or near a storm-hit city, you can still make an impact by donating to a national or local charity working on emergency relief and recovery. In addition to the two organizations mentioned above, here are examples of other local organizations to consider:

Cleaning (as if someone else might have to)

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Nancy Lundebjerg resizedNancy E. Lundebjerg, MPA
Chief Executive Officer
American Geriatrics Society

It started with the shoes in the corner of the bedroom—and it continued through three closets, two dressers, a huge chest in my living room, a small filing cabinet, the front hall closet, and even the desk in my office at work. Some might call this spring cleaning but, for me, it’s more episodic and usually sparked by something like being annoyed enough by the pile of shoes in the corner to find them a home.

As always happens during one of these all too rare bouts of purging, I think about the family cleaning events I’ve been part of as parents, aunts, and grandparents moved on. I was having dinner with a few friends last week and we were swapping our caregiver cleaning stories. I found that my late father’s desire to hold on to his power tools was matched by my friend’s father’s desire to bring them all with him to his new assisted living facility. I somehow ended up with a drill, hammer, and a ruler from my dad. The hammer is spattered with paint and the head may be a little loose but I think of my dad every time I use it and could not imagine purchasing a shiny new one. The ruler is an artifact in my curio cabinet – along with the rotary phone from my parent’s bedroom. They’re Items with no current purpose…and they make me smile.

I also spent several years as my aunt’s primary caregiver. Moving her out of her apartment was easier but still no less daunting. I had reached the point where I couldn’t maintain her at home given her advanced dementia, and so I undertook the hunt for a quality nursing home that she could afford and that would take her (Sidenote: “Would take her” is a thing…and a thing for an entirely different blog post!). Having found one, there came the task of cleaning out her apartment. My sister, niece, and I found that she had a closet filled with lightbulbs ordered from some charity (beware the telemarketer and your older loved one). There were bricks in that closet—from where and for what we still do not know. She also had a cedar chest (made by my grandfather) filled with old ConEd bills.

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What we’re doing in 2016, thanks to your support…

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Nancy Lundebjerg casualNancy E. Lundebjerg, MPA
Chief Executive Officer
American Geriatrics Society

“I have never seen myself doing anything other than helping older adults.”
—Christian E. Gausvik, AGS Student Leadership Council Chair, aspiring geriatrician, and medical student at the University of Cincinnati College of Medicine

Even if I weren’t the CEO of the American Geriatrics Society (AGS), I would love this statement.

Christian is logging 80-hour weeks and 36-hour shifts as a third-year medical student, but he still found time to organize our student engagement group, and he even launched his own charity event benefitting the Alzheimer’s Association in Cincinnati. Christian represents the future of eldercare in several important ways: he’s not only pursuing a career in geriatrics but he’s also one of several trainees receiving special support and assistance from the AGS’s Health in Aging Foundation.

Many of you are probably familiar with the Foundation because of the tip sheets and resources you’ve found right here at HealthinAging.org. Developing these is a critical part of what we do, but it doesn’t end there. Since 1999, the Foundation has been providing public education about the health and well-being of older adults while also supporting people like Christian who represent the future of geriatrics.

We’ve been hard at work on both of these fronts since 1999, and last year alone we made some pretty impressive progress:

  • We helped 75 health professions students travel to the AGS Annual Scientific Meeting, where they were able to present their own research and learn from other experts and mentors.
  • We developed some important new recommendations about medication safety for older adults, and we created a whole suite of online tools to make that guidance easier to understand for older adults and caregivers.
  • We supported the Surgeon General’s call to action on walking by compiling tips and resources to help older adults, their caregivers, and their healthcare professionals scale physical activity to make it fun and achievable for older individuals.
    We provided nearly 1 million older adults and caregivers with resources and information through HealthinAging.org.

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A Good Day at the White House—#AGSProud

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Heading into the East Room of the White House.

The White House Conference on Aging (WHCOA) was this week. It’s a once-in-a-decade gathering of people who are passionate about older Americans. The next time this conference occurs, I’ll be 66 and my siblings will be in their 60s with one turning the corner to 70. With a little luck and some healthy choices, we’ll be active and engaged with our communities well into our golden years.

One thing that is clear from the 2015 conference is that, as a country, we still have a lot of hard work to do if our communities are going to be ready for me and my siblings. That said, I was proud to represent geriatrics health professionals at the WHCOA and it gave me hope that the type of future we envision for older adults could be a reality (especially on the cusp of some momentous news today from the U.S. Senate—you’ll just have to keep reading to find out more!).

WHCOAPresObama

President Obama giving his remarks.

