In 1965, the Older Americans Act set in motion a new network of largely community-based social services and supports to help older adults remain healthy and independent, living in their homes and communities as long as possible.
On April 19, 2016, after legislation garnered bipartisan support from both houses of Congress, President Obama signed the latest and long-overdue reauthorization of the Older Americans Act. This is great news for millions of older adults, and truly a cause for celebration as we embark on Older Americans Month in May. This year’s theme, appropriately enough, is “Blaze a Trail.” And it is one that resonates deeply with all of us at The John A. Hartford Foundation, given our own trailblazing work in improving the care of older adults.
Why the Older Americans Act Matters
Avital Benson, a senior at the University of Pennsylvania School of Nursing, worked as a 2015 summer intern at The John A. Hartford Foundation.
The first vivid memory that I have is of carrying aluminum foil containers of food up to a large white house in New Jersey. Although I have always had this memory of delivering Meals on Wheels with my mom, I never realized how young I was (2 ½ years old) until I was reminiscing about it recently.
I was telling my mom about how Meals on Wheels often comes up in conversation at The John A. Hartford Foundation as an example of a program that’s a necessity for older adults who are homebound, and I mentioned my memory of helping her deliver meals. Stunned that I still remembered, she looked at me and said that memory had stayed with me for a reason. And she was right.
The landmark United States Supreme Court decision that same-sex marriage is a fundamental right guaranteed by the Fourteenth Amendment to the U. S. Constitution has important implications regarding the health and care of older Americans.
Studies show that denying same-sex couples the right to marry has a negative impact on their mental health, according to a 2006 report by Herdt & Kertzner. And a growing body of evidence suggests that policies conferring protections to same-sex couples are linked to lower health care and mental health care utilization, as well as to decreased health care spending.
There also are numerous studies confirming the health benefits of marriage for older heterosexual couples. “Married persons, on the whole, tend to have lower rates of fatal and nonfatal diseases, physical functioning problems, and disability compared to all other marital status groups,” reported Amy M. Pienta et al. in Health Consequences of Marriage for the Retirement Years, published in the Journal of Family Issues in 2000.
The White House Conference on Aging offers a special, once-a-decade opportunity to focus national attention on issues that the John A. Hartford Foundation has been working on every day for more than three decades. So I am honored and excited to be among those invited to attend this year’s gathering on July 13 with President Obama, national leaders, colleagues in the field, and people participating virtually across the country who will all join in a national conversation about our aging nation.
At the John A. Hartford Foundation, our focus is on better care for older Americans. We believe that improving the quality of care and the way it is delivered will result in better health for older adults and lower health care costs for the nation as a whole. “Healthy Aging,” one of four policy briefs drafted for the conference, addresses issues that are integral to the Foundation’s current grantmaking strategies, including managing chronic conditions, and prevention and treatment for diseases and behavioral health conditions.
I fervently hope that the national dialogue sparked by the conference will lead to more widespread recognition of the critical role to be played by health professionals with specific expertise in aging, and will support efforts to develop, test, and widely spread evidence-based models of care for older adults that achieve better health outcomes at lower costs.
Over 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.
I think it would be safe to say that most of us have trouble facing our own mortality. The idea that tomorrow isn’t promised fails to get many of us to actually live that way (I know I’m guilty).
Longer term and more connected to the John A. Hartford Foundation’s work, we don’t like to think of ourselves as “old”—let alone dying—and we don’t plan well for futures that will likely include the need for long-term care or services later in life.
Our health care system and policies reflect this short sightedness, as well. That’s why it’s been refreshing to see some provocative writing about these issues over the past few weeks that might help us all think and do more to live our final years in old age the way we would want.
Before starting my internship with the John A. Hartford Foundation, the notion of improving health outcomes while decreasing costs appeared implausible. Securing strong patient-centered care for a loved one had to come at an extra expense—a large price tag for both the individual, his family, and the institution administering the care. After all, my family recently hired a home health aide to assist and advocate for my grandfather during his stay in the hospital and then during hospice, what is supposed to be one of the most patient-centered forms of care. My family believed that a consistent, if costly, presence and support system would serve him well during employee shifts and other downtime between caregivers.
And it made a difference. Our aide, Abdulai (last name withheld), served as my family’s lifeline, the person my grandfather could rely on for personalized and direct care, the person my mother could trust in clarifying medications and complicated procedures.
Author Caitlin Brookner (back, left) with her cousins and grandfather, Leonard Weisberg.
Recently, I had the privilege of discussing issues important to the John A. Hartford Foundation on The Ohio State University’s podcast, Viewpoints of Innovative Health Care Leaders.
It was a great opportunity to talk about the key trends we see in health care today, what still needs to be done, the impact of the Affordable Care Act on aging, and how the Hartford Foundation is seeking to address these issues. The biweekly podcast provides a forum for leaders in the field to share the best evidence-based practices and emerging thoughts in health care.
It is hosted by Bernadette M. Melnyk, PhD, RN, associate vice president for health promotion, university chief wellness officer, and dean of The Ohio State University College of Nursing. I’d like to thank Bernadette, who was dean of the Arizona State University College of Nursing and Health Innovation when it became a Hartford Center of Gerontological Nursing Excellence, for inviting me on the program. You can listen to the podcast by visiting Viewpoints of Innovative Health Care Leaders. The full interview is about 15 minutes, and is divided into five sections by topic.