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The Long-Term Care Imperative conducted a statewide poll last fall to learn more about what Minnesotans think about senior care.

As a part of the poll, we asked an open ended question: What comes to mind when you hear the phrase ‘long-term care for seniors’? Here is a visual representation of the responses we received:

Pretty interesting – overwhelmingly, people think “nursing home” when they think about long-term care. Even more interesting is that nursing homes are actually the least common form of older adult services, reserved only for those with the most complex medical needs.

Senior care in Minnesota is actually a diverse system of different kinds of support, resources to help people stay independent, care options based on an individual’s needs and wants, and variety of different housing and lifestyle choices. We need the whole system (not just one part of it) to be strong in order to meet the changing demands of our aging population.

Below is an infographic developed by the Long-Term Care Imperative to demonstrate a few of the ways Minnesotans access senior care and the journey many people go on as their needs change.

Take a look:

What do you think – does this represent your experience?  What needs to change to make it easier for Minnesotans to get the care they need when and where they need it?


If you work in the field of aging services and ever wonder whether you’re really making a difference, this story is for you.

A few weeks ago, a team of amazing people from Presbyterian Homes & Services joined hundreds of Aging Services members for three days of face-to-face advocacy at the State Capitol in St. Paul.

Brandi Barthel, Care Center Administrator at The Gables of Waverly Gardens, shared this moving story about the connection her team shared during their time at the Capitol. It is a powerful reminder of what it means to care for another person’s loved one – the gratitude that people have for this important and honorable work.


Brandi writes:

It starts with a connection.

As we were waiting for our appointment with Senator Goodwin, her Legislative Assistant Billie Ball approached me and said “Bambi?” I looked at her with a moment of confusion.  It was then I remembered she was a family member of a past resident that resided at our Johanna Shores Memory Care Household.

I stood with excitement as the tears flowed down her face.  We shared the memories of her father who had passed away two years ago. She went back to her desk to grab a picture of her father dressed in his Sunday best wearing a hat and a big smile on his face.

This picture was taken during the “glamour shots” activity that we hosted while he lived at Johanna Shores. She said it was one of her favorite pictures of her dad and had it proudly displayed on her desk.

She stopped to show others who walked by the picture of her loving and happy father who embraced the staff of Johanna Shores as family just as we embraced him as our family.  And as families do, we continued to reminisce about everything that made him unique and special.

One of her other fond memories was the “beer and the boys” activity that was inspired and requested by her father. We laughed about how her dad insisted we serve “the real stuff” and how even living in our community he was still the “patriarch of our family.”

You can imagine how this inspired us as we were waiting to speak with Senator Goodwin about the much needed funding for our long term care employees and residents.

When our appointment time arrived, she introduced us to Senator Goodwin as the team that cared for her father and she was so grateful for what we do.  As we met with the Senator, we shared this story and she was compassionate towards our efforts to increase Long Term Care funding.

It was because of the caring staff at Johanna Shores and many other facilities that lovingly embrace the residents that make the positive lasting impressions on families that choose to place their loved ones in our care.

Reminiscing on those times that he shared with us at Johanna Shores reminds us why we have devoted our lives to this industry.  Our nursing assistants and nurses make that happen each day for very little more than a thank you followed by a sincere smile from those that we care for.

But unfortunately this is not enough to pay the bills for these special staff.  The time has come that we must re-invest in the staff that care and make a difference to the parents and loved ones that supported us through our lives.

Our mission says we take in and love the most frail of our people.  It is up to us to ensure the staff that we count on to make these memories can afford to continue to serve, because we cannot afford to lose them.

That is why we stressed to Senator Goodwin not to forget Long Term Care in the Legislative session this year.  It is our front line care givers that need this funding to continue the loving support of our residents and families. Support us in making memories in years to come.


Thank you, Brandi, for sharing this story. Because of your work, one more lawmaker knows just how important it is to support the caregivers who serve our loved ones.

This week, hundreds of caregivers, volunteers and aging services professionals will visit the State Capitol for a week of face-to-face meetings with lawmakers.

The goal of these meetings is simple: to share stories about the changing faces and places of senior care in Minnesota, and urge lawmakers to make this issue a top priority.

