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For Aging Solutions, Think Local

Sandy Markwood March 1, 2019
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There may be only one near-universal opinion among the nation’s 48 million adults who are older than age 65: an estimated 90 percent of them want to maintain their independence by aging well in their own homes and communities, and not in institutions such as nursing homes. This goal is shared by the baby boomers, 10,000 of whom turn 65 every single day. The good news is that this approach is the most cost-effective for consumers and taxpayers!

More good news? A host of aging supports and services that help enable older adults to do so are available in every community in the nation. Provided by the Aging Network—the national network of federal, state and local aging entities created by the Older Americans Act more than 50 years ago—these home and community-based services help older adults remain healthy and independent at home and in the community for as long as possible.

n4a’s members, the 622 Area Agencies on Aging (AAAs) and more than 250 tribal aging programs (Title VI programs), play a key role in developing, coordinating and delivering these core services. Services offered through Area Agencies on Aging include meals provided in the home and in community settings, in-home care assistance, transportation, information and referral, evidence-based health and wellness programs, medication management, case management and more. Millions of older adults and their family caregivers rely on the support of these local agencies and their community partners—because they are the trusted resources on aging.

Our country is aging at an unprecedented pace. Therefore we must bolster the capacity of the Aging Network to reach the growing number of older adults and their caregivers. Without significant investments, older adults and families will struggle to find or afford home and community-based options—driving up health care expenditures and pushing more people into unnecessary and much more expensive institutional care. n4a and our members are incubators for new ideas on ways to promote independence and help older adults to age in place. And here are just two of those ideas:

1. Invest in solutions and supports that help older adults age successfully at home. The federal Older Americans Act is the foundation of the Aging Network and an important source of home and community-based services for people who need help but aren’t low income enough to qualify for Medicaid.

With OAA reauthorization on the agenda for the 116th Congress, now is the time to dramatically increase the capacity of the Aging Network to reach millions more consumers. n4a is calling on Congress to double the size of the Act over five years to ensure that a greater percentage of the growing number of older adults can access critical community-based aging services and supports, such as in-home care, transportation, nutrition and health promotion programs.  

2. Recognize that health also happens at home. In other words, an older adult’s health is more influenced by what happens between doctor’s visits than our health care systems recognize. But that is starting to change.

As health care costs have continued to grow, the health care sector has taken a closer look at how social issues affect health—particularly individuals who have chronic conditions or other complications making them the most expensive to manage. These social determinants of health (SDOH) include, but are not limited to, access to housing, employment, nutritious food, community services, transportation and social support. Increasing evidence shows that addressing these factors improves long-term health and wellness outcomes.

This evolution creates new opportunities for health care organizations to work with Area Agencies on Aging and the Aging Network, which are deeply rooted in the communities they serve, to better meet the health and wellness needs of our nation’s aging population. Why reinvent the wheel when you have an existing high-quality, trusted network already on the ground?

As experts at providing services that address the social determinants of health, AAAs are increasingly partnering with health care to improve the health of older adults. In fact, a 2018 Scripps Gerontology Center survey found that 41 percent of AAA respondents have contracts with health care entities.

However, there is room to grow and growing pains to get through. That’s why n4a’s Aging and Disability Business Institute is leading the way in building the capacity of community-based aging and disability organizations to successfully partner with health care. We’re helping these community-based experts learn how to leverage their decades of experience to create new opportunities in the health care world. The mission hasn’t changed—our collective focus remains on helping older adults and people with disabilities lead healthy, independent lives—but now we have new ways to get there!

We are all stakeholders in an aging nation, with demographics that will present challenges for our society. Turning to local, cost-effective solutions that support healthy aging at home and in the community should be at the top of our list of responses to this sea change.

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Sandy Markwood

Sandy Markwood is Chief Executive Officer of the National Association of Area Agencies on Aging, a membership association representing America’s national network of 622 Area Agencies on Aging (AAAs) and providing a voice in the nation’s capital for the more than 250 Title VI Native American aging programs. Sandy has more than 30 years of experience in the development and delivery of aging, health, human services, housing and transportation programs in counties and cities across the nation.

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