Health AGEnda

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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Pitting Older Adults Against Children in Funding Debate Is a Zero-Sum Game

GIA_photo_contest_park_lake_400pThe house is burning with a child and his elderly grandmother inside. Which one should be saved?

Too often, this feels like the question being posed when thinking about the allocation of resources, whether through policy action or philanthropic investments. But this is the wrong question. In most cases, there is no need for this intergenerational Sophie’s choice.

This false war-between-the-generations framing gets used both in the media—as we saw last year from one of health care’s favorite provocateurs—and in everyday conversations with people who are generally supportive of our mission to improve the health of older adults.

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Grappling with the Tough Questions of How We Live—and Die

SeniorsRoses_400pI 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.

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Building the Field of Palliative Care Together

Funders share information on investments in palliative care at the recent convening.

Funders share information on investments in palliative care at the recent convening spearheaded by the Hartford Foundation.

Palliative care is an essential component of care for the seriously ill. Yet, the term is often misunderstood by policymakers, the public, health care providers, and, no surprise, even those in philanthropy.

The John A. Hartford Foundation has been a longtime supporter of the spread of high-quality palliative care through its funding of the Center to Advance Palliative Care (CAPC), led by Diane Meier, MD (see Celebrating CAPC and Our 500th Blog Post!). Dr. Meier often refers to palliative care as an “extra layer of support” for the seriously ill and their families.

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Happy Birthday SIF! Celebrating Five Years of Public-Private Partnership

From left: Rebecca Brune, VP of Strategic Planning and Growth, Methodist Healthcare Ministries of San Antonio; Regina Bonnevie, MD, Medical Director, Peninsula Community Health Services in Port Orchard, WA; Peggy Cary, Senior VP of Finance & Internal Audit, Methodist Healthcare Ministries; and Diane Powers, Associate Director, Division of Integrated Care and Public Health, University of Washington AIMS Center, Seattle WA, talk following presentations at the Eisenhower Executive Office Building in Washington, DC.

From left: Rebecca Brune, VP of Strategic Planning and Growth, Methodist Healthcare Ministries of San Antonio; Regina Bonnevie, MD, Medical Director, Peninsula Community Health Services in Port Orchard, WA; Peggy Cary, Senior VP of Finance & Internal Audit, Methodist Healthcare Ministries; and Diane Powers, Associate Director, Division of Integrated Care and Public Health, University of Washington AIMS Center, Seattle WA, talk following presentations at the Eisenhower Executive Office Building in Washington, DC.

Last week, the Social Innovation Fund of the Corporation for National and Community Service celebrated its 5th Birthday. There was cake.

More importantly, there was a celebration of the good that philanthropy can do to address the pressing problems facing the country. The goal of the Social Innovation Fund is to bring federal and private money together to scale up the best, evidence-based innovations to address problems of education, poverty, and health.

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Dying in America: There Must Be a Better Way

DyingInAmericaCover400pLast week, the Institute of Medicine released a new report titled Dying in America.

The committee that worked on the report included some long-time grantees and friends of the John A. Hartford Foundation,  such as June Simmons  of the Partners in Care Foundation, Jean Kutner, a Beeson Scholar  and faculty member at the University of Colorado, Diane Meier, leader of the Center to Advance Palliative Care, Patricia Bomba  of Rochester, NY’s Excellus Blue Cross/Blue Shield, and Joan Teno of the Center of Excellence in Geriatric Medicine at Brown University.

As always, we are proud to be associated with leaders who give their time to explore such urgent issues.

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Questions About Hartford Change AGEnts?
We Have Answers—and Opportunities

Change_AGEnts_logoSince launching our Hartford Change AGEnts initiative late last year, we’ve taken the first steps toward our goal of accelerating sustained practice change that improves the health of older Americans, their families, and communities.

Change AGEnts are connecting through our online community and the first two Change AGEnts Networks—focused on patient-centered medical homes and dementia caregiving—are already hard at work. We’ve funded nine Change AGEnts Action Awards and are currently accepting applications for our second cohort, and we’ve awarded collaborative pilot grants in partnership with the Change AGEnts program for our Centers of Excellence Scholars and for Beeson Scholars.

The initiative’s leadership team and our partners at the Gerontological Society of America (GSA) are working hard to support the Change AGEnts community and are ready and willing to help people engage. Since we get lots of questions about how people can get involved, we thought that addressing them in a Q&A would be helpful and highlight some immediate opportunities.

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Of Knights, Knaves, and Pawns: Physician Disillusionment and the Need to Realign Our Health Priorities

Doctored_Book_Cover_300pEver since I began working as a program officer at the John A. Hartford Foundation, I’ve tried to do my best to put myself in the shoes of the health professionals with whom we’ve worked and whose education and training historically has been one of our main concerns.

I’ve often found memoirs and other lightly fictionalized accounts to be the best way to get into the culture and daily experience of these health professionals. I’ve read Samuel Shem’s The House of God, countless memoirs of nurses and physicians, and even a very affecting memoir of a nurse’s aide in a nursing home.

One of the tricks of such reading is that we experience what our imagination and the author’s words together conjure in a special state of willing suspension of disbelief. Psychological research suggests that this process of imagination and purposeful lowering of critical skepticism is, in fact, what makes fiction so persuasive and engenders the feeling that novelists understand a truth about human character that other ways of knowing can’t match.

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Welcome to the New Cohort of Health and Aging Policy Fellows

Health-and-Aging-Policy_300While many of our legacy grant programs continue to support the development of leaders in the field of aging and health research and education (see this week’s earlier Health AGEnda post about our latest Hartford/VA social work research scholars), new and growing investments under the John A. Hartford Foundation’s current strategic plan are also nurturing leaders in aging and health practice and policy change.

As part of our Leadership in Action funding portfolio, we recently approved a $1.6 million grant to co-fund the Health and Aging Policy Fellows program, in partnership with The Atlantic Philanthropies. The program, which offers fellows the experience and skills necessary to make a positive contribution to the development and implementation of health policies that affect older Americans, has just announced its 2014-15 class and we welcome them to the Hartford family and our community of Change AGEnts.

With representatives from many of our legacy strategy programs, including the Archbold Pre-Doctoral Nursing Scholars, the Social Work Doctoral Fellows and the Jahnigen Scholars in surgical and related medical specialties, we are assured that many of our academic program alumni are right there with us in the shift to our current portfolio of strategies focused on taking geriatrics expertise and evidence and making real and lasting improvements in health care delivery for our aging population.

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Medicare Experiment Could Signal Sea Change For Hospice

Diane E. Meier, MD

Diane E. Meier, MD

Editor’s Note: For almost eight years, the John A. Hartford Foundation has partnered with Diane Meier, MD, to increase awareness of palliative care and make it more widely accessible. 

In March, the Foundation’s Board of Trustees renewed our support for the Center to Advance Palliative Care (CAPC) led by Dr. Meier to enable CAPC to transition to a more financially sustaining, revenue-generating model and develop a package of products to implement palliative care services in community-based clinics, nursing homes, and home care. We are pleased to share this excellent interview with Dr. Meier that first appeared on Kaiser Health News discussing a new pilot program that allows hospice patients to continue to receive life-prolonging treatment.

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