Health AGEnda

Same-Sex Marriage Ruling Contributes to Better Health for Older Americans

gay_coupole_nyc_shutterstock_235663813The 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.

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Hartford Foundation and CMMI Work Together to Spread Hospital at Home Model

Caregiving_400pFor two decades, the John A. Hartford Foundation has invested in the development and spread of the Hospital at Home model of care, which provides safe, high-quality, hospital-level care to older adults with select conditions in the comfort of their own home.

Over those years, studies have consistently shown that the model delivers improved care and outcomes at lower costs. But adoption has been limited, leading us to conclude that Hospital at Home was ahead of its time.

Now, its time has come. The Center for Medicare and Medicaid Innovation (CMMI), part of the Centers for Medicare and Medicaid Services (CMS), awarded a $9.6 million Health Care Innovation Award to the Icahn School of Medicine at Mount Sinai—in consultation with Johns Hopkins University—to test a version of Hospital at Home called the Mobile Acute Care Team (MACT).

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Adventures in Choosing Wisely

Amy Berman prepares for her image guided radiation therapy.

Amy Berman prepares for her image guided radiation therapy.

I live with stage IV cancer—cancer that has spread to the far reaches of my body, an incurable disease, a terminal diagnosis. But if you saw me—if our carts randomly bumped into each other in the supermarket—you would never think I live with serious illness.

And let me add that I feel as well as I look, just great.

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Geriatric Nursing Leadership Academy Achieves Impressive Results

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The latest cohort of fellows in Sigma Theta Tau International’s Geriatric Nursing Leadership Academy pose for a group photo with their leadership mentors, faculty, and representatives of Sigma Theta Tau and the Hartford Foundation.

I recently traveled to Indianapolis, home to Sigma Theta Tau International, the honor society of nursing. There I met six very special individuals, competitively selected as fellows in Sigma’s Geriatric Nursing Leadership Academy.

The Geriatric Nursing Leadership Academy aims to prepare and position geriatric-expert nurses as leaders within the interprofessional health care delivery environment. The fellows I had the honor of meeting expressed an unwavering commitment to developing their influence and impact in hospitals, nursing homes, and home health to benefit vulnerable elders.

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Narrative Matters, The Next Chapter: Amy Berman Reflects On ‘Living Life In My Own Way’

Amy Berman speaks at TEDMED's  Great Challenges in Health Care in 2013.

Amy Berman speaks at TEDMED’s Great Challenges in Health Care in 2013.

Editor’s Note: In this post, originally published on Health Affairs Blog, Amy Berman shares more of her story as a person living with stage IV cancer who has chosen a palliative care approach.

She contributes  regularly to Health AGEnda about her experiences and how they relate to the John A. Hartford Foundation’s support for palliative care for older adults facing serious illness. In March 2014, the Hartford Foundation awarded a new grant to the Center to Advance Palliative Care (CAPC) to build on the successful spread of hospital-based palliative care and move these services into care settings outside the hospital.

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Practice Change Leaders Improve Care for Older Adults

PCL_Color_Logo_250Change is hard. It takes leadership to drive change. Robert Jarvik—a former John A. Hartford Foundation grantee and inventor of the artificial heart—once said, “Leaders are visionaries with a poorly developed sense of fear and no concept of the odds against them.”

Today’s successful leaders need that same vision, but they also require a set of skills that go far beyond their clinical training and experience. They need strategies to address policy and payment methodology. They need to engage stakeholders. And they need to measure what matters in terms of cost and quality.

In order to develop this new kind of leadership, people capable of driving health care redesign for vulnerable elders, the Hartford Foundation funds—in partnership with The Atlantic Philanthropies—the Practice Change Leaders Program.

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Breast Cancer: Are We Making Strides?

Amy Berman, left, and her daughter Stephanie at the American Cancer Society's Making Strides event in New York's Central Park.

Amy Berman, left, and her daughter Stephanie at the American Cancer Society’s Making Strides event in New York’s Central Park.

Maggie Mahar is an influential blogger on topics from health care reform to the economy. Maggie and I agree that we are not making sufficient strides in the war on breast cancer. We disagree that I chose life over longevity. I chose life and longevity.

In honor of breast cancer awareness month, Maggie has allowed us to repost a blog she featured in HealthBeat on Oct. 11th. I am grateful that she uses her potent prose to draw attention to the needs of older adults. Cancer is, after all, primarily a disease of aging. Two-thirds of those living with cancer are age 65 or older.

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What the Heck Are Hartford’s New Funding Areas? Part Three: Models of Care

Jürgen Unützer, MD, brings the IMPACT model of depression care to Casper, Wy.

Jürgen Unützer, MD, brings the IMPACT model of depression care to Casper, Wy.

Given the John A. Hartford Foundation’s  focus on improving the health of older Americans, it should come as no surprise that the Foundation has looked for opportunities to create a more comprehensive, coordinated and continuous health care delivery system.

Since the 1990s, we’ve done this by investing in the development, testing, and spread of effective and affordable Models of Care to address barriers to the provision of high-quality, cost-effective care for elders.

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ACES Faces and Cases Spread to New Places

This year’s ACES faculty sessions were strictly standing room only.

New nurses need to be competent in the care they provide to older adults. Yet nursing faculty may lack geriatric preparation and may not be comfortable teaching the content.

ACES—or Advancing Care Excellence for Seniors—is a national program led by the National League for Nursing and Community College of Philadelphia aimed at addressing this important issue.

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Stunning New IOM Report Reframes How We View Cancer

IOM_Report250The Institute of Medicine (IOM) is swinging for the fences with the release of a new report, Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis.

The report makes recommendations in six areas critical to the delivery of quality cancer care:

  1. Engaged patients
  2. An adequately staffed, trained, and coordinated workforce
  3. Evidence-based care
  4. Learning health care information technology (IT)
  5. Translation of evidence into clinical practice, quality measurement, and performance improvement
  6. Accessible and affordable care.

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