Making Sure Our Longer Lives Are Healthy Ones

(Next Avenue invited all our 2016 Influencers in Aging to write essays about the one thing they would like to change about aging. This is one of the essays.)

When I was born, a person could reasonably assume a life expectancy of somewhere around 65, just two years more than the current average age of retirement. Speed forward to 2017, and life expectancy is 78.8 years, nearly a decade and a half longer.

Our longer lives — a testament to the spectacular advances in public health, nutrition and medicine over the last century — are something we should be able to cherish and celebrate. Yet, too often, our longer lives are blighted by financial and nutritional insecurity, ill-health and loss of independence. Indeed, it was witnessing this frustrating reality, as a social worker and a hospital and home health administrator, that prompted my creation of Partners in Care Foundation in 1997.

Another frustrating reality, one that Next Avenue's 2016 Influencer of the Year Ashton Applewhite so ably discusses in her book, is a tendency in the U.S. to see aging as something that, with enough potions, lotions or medical intervention, can be “fixed.”

Of course, it can’t. Alongside death and taxes, aging is, perhaps, the only other guarantee in life.

There are currently 46 million people aged 65+, projected to rise to over 98 million by 2060. Seventy percent of people turning 65 will likely need some form of long-term care during their lives. This bonus of time must be maximized by striving to optimize health over the years.

Let the enormity of those numbers sink in for a moment. There are now more Americans 65 and older than at any other time in U.S. history. At this new epoch, what must we do as a society, and as individuals, to ensure that our longer lives are a boon to our existence, not a burden?

Many governmental agencies and non-governmental organizations, including Partners in Care, are actively seeking answers to this question. And I’m happy to say they are coming up with some pretty compelling answers.

Here are just three of the innovations emerging from the imperative presented by the Triple Aim (patient satisfaction, better health of populations and lower per capita cost of health care), a model by the nonprofit Institute for Healthcare Improvement. These have made demonstrable improvements to the way we think about the process of aging and care for our older adult population:

1. Person-centered care. Bruce Chernof, CEO of The SCAN Foundation and a fellow Influencer in Aging, wrote recently on Next Avenue about the critical nature of person-centered care that “values individuals’ quality of life outcomes, not just the technical quality of medicine.” The passing of The Affordable Care Act ushered in new opportunities to replace fee-for-service models with bundled payments that have encouraged better coordinated care, helped cut down on unwarranted and invasive tests and procedures and have been demonstrated to significantly improve patient health outcomes and experience.
2. Post-acute care. This person-centered shift has also afforded far greater efficiencies and effectiveness in providing post-acute care. Care Transitions programs connect health coaches from community-based organizations like our own with high-risk patients recently discharged from the hospital. They help build health self-management skills, review medication use and identify the red flags of a worsening condition. That has dramatically reduced 30-day hospital readmissions, ER visits and the associated distress for patients and their families.
3. Health self-management programs. Roughly 91 percent of older adults have a least one chronic condition and 73 percent have at least two. Empowering these people with the skills to prevent those types of conditions and to stabilize and actually improve their health, is emerging as one of the most powerful strategies for improving quality of life and thus controlling health care expenditures.

We at Partners in Care hope that in its rush to repeal The Affordable Care Act, the new administration is not tempted to throw the proverbial baby out with the bath water.

So much progress has been made in developing programs that afford older adults the opportunity to age well, thus increasing their independence and dignity. We have unprecedented opportunities to redefine the aging experience — through prevention, through more coordinated, person-centered care that respects the uniqueness of aging and through personal empowerment to take greater responsibility for our own health.

Now is the time to respect, support and celebrate our extended lifespans. If care delivery systems, community organizations and individuals work together, we can reshape the journey of aging so it better serves us all.