Field of Work: Long-term care for older adults
Problem Synopsis: America's population is growing older and living longer. The over-65 population is expected to double in the coming decades. The fastest-growing segment of the population is people age 85 and older—those who are most likely to need help maintaining their daily lives.
The long-term-care system is not prepared to meet these shifts. It is underfunded, uncoordinated, biased toward institutional care and characterized by significant gaps in essential services. The consequences for older adults and their family caregivers include reduced quality of life, unnecessary health problems and premature disability.
Synopsis of the Work: Partnerships that included diverse local organizations and older adults worked collaboratively in 16 communities to raise awareness of aging issues and to undertake projects to improve the lives of vulnerable seniors.
Each partnership defined its own priorities and approach. Strategies included: developing neighborhood networks; improving the transition from hospital to home; removing cultural barriers to existing services; educating providers; supporting caregivers; expanding transportation options; and responding to crises.
Key Results: The national program office reported that:
- Fourteen of the 16 partnerships that received implementation grants continued their work in some form at the end of the grant period.
- Some partnerships piloted new or best practices and helped them spread—for example, by advocating for zoning ordinances that promote senior housing in Atlanta, and using elder advocates in Jacksonville, Fla., hospitals to help with the hospital-to-home transition.
- Some partnerships redefined services to target frail elders and strengthened their focus on diverse groups, as defined by geography, race/ethnicity or affinity. For example, a community ambassador program in Fremont, Calif., reached out to seven faith and ethnic communities.
- Some partnerships offered a forum at which to discuss community challenges and get help in identifying solutions. For example, the partnerships in Houston and Broome County, N.Y., built on their collaborative relationships to deliver needed supports to older adults in crisis following natural disasters.
The evaluators from Mathematica concluded that:
The partnership model demonstrated that there are many creative and exciting ways to work collaboratively to improve the long-term-care system. However, despite the potential for creativity, the partnership model may not always result in measureable outcomes.