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For far too long, the nearly 18 million family caregivers of older adults in the United States have been largely invisible to policymakers and our health care system, despite filling an absolutely essential role. The contributions these modern-day heroes make to the care of older adults is indispensable, and often comes at a significant cost to their own health, well-being, and financial security.
Chandulal Patel, grandfather of author Kevin Cordeiro.
Editor’s Note: With back-to-school season in full swing, we are pleased to share this post from Kevin Cordeiro, one of our summer interns who aspires to be a physician and has just returned to Boston University.
During my sophomore year of high school, my grandparents moved in with my family. Lucky for me, my grandfather was an avid fantasy football player so it was great having someone to confer with on fantasy team decisions.
Last week, new projections from the Centers for Medicare and Medicaid Services (CMS) published in Health Affairs show a predicted growth in U.S. health care spending of about 6 percent from 2015-25, outpacing the growth in gross domestic product. In a decade, health care is predicted to represent 20 percent of the U.S. economy. This unsustainable scenario underscores how imperative it is to continue focusing on all aspects of the Triple Aim: improving care, achieving better health outcomes, and managing costs.
These aims perfectly align with our mission and work at The John A. Hartford Foundation, where we remain committed to cost-effective, person-centered innovations that meet the needs of older people and their families.
CMS predicts that much of the projected increase will occur in Medicare and Medicaid expenditures due to the aging of the population. As the Health Affairs report states, there are many complex factors that influence health care spending growth. For example, with the Affordable Care Act, more people are now covered by health insurance than at any time in our nation’s history, and the number of Americans without health insurance is projected to drop to 8 percent by 2025.
Sophie Shepherd at the KANA Clinic in Alaska with therapist Meara Baldwin, LCSW, a care manager in the depression treatment program funded through the SIF initiative. – From the JAHF 2015 Annual Report
In addition to highlighting several important grant projects approved in 2015, the report features an in-depth look at the Foundation’s Social Innovation Fund initiative, a creative public-private partnership that is spreading the evidence-based collaborative care model of depression treatment to underserved, low-income rural communities in Washington, Wyoming, Montana, and Alaska.
Today, June 15th, is World Elder Abuse Awareness Day, offering an opportunity for all of us to join a global chorus calling for more awareness and action to end all forms of elder mistreatment.
As a clinician with expertise in caring for older adults, I have made elder mistreatment a priority in my research and practice. It is a common and even deadly problem, but it all too frequently goes undiagnosed and unreported. It has also too often been ignored as the true public health concern that it is.
An estimated one in ten older Americans suffer elder mistreatment, defined as physical, psychological, or sexual abuse, neglect, financial exploitation, or abandonment. I’ve seen it in clinical practice; we sometimes see it in the news. It is horrifying and awful, yet there is much we can immediately do to protect older adults, support their family caregivers, and prevent abuse and mistreatment from occurring.
We are very pleased to announce five new grants totaling $4.8 million approved by The John A. Hartford Foundation Board of Trustees in June that target critical gaps that exist in providing comprehensive, age-specific, coordinated care to older adults and their families.
Each of these exciting projects supports the work of innovative organizations and individuals, and all relate to emerging priorities that we see as critical over the next several years.
Through a new initiative that brings together national leaders in the move to improve home-based primary care, we are bridging the gap in care for the frailest, sickest homebound elders for whom house calls could be a saving grace. We are also addressing important gaps in health care policy related to palliative care, hospital admission status, and oral health through outreach, education, and advocacy. And through a potentially game-changing partnership with Kaiser Health News (KHN), we are addressing the gap in high-quality news coverage and public understanding about the complex issues of health care delivery and its impact on older adults and their families.
We are excited to announce a new national poll released today that shows physicians clearly understand the importance of talking with older adults about end-of-life care, and that they overwhelmingly support a new Medicare benefit that reimburses them for holding advance care planning discussions with patients.
Very importantly, the poll also provides valuable insights into some of the barriers that keep physicians from having advance care planning conversations. The survey of primary care and specialist physicians in 50 states was supported by The John A. Hartford Foundation and our wonderful partners at the California Health Care Foundation and Cambia Health Foundation. We will delve even further into the barriers we uncovered, as well as strategies for overcoming them, with a series of interprofessional focus groups of health care providers later this year.
Rani Snyder, MPA, Program Director, The John A. Hartford Foundation
Nothing pleases me more than having the opportunity to tell my colleagues and the world at large that I am the new Program Director for The John A. Hartford Foundation. And nothing could be truer than to say that the Foundation has not just shaped, but has actually determined the course of my professional life.
Like a parent guiding and teaching, the Foundation put me on a path and gave me the freedom to leave the nest and find my way—gaining valuable experience and maturity along the journey. Now, I have come back home.
From right, Amy Berman, John A. Hartford Foundation President Terry Fulmer, Jon Broyles of C-TAC, and Bud Hammes of Respecting Choices engage in a convening held in June 2015 by JAHF on “End of Life and Serious Illness.”
The John A. Hartford Foundation’s dedicated staff is constantly monitoring the dynamic health care landscape to identify powerful opportunities for large-scale change that will result in better care and better lives for all older adults. I am very pleased to announce that our Trustees last week approved three new grants totaling $6.7 million that leverage these opportunities.
One of the keys to effective grantmaking is to partner with innovative leaders at the very top of their fields. That is certainly true of the Foundation’s new grants.
As the new year approaches, we look forward to the new grant projects that promise to make 2016 an exciting time for the John A. Hartford Foundation, our grantees, and colleagues who are all working to improve the care of older adults! We have so much to celebrate that has already been accomplished and the momentum going forward is palpable.
I am pleased to let you know that last week, our Trustees, led by Board Chair Peggy Wolff, approved five grants totaling $6.7 million. These projects, while focusing on a range of settings where older adults need improved care, all have several important features in common.
Whether it is the emergency department (ED), nursing homes, or in primary care, these projects will each utilize the deep knowledge of our John A. Hartford Foundation network of experts in the care of older adults. And while a single organization serves as our official grantee for each, they all will be successful because of strong collaboration among multiple organizations that share a commitment to creating large-scale change to meet the needs of older adults, their families, and our entire society.