Critical Support: Nursing Homes Need Our Action NOW

Alice Bonner, PhD, RN, FAAN, Senior Advisor for Aging, Institute for Healthcare Improvement

Alice Bonner, PhD, RN, FAAN, Senior Advisor for Aging, Institute for Healthcare Improvement

This editorial is the work of four authors: two registered nurses with PhDs, one of whom is a former government/public health division director and one of whom leads a national foundation; a certified nursing assistant and director of a national CNA organization; and a nationally recognized health economist and nursing home expert. Their names and affiliations appear at the end of the article.

How We Got Here

For years, extended families formed the backbone of American communities. Children and young adults grew up living with parents and grandparents, or with the grandparents of friends and neighbors down the street. So why is it that we struggle with long-term care — how to create meaningful, purposeful living environments as we age? And why is it that skilled nursing and rehabilitation facilities and skilled nursing facilities (SNFs, historically called nursing homes) are always an afterthought, or completely invisible?

The greatest success story of the 20th century is human longevity; all of us love to tell the story of a relative or friend who has made it into their ninth or tenth decade. However, as a society we have not come to grips with how to care for older people. Antibiotics, pacemakers, renal dialysis, and artificial hearts are just a part of the story that has led to longevity — not to mention the extraordinary achievements of the public health system.

Why We Do This Work

Many of us have had a career focused on supporting or caring for older adults over decades. Why do we do this work? Because we believe we can create a comprehensive system of care, a continuum of health, housing, and social services that can better support ourselves — older people and our care partners —  in social engagement and the life of communities. Due to a variety of factors, some form of nursing home care will always be a part of that continuum.

Many not-for-profit associations, for-profit companies, and government agencies focus on creating environments for optimal aging.  The John A. Hartford Foundation, a foundation devoted to improving care for older adults, is dedicated to improving care of older adults in every place they reside.  Every day the team focuses on its mission and work with national and international organizations, government agencies, universities, and all components of the healthcare system, to try to create Age Friendly Health Systems. They are sorely lacking. Continue reading

Responding to Harvey: What We Can Do

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:

Elder Abuse: Being Part of the Solution

American Geriatrics Society Staff

The mistreatment of older adults is called elder abuse. It is more widespread than many of us realize. Although statistics suggest that one in 10 older people is abused every year, the actual number is likely to be much higher because so many cases of elder abuse go unreported.

That’s why it’s so important for us to put elder abuse on our individual radars. Signs of elder abuse may not be immediately obvious. Members of our own families may be subject to abuse, as can our older neighbors, friends, and acquaintances.

No matter how old we are, justice requires that we all be treated as full members of our communities, say experts at the National Center on Elder Abuse. However, because some older adults are not visible to other members of the community, they can be at greater risk for being neglected or abused.

The range of situations that make up elder abuse is broad. Elder abuse can include neglect (both intentional as well as self-neglect), and abuse that is financial, emotional and psychological, physical, and/or sexual. These are all forms of injustice we need to address to better serve our communities.

As difficult as it might be to realize that an older person is being abused, it may be even more difficult for us to report it—we may fear that we’ve misunderstood a situation or are overreacting. Trust your instincts. If you suspect that something isn’t right, act. Continue reading

A Police Training Program in Age-Related Health Helps Communities Better Serve Older Adults

JAGS graphic

Staying up-to-date on the latest geriatrics research isn’t just for healthcare professionals. That’s why HealthinAging.org is expanding its partnership with the Journal of the American Geriatrics Society (JAGS) to give you access to the cutting-edge insights that your healthcare providers use to guide your clinical care. The HealthinAging blog will now feature regular updates from JAGS—including future postings of our monthly research summaries—so be sure to subscribe to updates today!

For older adults with complex care needs, police officers are often the first people on the scene for a health issue or concern. Police officers often respond to calls for older adults with cognitive impairments (health problems that affect our ability to think and make decisions), or to concerns about abuse, neglect, or the general well-being of older adults who live alone and benefit from “well-being” assessments.

However, when police don’t have essential information about how our health changes as we age, they may risk causing unintended harm. For example, a police officer might not know the best way to assist an older adult with dementia who is behaving disruptively or even violently.

A new study published in the Journal of the American Geriatrics Society reports that most police officers receive little to no training in aging-related health concerns, and that promising approaches to such training can improve how officers can help older adults in their communities when they’re called to offer assistance.

The study detailed results from a program designed by geriatric care experts in cooperation with the San Francisco Police Department (SFPD). The team created an aging-related health segment for inclusion in the 40-hour “Crisis Intervention Training” police officers receive for addressing the unique needs of certain individuals. The training is mandatory for all SFPD patrol division officers. Continue reading

The Financial Costs of Family Caregiving: A Stark Reality

200-lynn-friss-feinberg-aarp.imgcache.rev1320086023339-1Lynn Friss Feinberg, MSW
Senior Strategic Policy Advisor
AARP Public Policy Institute

(This post was originally published on the AARP blog and is re-posted with permission.)

Families and close friends are the most important source of support to older people and adults with a chronic, disabling, or serious health condition. They already take personal responsibility for providing increasingly complex care to the tune of $470 billion (as of 2013). That figure, representing family caregivers’ unpaid contribution in dollars, roughly equals the combined sales of the four largest U.S. tech companies (Apple, IBM, Hewlett Packard and Microsoft, $469 billion) in 2013.

The out-of-pocket hit

Caregiving families feel great uncertainty and high anxiety about how they will continue to pay for long-term services and supports (LTSS) for a relative or close friend with increasing self-care needs. And for good reason. Family caregivers not only provide help with daily activities and carry out complex medical and nursing tasks, they also spend a considerable amount of money out of pocket for caregiving.

Out-of-pocket spending for caregiving generally refers to the purchase of goods and services on behalf of the person the family caregiver is helping. This can include housing, medical and medication premiums, copays, meals, transportation, mobility and other assistive devices, supportive services (such as adult day services and paid home care), and other goods and services.

A recent AARP research study finds that more than 3 in 4 family caregivers (78 percent) report incurring out-of-pocket costs as a result of caregiving. In 2016, family caregivers of adults on average spent nearly $7,000 on out-of-pocket costs related to caregiving, amounting to 20 percent of their total income. Among racial or ethnic groups, out-of-pocket spending for caregiving was highest among Hispanic/Latino family caregivers. They spent an average of $9,022, representing 44 percent of their total income in 2016.

Caregiving, therefore, can have a major impact on one’s current and future financial situation. A consensus report from the National Academies of Sciences, Engineering, and Medicine concludes that family caregiving for older adults poses substantial financial risks for some family caregivers. Especially vulnerable to financial harm are families caring for older relatives with significant physical impairments or dementia, low-income family caregivers, and those who live with or live far away from their older relative who needs care. Continue reading