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Much has been written in the US about the Green House movement, founded by Dr. Bill Thomas, creator of the Eden Alternative. The Green House model has been consistently featured in articles and as education sessions since its inception.
This recent article on Kiplinger.Com gives a good description of the model here in the US. If there are similar models of care in your country please share them with us.
Late in 2007 we wrote about the importance of care coordination for individuals moving from one level of health care to another. The OECD’s study highlighted four key areas for reform and gave an overview of practices in three countries – the US, Germany and England.
Now according to a recent report, the Australian Government has allocated AUS$300 million to provide transition services for elderly to help them regain heath and independence after discharge from a hospital. The program will provide a range of low intensity therapy services, including physiotherapy, dietetics and podiatry, as well as nursing support and personal care services.
This is a very important part of a comprehensive health care plan and is a good model for others to replicate.
Have you ever wanted to learn more about housing policy in the United States? If so, we have some great resources for you.
Thanks to IAHSA Board Member Steve Protulis we are able to connect you to reports that have been compiled in response to inquiries by international delegations visiting the Department of Housing & Urban Development in Washington.
These visitors have many questions about applying U.S. practices in emerging markets, structuring an effective secondary mortgage market, and managing credit risk. Three reports compiled in response to these inquiries are now available in multiple languages and
can be downloaded, free of charge, from the web pages listed below:
o Evolution of the U.S. Housing Finance System: a
Historical Survey and Lessons for Emerging
Mortgage Markets,
www.huduser.org/publications/hsgfin/US_evolution.html
(in English, French, Spanish, and Russian).
o Mortgage Securitization - Lessons for Emerging
Markets, www.huduser.org/publications/hsgfin/Mortgsecurity.html
(in English, French, and Spanish).
o The Measurement and Management of Mortgage Credit
Risk in the United States: Implications for
Emerging Mortgage Markets,
www.huduser.org/publications/hsgfin/MortgCreditRisk.html
(in English, French, and Spanish).
According to a new national survey of working adults in the US, one in four employees currently cares for an older or disabled adult.
The study, conducted by work-life benefits firm Workplace Options, noted that of the employees caring for an older adult, nearly half have missed work time.
The role of the employer was also reviewed and 61% of the respondents said that they would utilize a service that assisted with care giving if it was provided by the employer free of charge.
It would be interesting to see if the situation is similar elsewhere in the world. Please add a comment to let us know what you see in your country.
A recent article in the Telegraph UK featured a story about using a fake bus stop as a simple yet effective way to prevent dementia patients from wandering off.
Directors at the Benrath Senior Centre in Duesseldorf, Germany, tired of relying on local authorities to round up roving patients, joined forces with a local care association and the public transportation department to erect a faux bus stop outside their facility.
The idea is that seniors who wander will recognize the familiar green and yellow bus stop and wait there to be taken home. Care givers retrieve the patients from the stop by telling them the bus will be along shortly, and then they invite them in for a cup of coffee, says Richard Neureither, Benrath’s director.
This offbeat concept has proven so effective that several other nursing homes around Germany have set up their own bus stops to snare seniors.
I saw a similar set up when I visited some IAHSA member facilities in Australia a few years back. In addition to the fake bus stop, they also had an automobile in the yard that dementia patients could sit in to recreate the sense of everyday traveling. What a good idea! And it works.
The Australians have done it again – providing leadership in the creation of a user-friendly website to help carers develop cultural awareness and build appropriate strategies for building a respectful, caring relationship with client who are Greek and who have limited knowledge of English.
Greek Care provides practical advice and information on how to work with Greek elders — communication strategies, activities, religious information, information about beliefs and values that impact on service delivery — as well as background information about Greek history, geography and tradition. There are many hints on how to enhance the practitioner-client relationship. Often they are quite simple strategies that will nevertheless engage your client and elicit satisfaction on their part.
In the past we’ve blogged about the Australian Centre for Cultural Diversity in Ageing – another example of the importance given to this complex issue.
Thanks to Tim Dixon, Deputy Editor of Australian Ageing Agenda for telling us about Greek Care.
Recent research at the University of Helsinki, Finland, indicates that if a person’s spouse passes away, the surviving spouse is more likely to enter a long-term care facility than those with a living spouse.
