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?

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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?

If you spend any time on Twitter or Facebook, you’ve probably seen mentions of various reports confirming that indeed, older adults are taking the world of social media by storm.

Here are a few great reads that provide more detail on exactly how older adults are spending their time online – it’s fascinating stuff.

Pew Internet Survey of Adult Social Media Use:

  • 65% of online adults use social networking sites
  • 51% of those 50-64 and 33% of those age 65+ use social networking sites
  • In the past two years, social networking site use among internet users age 65 and older has grown 150%, from 13% in April 2009 to 33% in May 2011.
  • During this same time period, use by 50-64 year-old internet users doubled – from 25% to 51%.
  • Among the Boomer-aged segment of internet users ages 50-64, use of social networks on a typical day grew a rigorous 60% compared to one year ago.

Nielson State of the Media: The Social Networking Report:

  • Internet users over the age of 55 are driving the growth of social networking through the Mobile internet.
  • Over twice as many people aged 55+ visit social networking sites on their mobile phone than last year – a 109% increase in one year.

So it’s well-documented that older adults are embracing social media. That has all kinds of implications for aging – how well-connected we remain with friends and family, access to health and wellness resources online, engagement with virtual communities of people who share our interests and experiences as we age.

What does this mean for older adult service providers? Without hard data, it’s hard to tell, but it does seem as though the provider community is a bit behind when it comes to embracing the opportunities of social media to connect and engage with clients, residents, family members and the broader community.

That’s not to say there aren’t a lot of providers using social media in really interesting ways – they just don’t seem to be the majority. Part of the challenge likely is the fact that despite its rapid growth among older adults in the past few years, use of social media is still a fairly new phenomenon among this age group.

Social media is also a really important and effective way to connect with the next generation of the aging services workforce. Increasingly, access to professional networks, peer relationships, mentoring and continuing education happens online, often via social networking channels. In fact, the Nielson report confirms that more Americans visit Facebook while online than any other single web-based brand.

A few questions I’d love to know more about from you:

  1. Do you, your staff or your clients and residents use social media? If so, how? And what has been the result?
  2. If you don’t use social media to engage with residents and other community members, why not? Are there barriers or reasons you don’t?
  3. Are there any great examples out there that could inspire others? Your own approach or something you’ve heard about? We’d love to hear about them in the comments!

And in case all of the data and reports aren’t enough to convince you that seniors are online in record numbers – have a look (and a laugh) for yourself: http://bit.ly/ni687f.

In honor of Labor Day this week, it’s only fitting to take a few moments to acknowledge the men and women who dedicate their lives and careers to caring for older adults – those who choose this path as a profession, and those who are called to become caregivers when their loved ones need them.

It’s also fitting that this week a nationwide report gave Minnesota high marks as a leader in providing care and services for older adults. A lot of factors must be in place to ensure a strong system of care and support for seniors – good information, access to a range of support services and care settings, flexibility and innovation in how services are delivered and public policies and investments to keep our system strong.

However, even with all of these elements in place, there is one thing that rises to the very top: the front-line caregivers – paid and unpaid – who provide daily care and support for our loved ones.

For those who are not direct caregivers, it’s easy to lose sight of what it really means to care for someone who can no longer take care of themselves. What it means to help with the most intimate daily activities of bathing, dressing and eating, or tending to complex medical needs. It’s physically demanding. It’s emotionally draining. It can be very stressful and sometimes frustrating.

And yet – it’s one of the most rewarding and honorable positions in our health care system. Despite the demands of this role, I’ve heard countless caregivers say the reason they’ve built a career in this field is because it is an honor to be there for someone when they really need it. To provide encouragement and empowerment to help someone else achieve their goals and truly live their life to the very end.

At the Aging Services board meeting earlier this summer, Dan Dixon, president and CEO of Guardian Angels of Elk River, provided a reflection that opened up our first day of work. He talked of volunteering in his own hospice program. One day, after visiting the same man for many weeks, something happened – as Dan was leaving the room after a short visit, the man called out to him. He asked if Dan would sit and say a prayer with him. In that moment near the end of this man’s life, Dan said he was reminded of the powerful impact caregivers have on those they serve.

In some of the most challenging times of our lives, caregivers have the honor of providing support, encouragement, comfort and happiness. This week, we honor those people and thank you for the difference you make every day!

Is there a caregiver you’d like to honor? Tell us about them in the comments section. Better yet – nominate them for an Aging Services Award!

Last week, Governor Dayton kicked off his statewide jobs tour with a visit to PioneerCare in Fergus Falls. During his visit, Dayton spent a significant amount of time talking with administrator Nathan Johnson and the senior staff at PioneerCare, focused specifically on the unique workforce challenges and opportunities that exist in the field of older adult services.