Gayle Kvenvold, president and CEO of Aging Services of Minnesota, set the stage for this week’s meetings:

“Someone will always say there isn’t enough money. This is about priorities. Minnesota seniors and caregivers should be among our top priorities – they deserve our support and investment.”

When advocates and caregivers meet with their elected officials this week, they will highlight five key ways to strengthen senior care and prepare Minnesota for the future:

1.      Invest in Caregivers

  • Provide wages that attract and retain the very best caregivers, paying them adequately for the demanding work they do on behalf of Minnesota seniors.
  • Protect the more than 112,600 MN jobs that senior care generates across the state.

 2.      Invest in the Places Where Senior Care is Delivered

  • Fund infrastructure improvements in senior care buildings and communities that will increase the quality of life for residents and allow caregivers to deliver the best possible care.

3.      Invest in Quality 

  • Senior care is so much more than nursing homes. We must invest in new models and innovation that will continue to improve quality, while offering seniors the care/services they need and want.

4.      Create Financial Stability for Seniors, Families and Providers

  • People who can afford it should plan and pay for the cost of long-term care, and we should create tools to help them do that; and
  • Low income seniors should still have access to a safety net and the right level of services for their unique needs. Funding for home and community based service must be adequate to pay for what consumers need.

5.      Invest in the Future

  • Fund technology that improves how we care for seniors, and find ways to truly integrate long-term care services and supports with the rest of the health care world.

Advocates also will share with lawmakers the results of a recent public opinion survey conducted by the Long-Term Care Imperative. Key findings of that survey include:

  • 85 percent of Minnesota voters support increasing funding for in-home and community based care to make it easier for seniors to stay independent longer.
  • 77 percent said they support increasing funding for nursing homes to improve overall quality.
  • 75 percent support allowing individuals to cash in their life insurance in order to pay for long-term care.
  • And finally, 64 percent of voters are willing to pay more in taxes to improve long-term care in Minnesota.

Will you be at the Capitol this week? What will you advocate for? Take a few minutes to visit the Stars Among Us online gallery, where hundreds of senior caregivers have shared what they want lawmakers to know about the important work they do.

For a long time, senior care advocates, lawmakers and the media talked about the Age Wave as something that was “on the horizon” – somewhere out in the future.

Today, that wave of growing demand is on our front door step, and it’s time to ask a key question: Is Minnesota ready?

The second (here is the first) in a series of infographics from the Long-Term Care Imperative focuses on the demographic and economic realities we face, and how Minnesotans feel about specific proposals to help the state – and individuals – prepare for the future.

There is no single, magic way to prepare Minnesota for the changing needs of an aging population. We will need government, individuals, families, senior care providers, caregivers and entire communities to work together.

The Age Wave isn’t coming to Minnesota – it’s here.

A few weeks ago, we released the results of a statewide public opinion poll commissioned by the Long-Term Care Imperative. The results were both fascinating and worrisome.

“These numbers are striking in the reality they depict. Minnesotans act as caregivers for loved ones while they are financially unprepared for their own long-term care needs,” said Gayle Kvenvold, President and CEO of Aging Services of Minnesota. “We face a looming economic crisis as our population ages. Now is the time to advance real solutions that will protect access and quality of care for all Minnesota seniors and their families.”

At a very high level, four key themes emerged from the poll: 

1.    Minnesotans are not prepared to pay for their care.

2.    Access to quality senior care is a right, not a privilege.

3.    Caregivers (formal and informal/family) need more support and resources.

4.    Minnesotans support reform proposals that will achieve four key outcomes:

  • Improve care for seniors first and foremost
  • Address a looming crisis in our state
  • Improve conditions for caregivers
  • Improve the economy by delivering care more efficiency and strengthening the long-term care workforce

What do you think when you see these numbers? We know Minnesotans want to remain independent for as long as possible as they age, but we also know most won’t be able to pay for the care they need and want.

We’ll continue to post excerpts and additional findings from the Long-Term Care Imperative poll in the coming weeks – stay tuned.

Over the weekend, Lori Sturdevant of the Star Tribune wrote a thoughtful opinion piece on the critical need for Minnesota to change the way we pay for long-term care. The article was the result of a meeting several weeks ago with six key leaders who represent a diverse cross-section of section of Minnesota’s business and civic circles.

