Health AGEnda

New JAHF President Terry Fulmer, PhD, RN, FAAN:
‘Going From Strength to Strength’

Terry Fulmer, PhD, RN, FAAN, started as the John A. Hartford Foundation's new President this week.

Terry Fulmer, PhD, RN, FAAN, started as the John A. Hartford Foundation’s new President this week.

As I begin an exciting new chapter of a career deeply embedded in geriatrics, I am thrilled by the opportunity to serve as the new President of the John A. Hartford Foundation and bring all of my experience, expertise, and energy to the challenging task of creating transformative change in the way health care is delivered to older Americans.

Many of you already know me, but for those of you who don’t, let me briefly introduce myself: Most recently, I was University Distinguished Professor and Dean of the Bouvé College of Health Sciences at Northeastern University. Before that, I was the Erline Perkins McGriff Professor of Nursing and founding Dean of the New York University (NYU) College of Nursing. For 15 years, I also served as co-director of the Hartford Institute for Geriatric Nursing at NYU, and have held faculty appointments at Boston College, Columbia University, Yale University and the Harvard Division on Aging. I also am an elected member of the Institute of Medicine, and have held leadership positions at the American Geriatrics Society and the Gerontological Society of America, among others. My passion for improving the care of older adults has been central in all of these roles.

Continue reading

Hartford Grantees, Friends Shine at AGS Annual Meeting

National_Harbor_400pMost of our John A. Hartford Foundation staff have come to the banks of the Potomac River in National Harbor, MD, this week for the annual scientific meeting of long-time grantee and partner, the American Geriatrics Society (AGS). It’s always a great opportunity to catch up with valued friends and colleagues, learn about the latest advances in aging and health research, and celebrate those who have made important contributions to the field.

This year is no exception. In fact, it is gratifying to see how many of those being honored by AGS this week have been part of the Hartford Foundation community, through grants, scholarships, fellowships, and partnerships.

Steven R. Counsell, MD

Steven R. Counsell, MD

Continue reading

When the Health Care System Gives You Lemons, Form a Change AGEnts Action Community

A neighborhood lemonade stand set up by Rachael Watman’s son and his friends reminds us of some valuable lessons about success.

A neighborhood lemonade stand set up by Rachael Watman’s son and his friends reminds us of some valuable lessons about success.

My son and an enterprising group of neighborhood kids recently hosted a lemonade stand. They have done this in the past with modest success. This time, however, they outdid themselves by working as a team.

While my son and a few of the kids ran the stand, others rode their bikes up and down Main Street informing potential customers about the superior product to be had right around the corner. They also posted pictures on Facebook and scored their first delivery order to a local business owner.

Continue reading

Partnership Advances a Revolution in Mental Health Care

The author, Diane Powers, in Idaho in 2013, during a series of site visits in the Pacific Northwest to determine grant awards.

The author, Diane Powers, in Idaho in 2013, during a series of site visits in the Pacific Northwest to determine grant awards.

In 1998, a gallon of gas cost $1.15, the last episode of Seinfeld aired on TV, and the John A. Hartford Foundation quietly helped start a revolution in mental health care. That was the year Dr. Jürgen Unützer, then an early-career psychiatrist at UCLA, convinced the Hartford Foundation of the worthiness of a radical idea—bringing mental health care into primary care.

The idea of having a primary care provider treat patients for common mental health conditions was so different that Unützer and Wayne Katon, Unützer’s mentor and an established psychiatrist at the University of Washington, were having difficulty finding a funder to test it.

Continue reading

Making Electronic Health Records Responsive to Needs of Older Adults (Really Meaningful Use)

EHR_shutterstock_150374810_300pI was recently in New Orleans and coincidently listened to an interview with Robert Wachter of the University of California, San Francsico talking about health IT and his new book on where the nation stands regarding electronic health records (EHRs).

Somehow, the temptations of the French Quarter and the problem of EHRs combined in my mind to produce the image of the nation’s health system out on the town, binging on HITECH Act ARRA money, blackout drunk, and waking up married to some very inappropriate electronic health record system.

This isn’t exactly how it happened, but most of the bloom does seem to be off the rose of the electronic medical record and we are in a phase of regret and disillusionment. Physicians have been complaining for years about the hours added to their days by the workflow disruption of digital data entry and the breach in the relationship with patients created by interacting with the computer, rather than the person. At the same time most of the anticipated fabulous features of EHRs are still in the anticipated stage.

