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Today, the government of Australia released their blueprint for reform of the aged care sector. The proposal would strengthen government support of in-home care, increase wages for care workers and increase government funding for dementia care. While the plan tightens means-testing for elder care, Prime Minister Julia Gillard contends that means-testing increases fairness. The plan introduces more payment flexibility, changing the current system which requires up- front payments, to one in which users may pay either with a lump sum or over time. Interested in learning more? Check out the full report.
Prime Minister Julia Gillard
Photo courtesy MystifyMe Concert Photography™
Nearly two million lower-income seniors live in independent, federally subsidized rental housing throughout this country. The average age for someone living in affordable senior housing subsidized by the U.S. Department of Housing and Urban Development’s Section 202 program is 79 years old – up from 74 in 2006. More than 80 percent of older adults in the U.S. have at least one chronic condition – and half have two or more. These conditions can lead to severe and immediate disabilities like hip fracture and stroke. They can also trigger progressive ailments that slowly erode the ability of older adults to care for themselves. Chronic illness, along with poor health status and functional limitations, are more prevalent among the lower-income seniors. It would follow then that a large portion of residents in affordable senior housing would suffer from chronic illnesses and disabilities.
In fact, an analysis of data from the American Community Survey found that subsidized senior renters are much more vulnerable than those who own their own homes. According to the data, they are older, twice as likely to experience conditions and limitations that threaten their ability to live independently and three times more likely to live alone. Due to their low-incomes and high levels of disability, these renters are three times more likely to be at risk of needing Medicaid(A public program that assists the poor in paying for their medical care). Independent senior housing communities were never intended to be nursing homes. That said, many of these communities – typically in collaboration with community health providers – have taken steps to address the needs of their residents and provide them with access to basic health and preventative services. Research supports this. Taking relatively simple and inexpensive steps to support residents in adopting healthier lifestyles and getting regular health screenings can dramatically reduce an older adult’s risk of chronic illness, disability and premature death. Conversely, poor management of chronic conditions often leads to frequent emergency room visits and hospital stays and may necessitate the transfer of some older adults to nursing homes prematurely.
A wide range of health and preventative services have been made available to older adults living in subsidized housing communities across the country. Their availability is influenced by several variables, including the characteristics and preferences of residents; resident eligibility for different programs; the philosophy and commitment of housing managers; the availability and knowledge base of service coordinators; the availability of health services programs and providers in the community; the relationship between the housing property and potential community collaborators; characteristics of the physical plant (e.g., availability of common space, accessibility, etc.); and the resources available to support the work.
There is no one right way of choosing services delivery strategies – no one model that will work for all. There are, however, a number of lessons learned from the experiences of housing and services providers about the value to each of providing health and preventative services in affordable senior housing communities. Affordable senior housing communities can provide a means of delivering a broad range of services to low-income seniors. Building awareness of and disseminating information on new health program opportunities is easier when a large number of older adults live in close proximity to one another rather than being scattered across many locations. This economy of scale can also offer service providers a time and resource advantage. It is convenient for residents, especially those who are frail or have difficulty accessing public transportation, since they do not have to leave to participate in programs or access services.
Interested in learning more about affordable housing with services? Join our study tour to learn more about financing, delivery, and integration of services in the affordable housing setting.
Article by Alisha Sanders, reproduced with permission from the LeadingAge Center for Applied Research.
The LeadingAge Center for Applied Research was awarded a $698,000 grant from the John D. and Catherine T. MacArthur Foundation to conduct the an assessment in the United States that examines whether affordable housing with services can be instrumental in meeting the health and long-term care needs of low-income seniors.
The grant will help the centre study the role that housing with services can play in helping residents “age in place.” The goal to build the first national dataset on the health and functional characteristics of older people living in public housing with services.
Housing with services is often hailed under the “Berwick triple aim” as a mechanism to improve the care experience, improve outcomes and reduce spending. Interested in setting up a housing with services programme? Consider joining the IAHSA study tour this September.
You can also check out this video from the director of the Center for Applied Research, Dr. Robyn Stone, on the importance of creating an evidence base.
Question time at Parliament House is the next platform for National Aged Care Alliance (NACA) advocates in their bid to secure reform for the aged care system in Australia. The coalition of twenty-eight peak aged care organisations is urging supporters to join them in the public gallery of the House of Representatives during question time in Canberra on Wednesday 14 March as a show of strength and commitment to reforms they say are urgent and must be addressed in the May budget. Senior representatives of NACA member groups will again be visiting politicians at Parliament House on the 13th and 14th to continue to push their message. According to NACA spokesperson and COTA CEO, Ian Yates, the question time event will be held to cap off these meetings and demonstrate the urgency of the situation and the breadth of public support. NACA is seeking a minimum of 140 supporters to don campaign badges and help fill the public gallery in the House of Representatives on Wednesday 14 March. People wishing to join the event should register by emailing firstname.lastname@example.org.
Have you seen the new video highlighting the “House for Betty” concept and design? The video highlights how a home could be “future proofed” and marketed to persons with a genetic propensity for Alzheimer’s type dementia. Unique features of the property include safe wandering paths, bathrooms and kitchens designed for elders, and safety and accessibility features that allow ageing in place.