The study to be published in July in the American Journal of Public Health analyzed how the death of a spouse affects the likelihood of needing institutionalized care. According to an article in Reuters, the research team followed nearly 141,000 adults in Finland, age 65 and older, living with a spouse. They were followed for five years, and results showed the risk of entering long-term care was higher in those who lost a spouse as compared to those still living with their spouse.
One conclusion of the study was that targeted bereavement counseling would help reduce the need for institutional care.
During IAHSA’s 2nd European Conference in Vienna last week, there was a lot of talk about culture change – not only during the education sessions but also as a major theme for the networking breakout groups.
A primary tenet of culture change is creating an environment that honors person-centered care – where seniors in aged care facilities enjoy much of the privacy and choice they would experience if they were still living in their own homes.
In order to get an idea of how far Culture Change has progressed in the USA, the Commonwealth Fund conducted a research project to study nursing homes to determine the penetration of the culture change movement. The results were mixed with much room for improvement. However the researchers found that the more a nursing home adopts culture change the greater the benefits, in terms of staff retention, higher occupancy rates, better competitive position and improved operational costs.
IAHSA members around the world are embracing the culture change movement. Share your experiences with others by adding comments here.
The OECD recently released a report on the health workforce and migration policies in New Zealand, with a special focus on the international recruitment of doctors and nurses.
While the report focuses on New Zealand, primarily because NZ has the highest proportion of migrant doctors among OECD countries, the information should be of interest to all countries that are depending on immigration to support health care services.
Increasing international competition for highly skilled workers raises important issues such as sustainability and ability to compete in a global market. Better coordination and stronger collaboration could contribute to more effective and pertinent policies.
IAHSA will continue to monitor this important topic for our member’s benefit.
Seven years ago, Dr. Robyn Stone co-authored a white paper entitled Who Will Care for Us? Addressing the Long-Term Care Workforce Crisis in America.
This excellent paper challenged policymakers to take action on ways in which the USA can prepare for the coming baby boomer generation and the demands that they will make on the health care system in general, and the long-term care system specifically.
Now seven years later, the Institute of Medicine’s recent report, Retooling for An Aging America: Building the Health Care Workforce, echoes and expands on the issue, calling for bold initiatives designed to meet the growing needs of an expanding elderly population. Dr. Stone testified on the study before the US Congress saying, “The growing demand for long-term care, resulting from aging baby boomers and a much smaller pool of traditional caregivers, means the future will be immeasurably worse without decisive action by both public and private sectors.”
No one except our ageing service provider members seemed to be listening in 2001. Perhaps others will in 2008.
The Institute for the Future of Aging Services recently published a new report based on analysis of the 2004 National Nursing Home Survey [USA]. The report shows that 1 in 4 nursing home residents aged 65 and older has diabetes. The report also examined the association between diabetes and ethnicity, activities of daily living, source of admission, payment sources, length of stay, pressure ulcers, emergency department visits and medication usage.
Not only does this brief demonstrate the extremely high prevalence of diabetes in U.S. nursing homes, but it raises important issues related to planning for the special needs of this large segment of the nursing home population.
And even though it is based on US data, the lessons learned can be applied in many countries around the world.
According to new data published in the Human Resources for Health journal, the international migration of doctors and nurses has contributed to the critical shortage and inequitable distribution of health workers in many developing countries, resulting in a situation where people living in the most deprived areas do not have access to health services.
Some countries have introduced voluntary Codes of Practice (COP) for the ethical recruitment of international health workers. These intend to restrict aggressive recruitment from countries experiencing shortages of their own and also to protect the rights of migrant workers and support them in their job.
IAHSA views this issue as a top priority in our long term care workforce strategy. We will continue to follow this issue very closely as it has a tremendous impact on the availability of workforce for ageing service providers.
Majd Alwan, Director of CAST, is a well known and respected researcher in robotics and elder care technologies. He is also a believer in the importance of using IAHSA’s Global Ageing Network as a vehicle for sharing knowledge about potential technological solutions to the challenges of global ageing.
He and Dr. Jeremy Nobel of Harvard University have written a compelling three-part report that outlines the state of the field in the United States with respect to the development of technologies for the ageing service field.
The report, funded by the Blue Shield of California Foundation, offers a vision for long-term care that includes using integrated information technology systems to support and enhance the health, safety and social connectedness of older people living in their own homes.
