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.
I 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.
Last 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.
Since 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.
Ever 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.
While 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.
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.