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.
Nuala Pell served on the Hartford Foundation Board of Trustees for 19 years before retiring in 2000. She posed for this portrait in 1999.
Nuala Pell lived a remarkable life full of grace, dignity, and passion for the causes she believed in. With her passing at age 89 on April 13, the John A. Hartford Foundation has lost a former Trustee, friend, and faithful supporter of our work to improve the health of older Americans. She will be greatly missed.
A philanthropist who strongly supported the arts, humanities, and education, as well as health, Nuala and her husband, the late U.S. Sen. Claiborne Pell, devoted their lives to public service. Starting with her husband’s against-the-odds victory in the 1960 U.S. Senate campaign in Rhode Island and extending through his five re-election campaigns, Nuala was credited for her natural warmth and rapport with voters, as well as her wise political counsel.
If our work at the John A. Hartford Foundation has taught us one thing, it’s this: In the quest to transform primary care for older adults, a huge part of the answer is deploying more geriatrically expert primary care teams that can coordinate and deliver care designed around the patient’s needs. You could call this the low-hanging fruit of health care reform, because, if there is a population in which we have the biggest opportunity to see improvements in both cost and quality of care outcomes, it is older Americans.
The debate on how best to deliver effective primary care has gone on a long time, sometimes frustratingly so, but it has almost never included a crucial constituency: older adults. Today we are pleased to help change that.
We believe that listening to older adults is essential if we are ever going to transform our primary care system so it can and does deliver well-coordinated, comprehensive, accessible care centered on their needs and goals. This belief has already led the Hartford Foundation to conduct two previous public opinion polls, focused exclusively on adults 65 and older, examining serious gaps in geriatric primary care and mental health care.
Steven Dawson of PHI addresses the briefing on direct care workers held recently by Philanthropy New York.
The health of any given community is fragile and complex. It is greater than the sum of individual health outcomes or access to care. The health of a community rests upon an infrastructure that meets the changing demands and needs of its people within constrained resources. Increasingly, our infrastructure needs to address employment, economic stability, and rising health care costs.
This is especially true given the sea change occurring, with 10,000 people turning age 65 each day in the United States. The maturing of the boomers is fundamentally shifting our view of what a healthy community looks like.
For 20 years, the Hartford Centers of Excellence (CoE) in Geriatric Medicine have been supporting the development of geriatrician faculty at schools of medicine across the country. These scholars have become researchers, educators, and clinicians, helping transform academic medicine to better prepare the next generation of physicians to care for older adults.
As we forge ahead with our new strategic plan to rapidly change health care practice to improve the health of older adults, our funding for the Centers is winding down. We are now intent on helping current CoE scholars and alumni, in addition to our academic superstars in nursing and social work, utilize their geriatrics expertise to change health care delivery for the benefit of older adults. We believe this is best achieved by helping them to connect and collaborate.
We are pleased that many of our existing grants are aiding in this transition. Funds within the CoE program, administered by our grantee the American Federation for Aging Research (AFAR), have been repurposed to bring together CoE Scholars and support their work to improve care for older adults. In doing so, we are offering five $40,000 grants to fund collaborative pilot projects.
In the world of philanthropy, there are only a handful of foundations focusing on aging and even fewer on aging and health issues.
Five years ago, The SCAN Foundation—an independent private foundation created by, but independent of, The SCAN Health Plan in Long Beach, Calif.,—was born. Over the years, they have been excellent colleagues, co-leaders in Grantmakers in Aging (GIA) and occasional partners on projects. In 2013, the John A. Hartford Foundation and The SCAN Foundation together cofunded an $800,000 grant to the National Committee for Quality Assurance (NCQA) to take on a major challenge: to help develop measures of quality of care for frail and disadvantaged elders that would be based on personalized goals of care and preferences.
In December 2013, Bruce Chernof, MD, president and CEO of The SCAN Foundation, spoke to the Hartford Foundation board about SCAN’s new five-year strategic plan, long-term care reform, and our deepening partnership. We look forward to working with Dr. Chernof and our other colleagues at SCAN over the next five years and beyond.
Last year, I was concerned and puzzled by what looked like continuing and consistent declines in first-year geriatric fellows in Internal Medicine (IM) and Family Medicine (FM) based programs, despite improving financial incentives. This year, there is an abrupt improvement, with first-year fellows in IM and FM rising by almost 20 percent.
Ok. We did it. We collectively put Chris Langston’s “What-if-we-have-a-party-and nobody-shows” fears to bed.
We had hoped for 200 attendees at our launch of the Change AGEnts Initiative at the Gerontological Society of America’s (GSA) annual meeting last month. Huzzah! Close to 400 Change AGEnts showed and actively participated in the interactive activities designed to inspire conversation and connections.
In case the launch or the AGEnts initiative has been off your radar:
In health care for older adults (and for everyone really), we know where we want to end up.
It gets articulated in different ways, but generally speaking I think we can all agree we want care for our older loved ones that is coordinated, comprehensive, continuous, and geriatrically expert.
But the path that gets us to that destination is often unclear. To help guide us—the John A. Hartford Foundation and all other stakeholders in the business of health care—we have just funded three grant projects that we hope will shine a light on the way forward.
As part of our Tools You Can Use series, we like to feature new products and resources that improve the health of older Americans. In this installment, two researchers share a free toolkit that provides evidence-based resources for staff in senior living communities promoting non-pharmacologic strategies to address behavioral and psychological symptoms of dementia.
The toolkit, presented by Ann Kolanowski, PhD, RN, the Elouise Ross Eberly Professor and director of the Hartford Center of Geriatric Nursing Excellence, College of Nursing, Penn State, and Kimberly Van Haitsma, Ph.D., a Clinical Health Psychologist with a specialization in geriatrics at the Polisher Research Institute, addresses a huge problem.
More than 5 million Americans are living with Alzheimer’s disease, with the direct costs of their care in 2012 totaling $200 billion, including $140 billion in costs to Medicare and Medicaid, according to the Alzheimer’s Association. The burden of care to family and formal caregivers is equally troubling: 90 percent of people with dementia will hit, scream, become verbally abusive, or resist care at some point.