They identify several barriers to achieving this vision, but are confident that a combination of new knowledge, linked to effective collaboration among a variety of stakeholders, can overcome these obstacles to widespread technology adoption.
This is an important paper and most of the observations are applicable across the globe. Please share it with your colleagues.
For those of you interested in what’s going on in China – in addition to the Olympics and the issues surrounding Tibet – the Chinese Government has issued a paper describing its plan for dealing with its increasing elderly population. Entitled ‘The Development of China’s Undertakings for the Aged’, the paper outlines their official position on a variety of issues, including:
I. State Mechanism of Undertakings for the Aged
II. Old-age Security System
III. Health and Medical Care for the Aged
IV. Social Services for an Ageing Society
V. Cultural Education for the Aged
VI. Participation in Social Development
VII. Safeguarding Elderly People’s Legitimate Rights and Interests
Have you ever thought about using a robot as a baby sitter? Or having one give you a bath?
According to a study by a Japanese think tank, The Machine Industry Memorial Foundation, robots will be able to fill the jobs of 3.5 million people by 2025 in graying Japan, helping to avert worker shortages as the country’s population shrinks.
Japan has long been regarded as one of the ‘oldest’ countries, facing a 16% slide in its workforce while the number of elderly grows.
Rather than each robot replacing one person, the foundation said that robots could make time for people to focus on more important things. Like bathing?
It would take me a while to get used to having a robot give me a bath. How about you?
I read BBC online every day to see what’s going on around the world related to ageing. Today I’ll share three articles focusing on research on ageing and ‘drugs’ - I call it The Good, the Bad and the Tasty.
The Good News: Blood pressure drugs help elderly – Imperial College London researchers announce that blood pressure drugs cut the risk of strokes and heart problems in the over 80s.
The Bad News: Medication ‘worsens’ Alzheimer’s’ – a research report from Kings College London says that anti-psychotic drugs have no long-term benefit for patients with mild symptoms and may even cause a deterioration in behavior.
And The Tasty News: Daily Caffeine Protects the Brain – in the past there have been conflicting reports on the benefits or detriments of caffeine. Now research published by the University of North Dakota suggests that coffee may cut the risk of dementia by blocking the damage cholesterol can inflict on the body.
You never know what will effect your life. Personally I avoid taking any medications at all. But I do love a good cup of coffee. Thankfully I don’t have to worry about that, for now at least.
The Centre for Cultural Diversity in Ageing, located in Victoria, Australia, is an online source of information on culturally appropriate aged care.
The Centre was developed to guide and promote best practice standards of care that address cultural diversity across all levels of service design and delivery.
They have developed a glossary of over 1000 terms used in ageing and translated them into 13 community languages. Even though some of the terms are tailored to the Australian ageing service system, I would think that the Glossary of Aged Care Terminology would be very useful for organizations needing to promote consistency of translations of aged care information.
Last week I read an article from the Chicago Sun Times about the growing need for creation of accessible housing for the ageing baby boomers in the US - the Post-WW2 generation that will become the largest segment in US history to age at one time.
As they age and begin to hit geriatric roadblocks, some will need special housing.
Making new housing accessible is required by law – making new construction specifically designed to be lived in or visited by people who have trouble with steps or use wheelchairs or walkers.
But the term ‘visitable’ was new to me. And I think a good addition to the vocabulary. It means that the building is inclusive to everyone. It allows a person with a disability to become integrated into a community – to be able to ‘visit’. And these ‘visitable’ homes are designed to allow for greater adaptations as the owners’ needs change.
IAHSA is very lucky that we are very well represented at the United Nations by our two Ambassadors, Bill Smith, CEO, and Katie Weiss, Chair of the Board, both at Aging in America in New York City. Their regular attendance at meetings of the NGO Committee on Ageing and other UN events is very important in keeping us up-to-date on these global activities that can impact our members.
A recent presenter was Professor Robin Blackburn, author of Banking on Death or Investing in Life and Professor of Sociology at the University of Essex in England. Banking on Death offers a panoramic view of the history and future of pension provision. A work of unique scope, it traces the origins and development of the pension idea, from the days of the French Revolution to the troubles of the modern welfare state.
