Editor’s Note: Today, we welcome Pulitzer Prize-winning writer Ellen Goodman, co-founder and director of The Conversation Project, to Health AGEnda. The Conversation Project is part of a $3.5 million John A. Hartford Foundation grant approved in March supporting an exciting collaborative of six practitioners who will work cooperatively to expand the availability and improve the quality of advance care planning and end-of-life care. Since it was launched in 2010, The Conversation Project has focused on helping families and friends talk openly about their wishes for end-of-life care in a way that makes sure those wishes are not only expressed, but respected.
When we launched The Conversation Project, we knew the importance of encouraging people to express their wishes for end-of-life care before there was a crisis. In a survey we did, people often gave the same excuse for not having the conversation: “it’s too soon.” To which we always replied, “It’s always too soon, until it’s too late.”
There is nothing that shows the wisdom of that statement more than the terrible experiences of families and friends whose loved ones suffer from Alzheimer’s and other dementias. We—and my family is part of that “we”—often feel tragically unable to have these important conversations after someone we love goes into cognitive decline.
Each year, staff of The John A. Hartford Foundation look forward to May and the annual scientific meeting of long-time grantee and partner, the American Geriatrics Society (AGS). This year’s meeting in Long Beach, CA will once again offer us the chance to showcase the work of grantees, learn about the latest advances in aging and health research, meet with colleagues in the field, and celebrate those who have made important contributions to improving care for older adults.
Wally Patawaran’s mother, Emma, in Seville, Spain, before her first stroke.
“My mother understands everything we’re saying.”
My brother was addressing the latest home health aide, giving her an orientation. She nodded on cue, but it seemed clear that she was giving this latest assignment a look-over before signing on. She could have been forgiven for wondering about the truth of the statement.
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.
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.
“This report is really about success,” says Terry Fulmer, PhD, RN, FAAN, president of The John A. Hartford Foundation. “Life expectancy has almost doubled since the 1900s, from 40 years to 80 years today. The number of adults over age 65 also is projected to almost double in the coming decades, from 43.1 million in 2012 to 83.7 million by 2050. This is truly remarkable and something to celebrate. However, we now need to achieve the same level of success in meeting the care needs of this growing aging population.”
My 77-year old father underwent surgery two years ago and I recall how frightening it was for him, my mother, and our entire family. Unfortunately, our fear was realized when he had a terrible post-operative infection that sent him to the emergency room and on to a follow-up surgery.
Sadly, he and my mom were not given good hospital discharge instructions and they ignored signs of problems far too long. No follow-up appointment with his primary care provider had been set, either, which could have averted the complication (and to this day, I kick myself for not catching that).
It could have been much worse. For patients older than my father with more chronic conditions, even surgery that is technically perfect can be fraught with danger and poor outcomes without the application of geriatric best practices that address the whole-person needs of the patient.
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.
The Gerontological Society of America (GSA) has been one of the John A. Hartford Foundation’s key grantee partners for more than 20 years. The organization is now the home of the John A. Hartford Foundation Change AGEnts Initiative, which is helping interprofessional alumni of our programs work together in exciting new ways to make practice and policy changes that improve the care of older adults.
As a Fellow of the society who had the privilege of serving as president of the organization’s board, I know first-hand how important GSA is to the entire field of aging. The GSA annual scientific meeting has always been a highlight for me, and that’s especially true this year, as it’s my first time attending as President of the John A. Hartford Foundation. As always, I am thrilled to learn about the latest aging science across the spectrum of academic disciplines. And at this year’s conference in Orlando, I also get to engage with grantees to learn more about their work, and with leaders in the field to discuss the Foundation’s important efforts, which have often supported many of these individuals.
As it does every year, the GSA awards program features many of these Foundation-supported leaders among those being honored. We congratulate the following awardees and look forward to continuing to work with them and others to advance better care for our aging population:
Click image to view or download a PDF of the state-by-state report.
In health care, as in so much of life, where you live matters. Understanding geographic variation in health care has long been a useful tool for targeting our attention and making improvements where we need them most.
Thanks to a report card released earlier this month by the Center to Advance Palliative Care (CAPC) and National Palliative Care Research Center, you can find out how well or poorly your state and geographic region is doing regarding equitable access to palliative care in hospitals. You can use this information to help advocate for better access in your state and at the national level.