The Housing Learning and Improvement Network in the UK has recently released a guide that discusses what ‘social capital’ in housing with services means for seniors. The guide outlines best practice examples on the use of volunteers, development of neighbor support networks, intergenerational housing relationships and social enterprise. Based on a wide range of research, practice and responses from UK based housing providers, the authors discuss the challenges and barriers faced by many older people and provide a note of caution about clear assignment of responsibility for personal care and support in housing with services communities. In particular, they ask pertinent questions around:
- How do volunteers contribute to the running of sheltered and housing with services programmes and the quality of life of those living in them?
- How do those living in communities, exclusively designed for older people to support each other, contribute and connect to the wider community?
- What does choice and control mean for people participating in housing with services programmes?
- How can integrated housing with services programmes foster intergenerational solidarity?
You can see the full chapter here. If you are interested in housing with services, you might consider joining our study tour this September. Also, check out this video on the services that Patching Lodge, in Brighton, U.K. provides to its residents.
World Health Day is coming up on 7 April 2012. Aging and health is this year’s special theme, providing an opportunity for organisations and individuals worldwide to showcase solutions to population ageing. As we frequently mention on this blog the world is rapidly ageing, and less developed countries are seeing the fastest change. We are currently experiencing a window of opportunity to establish social and health supports for an ageing population before the strength of such systems will be tested.
2012 marks the 10the anniversary of the adoption of the Madrid International Plan of Action on Ageing (MIPAA). The plan is a resource for policy-makers, and suggests ways for governments, nongovernmental organizations and other stakeholders to re-frame the conversation around ageing.
It’s important to remember that elders possess a world of knowledge and are important contributors to social life and societal stability. Organisations, cities, communities and individuals are invited to celebrate in 2012 the contribution of older women and men on World Health Day through events and other activities. Making cities and communities age-friendly is one of the most effective policy approaches for responding to demographic ageing. Cities and communities wishing to become more age-friendly can take part in the WHO Global Network of Age-friendly Cities and Communities.
Does your organization plan to put out a call to action in support of World Health Day? The World Health Organization is recommending calls to action be issued around the topics of healthy active lifestyles across the lifespan, the creation of age friendly environments, and creating better understanding of elders needs among health care providers.
Photo courtesy lukaszduleba
Ageing in place is a concept that is frequently discussed, but yet not all organizations are taking steps to make it possible. Losing the ability to drive is a main push factor that causes rural seniors to have to move. There are a variety of ways that this problem can be overcome. Organisations can offer shuttle bus services for seniors; buses pick seniors up and transport them to grocery stores or day centres. Offering the service to multiple clients can keep prices reasonable for seniors while still being profitable for the organization. Alternately some organisations have organized volunteer driver programs. Using community based volunteers with autos, individuals pick up the senior and drive them to their activity or errand. Organizations charge the elder a small fee for this service to cover the cost of background checks on the driver and coordinating the driving schedule. Delivering services at home through information and communications technologies is another manner to overcome transportation issues. Examples of this include physiotherapy delivered through Skype sessions or vital sign monitoring transmitted to a nurse through a telehealth unit. Looking for more great ideas to incorporate into your homecare service? Join us on our Housing with Services tour this fall to see how Peter Sanborn Place, Hebrew Senior Life, and Cathedral Square keep their clients safe, healthy and engaged in the comfort of their own homes.
Photo courtesy of Johnny Söderbergs nya
Do you and your organization want to expand your home care services? Many seniors and families would like to stay in their home or residence rather than move to a care home, and yet they need help on a frequent basis. Receiving services at home can be the answer to the need for care, while affording elders the privacy and comfort they crave. One of our member organizations, Cathedral Square in Burlington Vermont, excels at providing and coordinating services at the home and community level. With their SASH (Support and Services at Home) model, they meet seniors where they are, perform a comprehensive assessment of needs and abilities, and create a custom healthy ageing plan. This work is executed through an inter-disciplinary team of physicians, nurses, social workers, and case managers that map out the variety of services that would benefit the elder. Through their coaching and transition team, they help seniors manage chronic conditions such as diabetes, chronic obstructive pulmonary disease, and arthritis, encouraging a whole-person approach including medication management, a healthy diet, and condition appropriate physical activity. Care plans are updated on an on-going basis to manage high-risk patients and adjust to changes in the elder’s condition.
The program takes advantage of local public health infrastructure and coordinates with area health authorities to promote population level interventions. SASH emphasizes social wellbeing, and works with a strong group of volunteer visitors that provide needed social interaction with seniors who have difficulty leaving their homes. Want to learn more? Check out the Cathedral Square video below or consider joining us on our Housing with Services Study Tour this fall.
The government of Hong Kong recently revealed plans to support elders as they age in place. The four-year pilot scheme will provide vouchers to the elderly to help them cover the cost of services they need. The government hopes that by directly providing payments to the elderly, they will choose the services that they most desire and enjoy. They also theorize that the elderly may prompt the delivery of different types of services, spurring greater efficiency and diversity in the services that the aged can receive at home. The proposed value of the vouchers would be a flat rate and be distributed to seniors with moderate impairment. The government also plans to make improvements to 250 community centres for the elderly to improve service delivery capacity over the next six years.
The vouchers and the centres are to function as part of a wrap-around service plan that includes public transportation, social welfare schemes, community care places and residential care places. You can read the full story here.