Thanks Bill & Katie. We’ll keep reporting on your UN activities to our blog readers
Consumers and ageing service providers are expecting a lot from new technologies - helping folks stay independent longer, enabling workers to concentrate on care giving rather then record keeping and reducing the number of medication errors, for example.
And if anyone can make it happen it is Dr. Majd Alwan, CAST* Director and world-recognized researcher in ageing service technologies.
In a recent interview with Nursing Homes Magazine, Dr. Alwan outlined CAST’s new direction in taking a more proactive role in assisting providers to identify their needs and review relevant technologies. CAST is also encouraging pilot research studies with outcome measures to validate the usefulness of various technologies.
“Key factors to success are ease of use, attention to staff training and good availability of technical support”, noted Alwan.
Bookmark CAST’s website – you’ll want to visit it often.
*Center for Aging Services Technologies
Unfortunately bad conditions are often the drivers for government to get involved in regulating private businesses. You’ve seen it in all types of industries and long term care is no exception.
And ageing services in Ireland is the latest example. The recently issued standards of care and welfare, announced by Ireland’s Health Information Quality Authority, were a result of an abuse scandal at a Dublin nursing home.
As the Irish Times reported, the 32 standards are aimed at keeping residents safe from physical, financial, material, psychological or sexual abuse and neglect. The new regulations are welcomed by Age Action Ireland as well as the association that represents nursing homes, Nursing Homes Ireland. However Tadhg Daly, CEO of Nursing Homes Ireland, noted that “It’s fair to say that regulations, no matter what sector, will have an increase in the cost both to the provider and also for those in our care.”
We all know that regulations do increase costs. And our hope is that they also result in an increase in quality. But sometimes ageing service providers need to create their own quality systems, such as Quality First in the US and My Home Life in the UK. Check them out and let us know what you think.
The approaching onslaught of over 70 million aging baby boomers could overwhelm the U.S. health care system and engulf the nation’s tenuous economy, according to a new study, “Will the Boom Bust Health Care?,” by management consulting firm Tefen USA.
Medical News Today reported that the study predicted some severe consequences:
-Health care quality will suffer, with wide variation in treatments and big differences in death rates and surgical complications.
-Federal spending on Medicare and Medicaid will skyrocket, forcing politicians to raise taxes or severely curtail a wide range of other government programs.
-State budgets will suffer under the crush of soaring Medicaid costs, compromising support for education and other local initiatives.
-The nation as a whole will have fewer and fewer dollars to spend on education, environmental protection, scientific research and national security.
“Despite what many people think, the solution is not a single-payer system,” said Barry Calogero, president, Tefen USA, and author of the study. “While socialized medicine provides some advantages from an access standpoint, it does not address the underlying cost and quality issues that threaten the functional integrity of health care in the U.S. The real solution to America’s health care challenges requires three components: implementing tort reforms, mandating the use of best practices and driving systemic process improvement.” The Tefen study provides insights and details on each of these three solution elements.
As I posted earlier this week, every 7 seconds there is a new case of dementia somewhere in the world. In 2001, 24 million people were diagnosed with Alzheimer’s Disease or other forms of dementia. Researchers expect this number to rise to 43 million by 2025 and to 81 million by 2050.
The medical community has long been challenged on how to make a definitive diagnosis of Alzheimer’s Disease. Currently doctors use a combination of brain scans, blood tests and patient interviews, but distinguishing the disease from other forms of dementia is difficult, and time consuming, and the accuracy of diagnosis is only about 85%. A truly definitive diagnosis is only possible after death.
Now, according to a recent BBC News report, researchers at University College London have published findings in the journal Brain showing that, using computer technology, they can identify brain damage caused by Alzheimer’s with an accuracy as high as 96%.
Alzheimer’s Disease symptoms only emerge after a considerable amount of damage has already occurred in the brain so it is important to make an accurate diagnosis early to improve the chances of effectively preventing further deterioration.
Having a powerful, non-invasive, fast and cheap technology to provide early diagnosis would be a much needed advancement in the treatment of this terrible disease. The researchers are doing further analysis to understand the full benefits and accuracy of the technique and to see if it can be used to assess the effectiveness of new drugs.
We have our fingers crossed that they are successful.