Continue reading

Using Storytelling to Drive Change

Caregiving_Walk_400pDid you hear the story about the New York woman who fought tooth and nail to honor her father’s wish to die at home, only to have the health care system bounce him from facility to facility? He died in a hospital hospice unit with deep pressure ulcers and a million dollars in costs for care that was unwanted.

Or how about the piano teacher dying from cancer who Atul Gawande wrote about? Through a conversation about her priorities, she returned to teaching his daughter and other students, all during home hospice care over the last six weeks of her life. She focused not on having a good death, but on having the best days possible right until the end.

These are stories that stuck with me. They hit a chord. They struck a nerve. However you describe it, they changed the way I was thinking and compelled me to share them—to get others outraged or to give them hope.

Continue reading

IOM Study Offers Hope for Solutions to Challenges Facing Family Caregivers of Older Adults

Gary Epstein-Lubow, MD

Gary Epstein-Lubow, MD

The first place I worked after completing my geriatric psychiatry training was an outpatient neurology clinic devoted to memory disorders. I soon realized that most patient encounters included other people who, in my opinion, could benefit from my attention: family caregivers—spouses, adult children, close friends, significant others, and occasionally parents—who usually accompanied my patients on their visits and had needs that were not being addressed.

I solved this dilemma of how to work with family caregivers through two action items. First, I honed my personal style to allow multiple opportunities for the patient and family members or friends to report concerns and ask questions. Second, I provided reliable avenues for a designated family caregiver to contact me after the patient visit.

Continue reading

Public Understanding of Aging Built on a House of Cards

HoC_300pOver the weekend, I walked past my wife and kids watching the new season three of Netflix’s House of Cards and was stunned to see the evil President Frank Underwood ranting at his cabinet to get on with designing his jobs program that would be funded by slashing the “entitlements” of Social Security, Medicare, and Medicaid that are “sucking us dry.”

I gave an impromptu lecture to the family on the folly of this policy position—I’m not sure they noticed. And of course, we’ve also written many times about the false narrative of zero-sum intergenerational conflict. (Read Pitting Older Adults Against Children Is a Zero-Sum Game and Analyze This: Misleading Federal Spending Stats Pit Children Vs. Older Adults.)

But what can anyone do when even television writers feel comfortable with this notion that the benefits that older adults earned in their lifetime of work are a dagger to the heart of the nation? While Underwood is certainly a morally compromised character, in this scene he is actually portrayed as the hero, taking decisive action in the face of a roomful of indecisive, equivocating, naysaying bureaucrats.

Continue reading

Caregiving: ‘A Gift and a Privilege’

Antonio Z. Zuniga, a first-generation Mexican American, who gave inspirational and spiritual lectures in the U.S. and around the world. Here, at the Cliffs of Moher, Ireland, one of the many countries where he once spoke.

Antonio Z. Zuniga, a first-generation Mexican American, who gave inspirational and spiritual lectures in the U.S. and around the world. Here, at the Cliffs of Moher, Ireland, one of the many countries where he once spoke.

After a long career writing primarily for newspapers and magazines, Marielena Zuniga took early retirement with the idea that she would finally be able to accomplish a goal shared by many writers: to get a book published.

She managed to self-publish Loreen On The Lam: A Tennessee Mystery, and also focused on creative inspirational and spiritual writing. But Zuniga soon found herself in a new and unexpected role: as a fulltime caregiver for her father after he suffered a stroke.

Continue reading

Family Caregiving: ‘A Progression of Life’

Rosemary Rawlins, right, and her mother in "The Bistro."

Rosemary Rawlins, right, and her mother in “The Bistro.”

For much of the past 13 years, Rosemary Rawlins has found herself thrust into the role of family caregiver in a series of very different scenarios.

First, her husband, Hugh, suffered a severe traumatic brain injury (TBI) after being hit by a car while riding a bike in 2002 and underwent two years of arduous rehabilitation. Then, a year after her husband made a recovery bordering on the miraculous, Rawlins became a caregiver to her parents, as described in her prize-winning story below. And most recently, she helped her husband take care of his father through Parkinson’s disease until he passed away last September, and is preparing to have her mother-in-law move in this spring.

Continue reading