Another highlight of this month's American Geriatrics Society meeting was the public policy address given by Assistant Secretary for Aging (HHS) Kathy Greenlee, who heads the Administration on Aging (AoA), a partner with the Foundation on several projects.
As this video clip shows, Secretary Greenlee discussed the need for a skilled geriatric workforce and some of the provisions of the Affordability and Patient Protection Act. But much more interesting to me was the framing she gave to the workforce issues (which I unfortunately didn't catch on video).
Secretary Greenlee told a story about a nursing home, some green striped towels, and a flash of insight into the needs of older adults. As part of a Kansas (where she was previously commissioner of aging) program to recognize excellent nursing homes that provide resident-centered care, she used to go to facilities, deliver a small check, and visit with residents. In one home she met with residents who were in the midst of a discussion of what color towels should decorate the bathrooms. Watching one of the older women in the conversation, she had what she described as a flash of recognition of a possible future self. With this recognition came some conclusions: 1. Despite this being an excellent, resident-centered home, it wasn't home and she knew she wouldn't want to live there herself. 2. People wind up in nursing homes because they have lost their health. It all starts with health.
As you might imagine, this was something the audience appreciated. But I think it is a great statement of why the Hartford Foundation does what it does. Providing more home- and community-based long-term care is important to preserving quality of life (and lowering costs). Making nursing homes less institutional and more resident-centered is essential for those who need that level of care. BUT, if we can promote health in older adults and more effectively prevent declines in function, we will have solved the problem at its root.
I believe that health care professionals who are more skilled in geriatric care can do this. They can delay or prevent some of the functional decline that often goes hand in hand with age and illness. They can reduce the risks of decline hidden in other parts of medical care, such as older adults losing the ability to walk after spending too much time in a hospital bed. Unfortunately, most current professionals still get little training in geriatric care, and much of what they do get is undermined by a prevailing ageist attitude that dismisses functional decline as inevitable. This brings us back to workforce: We desperately need health professionals with the knowledge, skills, and attitudes who can deliver this kind of health care, and they desperately need systems of care that will enable them to put their skills to work in service of their patients/clients. This is what the John A. Hartford Foundation is trying to accomplish.