This is exactly the kind of attention this problem demands. The apparent demise of the federal CLASS Act is disappointing evidence that we cannot wait for someone else to address the serious and imminent challenge of funding long-term care, particularly for the poorest and most frail seniors.

During the meeting with Sturdevant, Eric Schubert with Ecumen hit the nail on the head: “This is a Minnesota problem with an opportunity for a Minnesota solution.”

Exactly. So are we up to the challenge?

There are no silver bullets when it comes to this issue. Our success depends on our ability to develop a system of options and avenues designed to empower individuals to take greater control over their future, while also strengthening the safety net for those most in need.

Creative, strategic measures, products, services and systems will combine to transform the way we save and pay for long-term care. After touring the state talking to Minnesotans of all ages and backgrounds, the Citizens League created a report titled “Moving Beyond Medicaid” that offers up several examples of the kinds of solutions that could make a real difference.

Gayle Kvenvold of Aging Services of Minnesota highlighted many of the measures in the Citizens League report, as well as additional insight and urgency on this topic in a recent opinion piece in the Star Tribune.

And on January 12th, top experts from across the country and right here in Minnesota will gather at the Humphrey School of Public Affairs at the University of Minnesota for a day-long forum on this very topic. The fourth annual Long-Term Care Financing Solutions Forum is free and open to the public. It is an opportunity to look closer at the very real and practical ways Minnesota can be a leader on this issue, as we have in so many other areas of our health care system.

Slowly but surely, there has been a notable increase in public discussion about the urgent need to change the way we plan and pay for long-term care. This is a welcome development and critically important to our success – but if we aren’t able to harness talk into action, we will fail.

Will Minnesota wait for someone else to solve this problem, or will we step up with our own solutions?

Those who have cared for someone with Alzheimer’s or another form of dementia know that it can be a confusing, frustrating and sometimes frightening experience. As with so many of the things about daily life that dementia can turn upside down, the traditional dynamics of caregiving also are challenged. We have to re-learn how to engage, respond and serve those in our care.

These challenges don’t just apply to family caregivers – professionals are in new territory, as well. As we look at the growing need across the state and nation, a critical question surfaces:

Do professional caregivers have the knowledge and skills they need to effectively serve the growing number of people with dementia?

That question is exactly what led Aging Services of Minnesota to partner last year with the Alzheimer’s Association – MN/ND Chapter to develop a training program that is the first of its kind in the nation, pairing direct care providers with the Alzheimer’s Association and leading researchers and practitioners in the field of dementia care.

In its first year, approximately 225 caregivers from across the state participated in the Dementia Care Certificate program. They include professionals in a wide variety of roles, including direct caregivers, dementia program directors, directors of nursing, social workers, activities coordinators, housing managers and administrators. Participants come from a wide variety of aging services settings – including home care, adult day care, assisted living/housing-with-services and care centers.

The program is impressive – but this isn’t just about a program, it’s about the impact this training will have on the lives of thousands of Minnesotans, their families and the caregivers who serve older adults.

Here’s what this training will mean to them:

  • Caregivers will have the skills they need to interpret complex behavior signals – as a result, they will be more confident, effective and satisfied in their roles
  • More confident and effective caregivers will lead to better care and outcomes for the people they serve
  • Individuals with dementia, their families and caregivers will experience lower stress and anxiety because they have the skills they need to navigate challenging situations
  • People with dementia are able to live safely in environments specifically designed to minimize factors that can increase agitation
  • Family members feel more confident about the care their loved ones are receiving, knowing that caregivers are specially trained to deal with difficult circumstances and respond to certain signals
  • Family caregivers develop new skills, in addition to learning about important ways to maintain their own health and safety as caregivers

This new program is just one important way Minnesota’s long-term care providers and caregivers are stepping up to prepare for the demands we will face.

How is your organization or community preparing to better serve the growing number of people living with dementia?


Just 3% of adults in the United States have their own private long-term care insurance policy. Compare that to the fact that nearly 70% of us will need some kind of assistance with daily activities such as eating, bathing or dressing after we turn 65, and the reality that Medicare doesn’t cover most long-term care costs.

