LeadingAge

In his recently published book, The Longevity Economy, Joe Coughlin, director of the MIT Age Lab wrote “the visionaries who will help build a better old age will be those who understand, at a deep, intuitive level, what older adults want diverges from the current narrative. The products that bridge that gap will empower older adults. They will help them continue to participate in society economically, culturally and socially. And as cultural objects, these products will send forth the message that personal agency in old age is normal.”

The way to get to that “deep, intuitive level” is to listen to the users—designing WITH rather than designing FOR. Fifteen years ago, LeadingAge established the Center for Aging Services Technology (CAST), whose purpose is to be a platform for dialogue between providers, researchers, and technology companies. Dialogue to ensure that new technologies for aging services meet the needs of providers and older adults alike. Dialogue to ensure that products empower older adults and improve their quality of life.

Fifteen years ago, dialogue like this did not take place. Older adults and aging services providers were rarely consulted during new technology development. We believed then—and still do—that the needs of older adults and those who serve them are unique. Anything short of technologies designed with OUR users was inadequate. In 15 years, I am pleased to say that we have made demonstrable progress. CAST’s platform has grown exponentially larger and LeadingAge members are willingly testing and deploying technologies as well as providing critical feedback to technology companies.    

We also believe that “at a deep, intuitive level” what older adults want is in perfect alignment with what providers want. There is no dividing line when it comes to technologies to improve quality, to increase efficiency, to foster social engagement, to manage medications, to protect sensitive data, or to connect an older adult to a clinician. And, together, these technologies hold the key to addressing the challenges and opportunities of a society that is rapidly aging.  Perhaps a different interface—but the fundamental goals are the same.

Since the inception of CAST, LeadingAge has been a strong voice for user-centered technologies. We’ve worked hard to take the guesswork out of investments in technologies by co-creating tools with our members to help with decision-making. The key is co-creation. We don’t just trust our instincts. We check them constantly with members and they, in turn, bring the voice of those they serve. We facilitate dialogue with technology companies and we assess results through case studies.

In all, we know that technologies are not a “nice to have” but a “need to have.” They integrate with the daily work of providers, influence partnerships, facilitate transparency, and are an indisputable expectation of consumers. We’re advocating for demonstrations to prove cost-savings as a result of technologies, to ensure broadband in rural areas so providers and consumers can take advantage of essential technologies, and to level the playing field for investment and cost recovery between the acute care settings and aging services.

Our goal is that ALL members and those they serve have equal access to technologies—not just those who have the means to do so. The promise of technology to improve quality of life in the future will be continually enhanced with artificial intelligence, exoskeletons, and things we can’t even imagine today. The foundation we have laid at LeadingAge through CAST’s forward-thinking focus on technology is imperative to realizing that promise.

Learn more now about CAST.

This year has been challenging for so many. Many areas of our country were ravaged by hurricanes and fires, several of which are still burning furiously in California. Member organizations, staff, residents, clients and families have had their lives upended. And you rose to the occasion.

The overwhelming generosity of the LeadingAge community has allowed us to provide financial support to many. Disaster relief funds have covered insurance deductibles, relocated a resident to be with his family after being evacuated, replaced flooded cars so staff could get to work, helped many rebuild their lives, purchased supplies, and so much more. The needs are great and the response has been heartwarming.

But all is not back in order. The New York Times this week reported on the devastating situation in Puerto Rico. Many older adults are still without power, and food and medicine remain in short supply. Earlier this week, Nancy Hooks and LeadingAge board members Roberto Muniz and Mike King, along with staff and leaders of members National Church Residences and VOA, traveled to Puerto Rico to deliver checks to affordable housing communities and learn first hand what else we can do. We’ll post photos on our website following their visit.

As I think back on the year, there have been moments of triumph and moments of despair, but never a second in which we have given up hope. Despair at the inability to move CMS to reconsider burdensome regulations for nursing homes, despite our best efforts. Despair at the growing number of older adults on waiting lists for affordable housing—numbers that will continue to grow without Congressional action to provide for new production. Despair at the prospect of cuts to Medicaid and Medicare, threatened as a result of the deficit spikes caused by the tax bill that is working its way through Congress this week.

Triumph, on the other hand, is personified by the compassion of the LeadingAge community to help our fellow members in difficult times. Triumph resulting from the unprecedented outpouring of grassroots support (over 32,000 letters and phone calls to Congress from LeadingAge members) to stop the proposed changes to Medicaid that would be so devastating. And triumph embodied by the unwavering commitment of members and their staff to provide the best for their residents, clients, and families.

Your work doesn’t get easier; it just gets harder. New regulations, competition, staffing challenges, fragile business models, funding cuts are just few of the hurdles you face every day. And yet, you keep at it.

You reassure families who are worried about the health and safety of their parents and grandparents. You engage volunteers who lovingly devote thousands of hours to your organizations. You cultivate donors to support your mission. You foster strong governance with board members who care deeply about your purpose. You train and reward staff for their dedication. You build and nurture partnerships that contribute to the success of your organization.