Every 7 seconds there is a new case of dementia somewhere in the world. In 2001, 24 million people were diagnosed with Alzheimer’s Disease or other forms of dementia. Researchers expect this number to rise to 43 million by 2025 and to 81 million by 2050.
These figures were outlined in a recent article about global ageing in the AARP Journal by Marc Wortmann, Executive Director of Alzheimer’s Disease International [ADI], an the umbrella organisation of Alzheimer associations around the world.
ADI plays a very important role helping national Alzheimer associations become stronger, educating the public about the disease, and serving as an important resource to emerging economies for developing resources to address the needs of their populations.
‘Change’ is constantly in the news these days – especially in the USA where all of the Presidential candidates are portraying themselves as ‘agents of change’.
I think that action speaks louder than words – as demonstrated in a recent Wall Street Journal article that eloquently describes 12 individuals who are true agents of change.
Two of these leaders, Eric Dishman and Dr. Bill Thomas, are well known to the IAHSA family, both having appeared at an IAHSA Global Conference in the past. Eric and his colleagues at Intel are developing technologies to help people stay home as they age and become frail. Bill is best known for his pioneering work in culture change and his Eden Alternative program. He also posts daily to his blog Changing Aging. Its very worth reading.
Others are also doing very important work in a wide variety of fields including financial planning, advocacy, retirement living, and urban planning, to name a few.
Let us know who the Ageing Change Agents are in your country.
On 12 February, I participated in – The Untapped Resource: Older Persons in the World of Work – a session organized by the United Nation’s NGO Committee on Ageing. This programme was held as “side event” in conjunction with the 46th Session of the U.N.’s Commission for Social Development (which concludes today in New York).On behalf of IAHSA, Dr. Robyn Stone, Executive Director of the Institute for the Future of Aging Services/IFAS (co-located with IAHSA in Washington, DC) gave the session’s keynote presentation.
Robyn’s presentation – The Geriatric LTC Workforce: Challenges & Opportunities for Older Persons – was extremely well received and a number of her points particularly resonated with me and my colleagues in attendance:
· We are currently experiencing a great crisis in the recruitment and retention of the geriatric workforce (especially in regards to the frontline caregivers) that will only get worse as population ageing has made long-term care one of the fastest growing sectors in our economy.
· While a significant percentage of the frontline workforce is already comprised of persons aged 50+, many older informal caregivers become “hooked” on this role and become professional caregivers once their responsibilities to their loved ones end.
· Many older persons want to continue working in order to keep active and engaged, while other older persons must stay in the workforce out of economic necessity.
Robyn offered the following strategies regarding older persons as part of the long-term care and employment solution:
§ Technologies to help retain quality older staff (e.g. reducing physical burden)§ Work redesign (e.g. job sharing options)§ Retired physicians, nurses, administrators as volunteer mentors/coaches for younger staff§ Retired geriatric professionals as educators in colleges, universities, trade schools§ Retired CNAs, home health and home care aides as trainers for new direct care workers and family caregivers§ Second careers for older persons§ Family caregivers as formal providersIAHSA will keep you posted on our continuing collaborations with Robyn and IFAS on long-term care workforce issues! For more on IFAS’s research visit http://www.futureofaging.org/.
Keeping quality front line staff is a constant challenge to ageing service providers all over the world – especially challenging is finding the right mix of incentives and training.
Recent research in the US shows that development of career ladders and other training initiatives has a number of positive outcomes:
- Improved communication, between and among staff and residents
- Increase in clinical skills
- Increased and improved teamwork
- Increased self-esteem and self-confidence among staff
- Improvement in recruitment and retention numbers
There were implementation challenges facing organizations, including the need for language training, providing staff coverage during training, and translation of training into practice.
This project, through funding by the Commonwealth Corporation, was conducted by the Institute for the Future of Aging Services [IFAS] and the Gerontology Institute at the University of Massachusetts, Boston, was 18-month qualitative evaluation of the Extended Care Career Ladder Initiative, a program of the Massachusetts Nursing Home Quality Initiative.
IFAS is continually doing quality research on issues related to the long term care workforce. You should bookmark their Web site.
When you think about the elderly and ways to care for them as they age, most of the time the focus is on the general population and development of services that can meet their needs ‘in the place they call home’ – be it in their residence or an institutional setting like a nursing home.
