Policy change is hard. Just think about the 2010 Affordable Care Act, its tortuous path toward enactment, and the ongoing debates five years later that swirl around the law and its implementation.
There are many theories for how policy change happens, but one of my favorites is Kingdon’s policy streams model. To simplify a bit, it proposes that a window of opportunity opens when three separate streams come together: a problem gets defined and recognized as such, viable solutions are available, and there is political will to match them up.
Except for the political will part (thank you, partisan gridlock), at first glance this might seem easy. But think about how often your problem is not seen as a problem by others. For years, we faced this challenge when it came to making the case that older adults don’t get the care they should because they have special needs that require specialized, geriatrics-expert knowledge. Because of this challenge and the constantly shifting political landscape, it’s important to have policy solutions at the ready for the time when the problem and politics streams come together.
Todd Shurn and his mother, Alice, in 2013. Todd became a fulltime caregiver when his mother could no longer live on her own due to dementia. Photo courtesy of Todd Shurn.
Editor’s Note: The Jan. 15 deadline for submissions to the John A. Hartford Foundation’s second annual story contest is fast approaching. This year’s theme is Better Caregiving, Better Lives: Real Life Strategies and Solutions, and we are looking for stories from family caregivers and health care providers that illustrate the strategies and solutions caregivers are using to effectively and gracefully care for older adults. We are especially interested in stories about caring for older adults with dementia/Alzheimer’s disease.
So today, we share a dementia caregiving story written by one of this year’s contest judges, Yanick Rice Lamb, who teaches journalism at Howard University and is co-founder of FierceforBlackWomen.com, which partnered with TheRoot.com on the article. Lamb wrote a special introduction for Health AGEnda discussing how she approached writing the story and what she hoped to accomplish. It is our hope that Yanick’s behind-the-scenes insights into the writing process and her well-written, moving story will inspire others to share their own stories with us, and shine a light on how to “show” a story, not just “tell” it.
We were introduced to Sally and her daughter Edna last year in a video from our grantee Community Catalyst. I learned recently that Sally has since passed away, but I am so grateful that her and her daughter’s story lives on.
It embodies the promise of the Voices for Better Health initiative, which advocates for quality care for low-income older adults and younger disabled people dually enrolled in both Medicare and Medicaid, as Sally was.
And fortunately, as states rapidly move to integrate Medicare and Medicaid financing and care for the “duals” population, advocates from Voices for Better Health and anyone concerned about people like Sally have a new resource.
Jessie Gruman, founding president of the Center for Advancing Health, died on July 14 after a fifth bout with cancer. Jessie was a hero to patients, families, and health care providers for her selfless work to help people better understand their role and responsibilities in supporting their own health.
The nation’s four million home health aides, certified nurse aides, and personal care attendants are a lifeline for many older adults and people with disabilities. Our grantee, PHI, is the nation’s leading authority on the direct-care workforce, and they promote quality direct-care jobs as the foundation for quality care for elders and people with disabilities.
With our new grant, PHI is embarking on a campaign to rapidly scale up their work and double their “mission impact” to transform eldercare and disability services. In partnership with our long-time communications partners at SCP, they have developed what we think is an excellent example of an effective communications tool.
PHI’s new campaign brochure uses beautiful photography, plain but compelling language, and incorporates the voices of direct-care workers, the people they serve, and other stakeholders to tell their story.
From left, Cherie Brunker, Meg Wallhagen, Rosanne Leipzig, and Aanand Naik put their pieces of the puzzle together to complete the picture at the recent Change AGEnts event at the AGS annual meeting.
For the thousands of researchers and clinicians who have been a part of the John A. Hartford Foundation’s programs during the past three decades, we are pleased to invite you to put your geriatrics expertise to work by becoming an active Hartford Change AGEnt.
You can now enroll in the online Change AGEnts Community, where you can find other Change AGEnts and work together to make our health care system better for older adults and their families.
Dr. Julie Bynum moderates the Health Affairs briefing on the special issue on Alzheimer’s disease.
We all have Alzheimer’s disease.
This is a key message I took away from the April special Alzheimer’s issue of Health Affairs, the country’s leading health policy journal. One of the contributing authors, Jason Karlawish, makes this point writing about the ethical challenges inherent in caring for patients losing their cognitive abilities and autonomy. Inevitably, the disease belongs to caregivers and other people in that patient’s life.
Adult children and spouses are the primary caregivers of our nation’s older adults. They provide critically important assistance that helps frail elders remain at home, from meal preparation to such complex medical/nursing tasks as medication management, wound care, and care coordination.