You do this all day, every day, all year long.

On behalf of the staff at LeadingAge, thank you for inspiring us. Thank you for riding the waves of triumph and despair with us. I look forward to 2018 and trust that, working together, hope will prevail and our Power of Purpose will continue to guide us in the weeks and month to come.

I offer a very heartfelt season’s greetings to you all.

Warmly,

Katie

Imagine returning home from a conference and being greeted at the airport by an enthusiastic crowd of well-wishers singing and dancing to celebrate your arrival. The occasion? You and your organization received an Award for Excellence in Ageing Services at the Global Ageing Network conference. A prestigious recognition for anyone—but even moreso for a small organization with a meager budget in Nairobi, Kenya that provides food, shelter, and basic home care for older adults.   

The Global Ageing Network is an amazing and unique amalgam of individuals and organizations that come together around a common goal: Make the world a better place to grow old.

Well-resourced organizations from the U.S. and Australia sit side-by-side with organizations comprised largely of volunteers from less developed parts of the world to learn and grow together. Issues they tackle are varied but cross borders and overcome language barriers.

• What do we know about supporting people with dementia?
• How do we best address cultural norms that counter what is considered "best practices"?
• How do we address loneliness in older age?
• How do we prepare family members for a caregiving role?
• What impact does ageism have on public policy?
• How do we build the leadership skills necessary to help organizations grow and thrive regardless of the size of their budgets?

As provider members of LeadingAge, you are also a member of the Global Ageing Network—along with providers from 30 countries in 6 of the 7 continents. Twenty-five years ago, the leaders of what is now LeadingAge determined that we had much to learn and to share from our peers around the world. They created the International Association of Homes and Services for the Ageing, which is now the Global Ageing Network. In recent years, it has grown in depth and breadth. How can it do anything else, given the unprecedented demographic shifts in countries around the world?

The nature of a network is that it is fluid, with multiple touch points and ways to engage. It is a place for creativity and opportunity. A number of LeadingAge members have tapped into the network over the years, some as recently as a few weeks ago when they attended our 12th biennial conference in Switzerland. They reported that the experience was instructive and inspiring, and they left having made friends from around the world.

As we anticipate an unprecedented number of older adults by 2030--more than double the number from 2000 estimated at 74 million people--we must look to other countries who have experienced a similar demographic shift for solutions. Japan is one such country and is frequently cited for its approach to positive aging. Going beyond our own borders to learn from other countries must be a key part of our strategic thinking. And having the Global Ageing Network at your fingertips should make this easier than ever.

Stay connected with your peers around the world by learning more about the Global Ageing Network. Follow us on Facebook and Twitter and take part in conversations about making the world a better place to grow old.

Recent efforts to repeal or replace the ACA have been acrimonious from a policy perspective and confusing for the citizen observer. The specifics, key players, and data supporting policy directions changed daily—sometimes hourly. It was a roller coaster.

During this time, LeadingAge's time and attention were focused on preserving the structure and financing of Medicaid and, for now, our efforts have paid off. Beyond the immediate policy victory, the real win is the enhanced understanding of what the Medicaid program is, who it covers, and for what benefits. Prior to the recent policy debate, this was not widely known or understood—altogether surprising for a program that touches 1 in 5 Americans.

Medicaid is essential. It is stretched thin, in large part, because it fills needs that reach beyond its intended purpose. Specifically, it is the payer of last resort for long-term services and supports. People in need of these services, which includes 50% of people over the age of 65 at some point in their later years, pay out of savings and retirement income first. They might then look to family members for financial and other essential support. At some point, all resources are depleted and they turn to Medicaid.

We need a solution to take the pressure off individuals, families, and Medicaid, particularly as we face growing demand resulting from a rapidly increasing aging population. We must acknowledge that personal responsibility needs to be matched by public responsibility.

Two weeks ago, we released a report: A New Vision for Long Term Services and Supports. Our vision includes a more rational, balanced system that is based on the following 3 essential features:

1. A universal approach to coverage: The mandatory program would spread risk over a large population, thus lowering expenses for individuals, and increasing overall funding for LTSS.

2. A catastrophic benefit period: The program would finance care for individuals with high needs for LTSS. Benefits would begin after individuals had financed their own care for two years through private long-term care insurance or out-of-pocket spending.

3. A “managed cash” benefit structure: Beneficiaries would use a cash payment to purchase services and supports related to an LTSS need. This flexible approach would ensure that services and supports were tailored to individual needs and preferences.

We hope this vision will stimulate a national discussion at all levels. And that it will be the first of many discussions to come. It is incumbent upon us to help those who struggle daily to meet their own needs for long-term services and supports.

Abraham Lincoln was once asked what he would do if he had 1 hour to chop wood. He responded that he would spend the first 15 minutes sharpening his axe.

Developing and sharing LeadingAge's vision prepares us for the bigger task ahead. Enacting a fair and rational system to ensure access to quality long-term services and supports for all who need it is imperative.

We have sharpened our axe. Now we begin chopping wood so we can all age with dignity and choice.