But as the Japanese are discovering, there is another population that is ageing as well – the inmates in their prisons. The number of prison inmates over 60 has more then doubled in the past 10 years and this will continue to increase, reflecting the general ageing trend. To accommodate the needs of the ageing inmates, Japan is building three new barrier-free jails with disabled access, including elevators, wheelchair ramps and grab-bars in bathrooms. But rest assured, the prisons will not be totally ‘barrier-free’, as reported in an article by Reuters.
The other day, I went to see my doctor for some tests. As I was sitting in the waiting room, I heard the nurse on the phone trying to help someone find a rehab hospital to go to after an operation. After placing a number of calls, the nurse finally found placement, only to be told that the patient’s insurance company wasn’t on the facility’s list of ‘preferred’ providers. Eventually they found a place for the patient to go but at a great waste of time and expense.
This is a scenario being played out every day here in the US, the story of a frustrating and inefficient system. The question is: How can we simplify the challenge of having to be transferred from one type of care to another and create patient-centered care that is more coherent both within and across care settings and over time?
And it is not just a problem in the US health care system, as discussed in a recent report by the OECD entitled Improved Health System Performance Through Better Care Coordination. This is a comprehensive paper focusing on the issue of care coordination and including an overview of the issue, identification of four key areas for reform, and an overview of practices in three countries – the US, Germany and England.
Major findings include:
- Interest in coordination of care issues is increasing
- Targeted programmes appear to improve quality but evidence on cost-efficiency is inconclusive
- Care coordination would be facilitated by better information transfer and wider use of ICT
- New ambulatory care models need consideration
- Care coordination may benefit from greater health-system integration
The OECD report didn’t mention NTOCC – the National Transitions of Care Coalition – probably because it is so new. NTOCC was formed in the US in 2006 with a mission of being an influential stakeholder in public awareness, education and health policy to focus on improvement of quality of transitional care. NTOCC is rapidly building a following among all sectors of health care and could be a good model for others. Is there anything like this happening in your area? If so, please share with us.
Starting in April 2008, millions of pensioners will be handed control over how the money is spent, rather than relying on social workers to make the decisions. As reported in the BBC News On-Line, Health Secretary Alan Johnson, who officially announced the scheme on Monday, said it was a “radical transfer of power from the state to the public”.
Individuals will be means-tested to assess their health and personal needs, and councils will then pay the cash into their bank accounts or those of nominated relatives.
According to the government, the changes are designed to create more competition among care agencies.
Similar programs exist in other European countries. A 2005
OECD study showed that other countries, such as The Netherlands and the USA have developed a variety of cash benefit programs to allow dependent persons and their families more individual choice among care options. Consumer choice can improve the self-determination and satisfaction of older persons and increase the degree of independent living, even in cases of dependency. Surveys have shown that greater choice and consumer direction can contribute to better quality of life at a similar cost compared with traditional services.
In the UK, Campaign Group Age Concern did welcome the scheme.
Director General Gordon Lishman said: “It is absolutely right to put older people’s needs at the centre of the care system and to place a clear emphasis on preventive services.
“Older people and their families will continue to need information and support to help them negotiate the best care package at the best price with care providers.
“This will be challenging but we are sure it is something the government will want to address.”
This summer we were given a very special movie, Away From Her, a heart breaking story about a family’s struggles with the ravages of Alzheimer’s disease. The film portrayed the ravages of the affliction with clear-eyed honesty, tracking not only the effects on the victim, played by Julie Christie, but also on the caretakers who provide support even as she faded away right before their eyes.
So when I read the USA Today news article A New Page in O’Connors’ Love Story about how Alzheimer’s has changed the life of John O’Connor and that of his wife, retired Justice Sandra Day O’Connor, I couldn’t help but think about how life imitates fiction. In the film, as in the real life of John O’Connor, the main character finds a new love with a fellow resident at the Alzheimer’s facility. While the impact on the partner ‘left behind’ can be devastating, it provided a sense of relief for Justice O’Connor. As their son Scott said, “For Mom to visit when he’s happy – visiting with his girlfriend, sitting on the porch swing holding hands – was a relief after a painful period’.
As a reviewer said of Away From Her – ‘it is poignant, wise and unafraid’. The same can be said of Justice O’Connor and her family.