It’s no surprise that Governor Dayton would choose a long-term care provider as the first stop on a statewide jobs tour – the long-term care sector in Minnesota generates nearly $7 billion in economic activity across the state. Older adult service providers are job-creators who play a significant role in the economic vitality of their communities.

If Minnesota is going to meet the growing demand for a full spectrum of housing, support services and health care for older adults, we will need to develop new career paths in long-term care and ways to attract and retain the very best workforce. As providers transform the ways they deliver care and services to meet the demands of today’s seniors, we also must ensure that the career opportunities in this field reflect the changing skills, interests and demands of the next generation of our workforce.

The Health Support Specialist apprenticeship program is a perfect example of a new workforce model for older adult services designed to do just that. This first-of-its kind program cross-trains workers to build the skills and confidence to perform a much wider range of roles and responsibilities within the emerging “household model” of delivering care.

This new position offers greater depth of responsibility, more job satisfaction and higher wages for employees, while delivering a new kind of customer service for residents and greater overall value and flexibility for employers. Often described as the “blended worker” model, this is just one example of the kinds of new ideas that will shape the future of Minnesota’s health care workforce.

Click here to read about how the team at PioneerCare is thinking about these issues, and how they spent their time talking with Governor Dayton.

What is your organization doing to attract and retain the next generation of workers? What are the challenges you’re facing as you build your team?

“You live your life the way you want.” That’s how Ecumen’s vice president of business development recently described the company’s philosophy regarding the experience of all seniors who live in one of their communities.

That’s what we all strive for, right? Housing, support, services and eventually care that are all driven by what we want for our lives; guided by decisions we’ve made about what’s best for us and our families.

But that quote – “live your life the way you want” – also got me thinking about something we all try to avoid: Will there be a point at which, no matter how much support I have, I won’t really be able to live my life the way I want? What then? I don’t foresee a situation where I will want to need 24-hour care or be limited in my physical or mental abilities to make my own choices – but none of us knows what the future will hold.

Fifty may be the new 30, and 80 sure isn’t what it used to be – but none of us can outrun the clock, and at some point we will need help. In fact, statistics show that if we make it to age 65, 80 percent of us will need some type of long-term care.

That’s why it’s so important that we – as individuals, families, communities, lawmakers and care providers – are honest about the realities of growing older and talk about the full spectrum of needs and choices we’ll eventually face.

Those choices might start with adding some help and services to make life easier and safer or moving to a new community that provides companionship and new adventures. Eventually, it could include tough choices about how and where we want to live out our last days.

What do you think? Do you talk with your spouse or family about how you want to live your life into old age? If you’re a provider, how does the “live your life the way you want” philosophy makes its way into your organization? What can lawmakers do to support the full spectrum of long-term care options?

 

A recent Washington Post article highlights the variety of ways communities across the country are adjusting to meet the changing needs of an aging population.

What I love about this article is not just that it addresses the practical realities that come with an older population, but that it also provides great insight into how broad and far-reaching the impacts of aging really are.

Many of us focus on the immediate family decisions and stresses that come along with an aging loved one – decisions about whether or when to seek additional support, move out of a life-long home, or directly address end-of-life issues.

But what about the less obvious challenges – and opportunities – of aging? For example:

  •  The need for new transportation options to accommodate active seniors who want to shop and socialize the way they used to, but no longer drive themselves.
  • In Minnesota, we’ll soon have more people aged 65+ than kids in school – that will bring some challenges, but what about the amazing resource at our fingertips? How are we engaging older Minnesotans to help teach our kids or support and volunteer in schools?

What else? Is your community doing anything unique to meet the needs of an aging population? Are there opportunities we’re missing?

It would be great to hear from city planners, first responders and other city officials if you’re working on anything on this particular topic…

A few years ago, Aging Services of Minnesota launched this blog as a way to provide timely updates on policy and advocacy activities at the state Capitol and in Washington, D.C. After a year-long hiatus, we’re excited to report we’re reviving the blog! We’ll still include important advocacy updates and engagement opportunities, but we’re also going to expand the discussion to a broader mix of topics.

Every morning as I make my way through multiple news sources and the crazy, wonderful world of social media, I stumble onto stories about aging and older adult services that make me think. Fascinating stories about individual people who are breaking the rules and redefining what it means to age today, innovative providers who are paving the way to the future and family members asking deep philosophical questions as they realize that age is taking its toll on a loved one. This is the world we live and work in, and it just begs for more conversation.

We also want to use this space to shine a light on the talented, dedicated, innovative people and organizations that are shaping the field of aging services in Minnesota. Their stories don’t often make the front page of the paper, but they are truly inspirational and deserve to be shared far and wide.

We’ll use the Aging Exchange blog to ask questions, give props, and share stories that put a human face on the complex issues of aging and long-term care.

We hope you’ll visit often and most importantly, join the conversation! If you have a story, idea or big question we should feature on the blog, please share it! Here are a few ways to connect with us:

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ABOUT THIS BLOG

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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