The challenge. Lyons Township, which encompasses 20 suburban communities south and west of Chicago, is home to a burgeoning population of older adults. By one estimate, half the population will be 60 or older later this decade.
Services for seniors are plentiful in the township, yet older adults surveyed in 2004 said they often did not know where to go for assistance. Even agencies that provided services did not make routine referrals to other organizations because they knew little about them. And police, firefighters and paramedics who had frequent contact with isolated older adults often did not know how to offer help.
The Aging Well Partnership was designed to ensure that seniors and their families get help to maintain their independence for as long as possible. The Robert Wood Johnson Foundation (RWJF) provided funding through its Community Partnerships for Older Adults national program.
Coordinating services for older adults. Three community leaders—Pat Rogers, then the elected supervisor of Lyons Township; Jim Durkan, then CEO of the Community Memorial Foundation; and Debbie Verschelde, director of what is now called Aging Care Connections in La Grange, Ill.—formed the Aging Well Partnership in 2004 to create a "web of care" that encouraged collaboration among institutional, home care and supportive services. They were especially concerned about at-risk older adults who had various physical, mental, cultural and social needs.
With many suburban communities expecting a surge of older adults, especially the "oldest old," the Aging Well Partnership offered a promising model. It also meshed nicely with a state effort in Illinois to rebalance its long-term-care services so that "money followed the person"—meaning that reimbursement was available in the most appropriate care setting.
Coordinating services among 20 local governments, each with separate political agendas and turf issues, was an ambitious goal. But as staff of service agencies, businesses, health care organizations—and especially older adults themselves—from the various towns gathered around the table, they found many common concerns.
"Once we started trying to rise above just the interest of our own organizations," Verschelde said, "people wanted to come together collectively to try to push aging to the forefront and look at the issues that affected all of the communities in this catchment area."
Hundreds of older adults and some 130 organizations eventually joined the Aging Well Partnership.
Starting at the grassroots. "There was a very strong feeling that older adults needed to be involved throughout every aspect of this program," Verschelde said. That mandate gave rise to community action teams, made up mostly of senior residents, with support from the staff of partnership organizations.
These teams identified needs and developed a host of responses. For example, older adults in several communities were struggling with simple home maintenance. One team organized a handyman service program, while another gathered volunteers and resources to provide basic lawn care for older residents.
"They reached out to a lot of the local businesses and neighbors," said Ken Grunke, who became the manager of the Aging Well Partnership in 2009. "There was a big leaf-raking project in one of the communities that was extremely successful and involved the younger generation."
Other community action teams also started:
- A program where elders read stories to youngsters at local preschools
- A media campaign to alert the community that one call—to the Aging Well Partnership—was the doorway to an array of aging-related resources
- An effort to install lock boxes, where house keys can be hidden outside the home, so that first responders don't have break a window or door to enter the property in an emergency
- Health fairs and flu-shot clinics
- A book delivery service to the homebound in collaboration with the local library
- Socialization events, including senior talent shows, picnics and a "swap'n'shop" where unwanted household items can be traded for wanted ones
A number of these programs started in one community and then spread to others.
The file for life. One community action team created a "file for life"—a sheet with emergency contact information for physicians and family members, as well as key notes about health conditions and medications.
"What started as an insert that people could keep in a binder at home became a magnet that could be placed on the refrigerator," Grunke said, "so that EMS or anybody coming to the assistance of the older adult could grab that magnet and be able to say, 'Oh, they're taking these prescriptions' or 'They have these kinds of health situations.'"
The kitchen magnet has shown its utility. In the town of Summit, a grandparent caring for his grandchild fell and was knocked unconscious. Because the grandchild had been told about the file for life, she was able to call 911 and provide essential medical information to the operator.
"By the time EMS showed up," Grunke said, "they were well-prepared to be able to take care of the grandparent. It was exciting to know that this information was accessible and important for everybody to know, including the grandchild."
From micro to macro. While community action teams identified needs in specific township communities, six workgroups focused on cross-cutting issues.
For example, the community outreach workgroup recruited and trained senior ambassadors to disseminate information about senior services to grocery stores, beauty salons, government offices and other places frequented by older adults.
Another workgroup developed a training program that helped 300 police officers, firefighters and emergency personnel learn to recognize at-risk older adults and know who to call for help. Police reports increased significantly after the training sessions, which have since been rolled out to more fire departments, emergency personnel and postal workers.
Other workgroups focused on transportation needs and future planning for the baby boomer generation.
Affordable senior housing. The symbiotic relationship between community action teams and the workgroups was demonstrated in the partnership's effort to bring more affordable senior housing to Lyons Township.
Partners trying to win approval for new building projects relied on senior members of the community action teams to explain the need for housing to city officials. "We would bring them to village meetings and they would talk about the importance of the project in their community," Verschelde said.
One team provided a list of specific people who said they needed affordable senior housing. "That was huge for us," Grunke said. "Sometimes it is difficult to get an older adult to say, 'Yes, I would like to consider independent living housing or some other alternative.' It was great to have the community action teams identify those people."
Partly due to their efforts, a new affordable senior apartment building opened in the village of Countryside in September 2010.
Moving out of silos. Through partnerships, coalition members are better able to fast track community problem-solving and avoid service duplication. "It is nice to know what everybody is doing so we can focus on what kind of gaps need to be filled versus just creating programs because we are not sure what the other partner is doing," Grunke said.
For Aging Care Connections, the partnership has meant it does not have to be all things to all people. "It allowed us and some of the other partners to ask, 'If we decide to give up this service, can it be strengthened somewhere else?'" explained Verschelde.
Grunke agreed that a shift in thinking has occurred among agencies that serve older adults. "The partnership was an opportunity for agencies in aging to look at their own missions and say, 'What do we really do best?'" he said. "So often nonprofits want to be everything to everyone, and sometimes you forget what your real core is."
As the communities of Lyons Township embrace the mission of caring well for their aging citizens, Grunke said, "We have, surprisingly, received a lot of support when we go out and make the ask. I don't think anybody anticipated that because it was such a new concept and no one understood exactly what it was. But when the word got out, that news spread like wildfire and people responded and wanted to be a part of it."
RWJF perspective. Community Partnerships for Older Adults was an eight-year, $28 million national initiative of the Robert Wood Johnson Foundation (RWJF) that supported 16 communities to create collaborative partnerships to address the many gaps and inefficiencies in long-term care and supportive systems for vulnerable older adults.
RWJF Director of the Vulnerable Populations Team and Senior Program Officer Jane Isaacs Lowe notes, "One of the goals was to make what is a patchwork of long-term-care services in communities behave more like a coordinated system. We wanted to make sure that along that continuum of care, elders in communities had the breadth of services they needed.
"In general, the partnerships have demonstrated that innovations are possible in communities across the country—that allow people to age in place and that make for better care delivery for people with long-term-care needs."
While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
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