Today, that equation results in a large number of Americans defaulting to Medicaid, a program designed for low-income individuals. Even those who have saved throughout the lives are now finding they are unable to pay for the costs of long-term care, leading them to a place they often find hard to believe – “spending down” to qualify for public subsidy.

A recent Washington Post piece offers a great summary of the key challenges we face in preparing ourselves as individuals and as a country for the long-term care costs that lie ahead.

Our current approach to paying for long-term health care is flawed on many levels. On a public policy level, it simply is not sustainable for government to continue to be the primary source of funding for long-term care, particularly as the number of older adults in Minnesota and across the country grows rapidly.

On an individual level, it is discouraging and disheartening to find oneself in a position of total financial dependence after a life spent planning and saving. Financial strains quickly translate to family stress, which can often lead to physical health impacts for seniors and caregivers. Total reliance on government funding also greatly reduces the flexibility we have to choose when, where and how we will receive care.

It would take far more than a blog post to outline the many options we have to empower more individuals to take responsibility for financing their own long-term care needs, and we will certainly dive into those issues in more detail as we approach the 2012 legislative session.

For now, the most important message is the need for urgency on this topic.

We can’t wait until after the 2012 elections to make real moves on the topic of long-term care reform. We can’t let the perfect get in the way of the good when it comes to building a toolbox of resources that will help people develop an approach that works for them.

What do you think? What creative ideas would you implement to put more control and financial responsibility back in the hands of individuals? What kinds of resources would make it easier for you to save for your own long-term care?

To kick-start your thinking, take a peek at the Moving Beyond Medicaid report created by the Citizens League’s Long-Term Care Collaborative, of which Aging Services was an active partner.

Minnesota’s state demographer Tom Gillaspy posed this tongue-in-cheek question early on in his presentation to a room full of leaders at the Aging Services of Minnesota Annual Meeting in September. Of course we all know the answer – we’ve known about the demographic wall we’re about to hit for many years. However, human nature, political realities and a host of other factors have left us unprepared for the challenges we’re about to face.

An hour-long discussion of the ways our aging population will shape Minnesota’s future – from our economic health to changes in our education, health care and public safety systems – is likely to leave a person seriously stressed or strangely optimistic, depending on your view of the world.

It’s true, the demographic changes we face are significant. Here are a few highlights from Gillaspy’s presentation:

  • In the next 10 yrs, MN will need 46% more healthcare workers to meet the growth in demand for services – especially in older adult field.
  • The single most common and fastest growing type of family in MN is 55+ empty-nesters with no kids at home.
  • In 10 years, MN will add as many people age 65 as we have in the past 4 decades – this number in particular begs the question, if we can’t afford long-term care today, what will we do in 20 years?

Looking at numbers like these reinforces the notion that nothing short of transformational change is needed to recreate our systems for the future. We are officially beyond the point where small changes, cuts and reforms around the edges will be sufficient – we need game-changers to stay ahead of the curve.

But that’s exactly where the opportunity lies and Minnesota is good at game-changers. We have been national leaders in seeing new and different ways to do things, creating unique partnerships, looking beyond how things have always been done and translating possibility into reality.

The evolution of Minnesota’s long-term care system is a prime example of what can be achieved when individuals, businesses, nonprofits, community leaders, families and elected leaders come together to envision something different.

We now face challenges that will require new partnerships and another infusion of energy, commitment and creativity to bring the next wave of game-changers, not just to our health care system, but all across our state.

Finally, I’ll leave you with a snapshot of how Minnesota’s leaders in the older adult services field are looking at the future: A live-poll of 200 Aging Services members at our Annual Meeting revealed that 78% are still optimistic about the future, despite many challenges on the horizon.

What do you think? Does the demographic crystal ball make you cringe, or are you doing new things to help shape the future?

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Aging matters to all of us.

This blog will address the issues, questions, challenges and opportunities that surface as we work to meet the demands of an aging population.

It’s also a place to highlight the people and organizations whose passion, creativity and commitment are shaping the future of older adult services in Minnesota.

Everyone has a story about how aging impacts their life – we hope you’ll join the conversation and share your story.

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