First, the things that made me proud…

Falls Prevention Takes Center Stage at the Centers for Disease Control & Prevention: In 2001, the American Geriatrics Society (together with the British Geriatrics Society and the American Academy of Orthopedic Surgeons) released our first Guideline for the Prevention of Falls in Older Persons, with an updated guideline issued in 2010. This was seminal work, and not just for the AGS. In fact, our most recent guideline informed the U.S. Centers for Disease Control and Prevention (CDC) work on creating the Stopping Elderly Accidents, Deaths, & Injuries (STEADI) initiative that was announced at the WHCOA. STEADI provides educational tools to healthcare professionals that can help them identify individuals at risk for falls, understand how to modify certain risks that they are likely to find, and learn how to implement effective options for preventing falls altogether. The CDC has been working with Epic Systems Corporation (an electronic health record technology provider) and EPIC will be rolling out a clinical support tool for falls assessment. This resource will make it easier for ALL healthcare providers to screen for falls, intervene to reduce risk, and provide follow-up care. AGS members are leading the STRIDE study that is testing a multifactorial fall injury prevention strategy that is being co-funded by the Patient-Centered Outcomes Institute (PCORI) and the National Institute on Aging (NIA). I’m proud of AGS and our members—we built the foundation for STEADI and, looking towards the WHCOA in 2025, I expect that we will have progressed even further in our understanding of how to prevent older adult falls.

Medicare & Geriatrics Health Professions Funding: President Obama had some good news for geriatrics health professionals, as well—noting that we are working to implement Medicare payment models that support the quality rather than the quantity of care. AGS has been at the forefront of efforts that will benefit beneficiaries by ensuring that clinicians are supported to provide care coordination, care transitions, and advance care planning. We continue to advocate for payment models that support geriatrics health professionals in doing what they love to do: maximize the function and quality of life of the older adults they serve. Look for more news from us on the recently released 2016 proposed physician fee schedule rule in the coming weeks.

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Multiple Chronic Conditions and You

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Nancy Lundebjerg casual

I have multiple chronic conditions (MCCs). There—I’ve said it: in my mid-50s, I already have MCCs. Fortunately, nothing is life-threatening, but I do need to keep track of my arthritic toe, my eyesight, and a bit of acid reflux. My friends and I also talk about our weak bladders—likely the precursor to being incontinent later in life, but for now we are managing with the philosophy (in my case, after speaking with my gynecologist): “If there’s a bathroom, we should use it because we never know when we’ll spot another one!”

You’re probably wondering why I’m sharing all of this on the Health in Aging blog. After all, at my age I don’t yet qualify as an older adult. But thinking about all of your conditions any time you get a new diagnosis, try a new vitamin, or are prescribed a new medicine is important at any age. It’s particularly important as you get older, and the American Geriatrics Society (AGS) and the Health in Aging Foundation have tools you can use to create care plans with your providers that take into account all of your conditions and your preferences.

So just what is a chronic condition? Simply put, it’s a physical or mental condition that lasts a year or more and requires ongoing medical attention and/or limits what you can do on a daily basis. At one point, my arthritic left toe was limiting how far I could walk, which, for a New Yorker, had a big impact on my quality of life. Even now, post-surgery, the toe requires an orthotic and monitoring by my doctor. Cute little shoes are basically not an option!

MCC Tools for You
According to Medicare data, more than two-thirds of beneficiaries have 3 or more chronic conditions. If you—or someone you care for—has MCCs, the AGS Health in Aging Foundation has tools that can guide you as you work with clinicians to plan a course of care that takes into account your goals and also helps to prevent having a bad outcome. I always start with our A-Z chapters, as these provide a general overview of a topic and serve as a road map to AGS Health in Aging Foundation resources and those from other organizations. Our chapter on Managing Multiple Health Problems is based on a piece that we created to assist health professionals who are caring for older adults. You can also find other tools, including advice from Drs. Cythia Boyd and Matt McNabney.

Tools for Your Clinicians
The tools and resources that we provide on HealthinAging.org are drawn from the health professional resources of the AGS. In 2012, AGS developed “Guiding Principles for the Care of Older Adults with Multimorbidity: A Stepwise Approach for Clinicians,” which provides a stepwise approach (or one based on a series of stages or steps) for any clinician who is caring for someone with MCCs. One of our primary goals in creating this document was to help clinicians who do not have training in geriatrics and who are treating patients for one or more of their chronic conditions. This is why, with funding from the Agency for Healthcare Research and Quality (AHRQ), we created and released our MCC Geriatrics Evaluation and Management Strategies (GEMS) app this past May and are currently disseminating it to our specialty physician partners. The MCC GEMS app provides a short overview of the guiding principles for busy clinicians as well as some suggested tools that can be helpful to them in managing their older patients.

I know I need to take an active role in managing my own healthcare. That’s why I look for information from trustworthy sources whenever I have a decision to make. Having worked with leaders in the field of geriatrics and gerontology on creating HealthinAging.org, I also know that the information we provide is based on the best evidence available and that it can help you (or someone you love) make healthcare decisions that are consistent with your goals and preferences.

About the Author
Nancy Lundebjerg is the Chief Executive Officer of the American Geriatrics Society and the AGS Health in Aging Foundation.