When I’m ready to post a message on IAHSA’s Global Ageing Blog, I often cruise the internet, looking at a variety of blogs to see what’s new in the field of ageing and what’s news that will interest IAHSA’s blog readers.
One blog I’ve found is the brain child of Dr. Bill Thomas, founder of the Eden Alternative and professor at Erickson University in Maryland.
His Changing Aging blog not only serves as a vehicle for his thoughts on a wide variety of topics, from Nobel prize winner Doris Lessing to the demise of the Red Hat Society, it also is developing a good list of blogs that deal with ageing. Check it out at changingaging.org
Unfortunately, most of the blogs I’ve found are US based. If you know of ageing related blogs from other parts of the world please send us the links – we’ll blog roll them.
This week I had the honour of being part of a high-level dialogue on long-term care, hosted by AARP International and the German Ministry of Health. The dialogue convened an elite group of experts and opinion leaders from both the US and Germany for a discussion that highlighed important common challenges and opportunities on key long-term care issues. The aim of the long-term care dialogue was to develop a platform for exchange and dialogue, conduct policy analysis, and identify best practices to inform policy debates in both the US and Germany.
IAHSA & AAHSA were well represented in the program. Dr. Robyn Stone, Executive Director of the Institute for the Future of Aging Services, addressed the important issue of workforce in maintaining a viable ageing services system. Barbara Manard, AAHSA Health Strategist, contributed to the dialogue on long-term care financing options. And Dr. Majd Alwan, Director of CAST, convened a panel on the value of technology in ageing services. My panel focused on long-term care insurance, with a discussion of the relative merits of a voluntary insurance market [US] versus a mandatory one [Germany].
This was a very important discussion that enlighted participants from both sides of the Atlantic. And I was able to meet new colleagues while renewing old friendships. That is what makes a great meeting.
Concurrent with the meeting, AARP International released a policy paper that compares long-term care in Germany and the US. A copy of the paper can be found here.
Everyone is talking about the Global Ageing Crisis – the demographics, the cost of care, the demands on the ageing services, the impact on the environment.
IAHSA members also talk a lot about the current and soon to be devastating shortage of direct-care workers. But historically that is the one issue that many governments have avoided talking about.
Josh Wiener, a well-known author and policy analyst, calls it The Elephant in the Room. As Wiener noted in a recent interview by the Paraprofessional Healthcare Institute in the US, “When I talk to policymakers about the need to address the workforce, much of the reaction I get is: ‘Yes, this is going to be a big problem, and no, I don’t want to deal with it right now, thank you’. That’s why I’ve called it the Elephant in the Room – everyone knows it’s there; everyone knows it’s going to have a huge impact, but few policymakers are willing to take on what it would need to address this in a systematic fashion”.
Wiener feels that if countries are intent on improving quality of care or change the delivery system, they have to start with an adequate workforce who can provide services.
He believes that there are a number of common sense things that could be done to improve the direct-care jobs in order to find and keep the growing number of workers needed.
“The troika is basically wages and benefits, trying to change the organizational culture and providing additional training and job design – making it more into a career ladder”.
IAHSA agrees. And together with the Institute for the Future of Aging Services [IFAS], we are facilitating discussion among our global members on this important issue. That is the only way we’ll be able to let the Elephant out of the Room.
Workforce Recruitment & Retention Research – Local Results; Global Impact When we ask providers, ‘What keeps you up at night?’, almost everyone responds, ‘Having a quality and stable direct care workforce’.
Workforce consistently ranks NUMBER ONE as the most challenging part of your job.And finding successful ideas to increase your ability to recruit and retain workers is not easy.
Now, under the leadership of Dr. Robyn Stone, Better Jobs Better Care just released the findings from a 4-year study of different aspects of recruitment and retention strategies. Even though the study took place in the USA, the lessons learned are applicable around the world. Key findings from their recently released report include:
- Older workers are interested in direct care work
- Formerly paid family caregivers could add to the pool of home care workers
- Supervisors’ management styles have major impact on retention
- Retention specialists can reduce turnover
- Cultural competency affects job satisfaction
- Direct care workers and supervisors need training changes
- The right kind of training improves job satisfaction and team care
As you read this you’re probably thinking – This is just common sense: I knew all that. But the difference is that BJBC has clinical evidence and if you read their report you’ll get some hints on how to apply the findings. Give us your feedback
