The linkAges™ program of the Palo Alto Medical Foundation (PAMF) Innovation Center has received a grant of $714,000 over three years from the Robert Wood Johnson Foundation to help fund development of systems that support seniors aging in the community. The grant will support development and evaluation of linkAges Connect, part of the broader linkAges platform that fosters multi-generational community support for seniors living independently in their homes.
To complement traditional health care’s role in delivering high quality medical care, PAMF’s Innovation Center is focusing on non-medical aspects of health.
According to research conducted by Dr. Carla Perissinotto at University of California-San Francisco, seniors who are lonely have a 45 percent increased mortality over six years.
On Sept. 27, more than 200 people attended the “Aging and Community Redefined – A Vision for the Future” symposium, sponsored by the Palo Alto Medical Foundation (PAMF). Held at The Computer History Museum in Mountain View, CA, the event explored ways that health systems can partner with communities to ensure that seniors can live independent and fulfilling lives in the communities they love.
The event’s keynote speaker, Dr. Bruce Chernoff, CEO of the SCAN Foundation and Chair of the Federal Commission on Long-Term Care, said we should think more broadly than the impact diseases have on seniors. “Diseases only get you halfway there. Function is about the quality of life,” he said. “It’s about how we help our older, valued, community and family members be fully connected. That’s a good thing for the medical system.”
On Wednesday, February 20, 2013, the City of Mountain View’s Senior Advisory Committee (SAC) voted to affirm the value and potential for positive impact of linkAges, a pilot program being launched in Mountain View. Developed by the Druker Center for Health Systems Innovation of the Palo Alto Medical Foundation, linkAges™ is an innovative community-based network to support successful aging.
Since the SAC was formed in 2009, the group has served in an advisory role to the City Council on senior issues and the operation of the Mountain View Senior Center. The SAC’s seven-member group knows the issues and needs of Mountain View’s older residents, making their endorsement of a new successful aging pilot program all the more significant.
Most aging adults want to stay in their own homes for as long as possible, but many lack knowledge of programs and services that support extended independent living. To help with the successful aging process, on Saturday, February 9, 2013, the Mountain View Senior Advisory Council is hosting its second annual Aging in Place conference at the Mountain View Senior Center from 9 a.m. to 3 p.m.
The one-day event is geared toward seniors, their families and caregivers, and baby-boomers, and is sponsored by the City of Mountain View’s Senior Advisory Committee and the Palo Alto Medical Foundation’s (PAMF) Druker Center for Health Systems Innovation.
At this event, PAMF’s Paul Tang, M.D., vice president and chief innovation and technology officer, will introduce linkAges™, the Innovation Center’s successful aging program. PAMF’s Innovation Center team has selected the city of Mountain View as the place to launch the pilot program for linkAges™.
As generations age, how do different countries and cultures plan and provide for them? Information and ideas about senior support and preventing social isolation spanned the Atlantic when a group of 12 health care leaders from Denmark spent the afternoon at the Palo Alto Medical Foundation’s Druker Center for Health Systems Innovation on October 10, 2012.
Danish and American physicians, executives and directors from large health systems, government, universities, senior centers, hospitals and hospices joined for the four-hour exchange at the Innovation Center. The goal of the visit was to share knowledge of and opinions about the diverse challenges of aging populations in Denmark and the United States. From the many dynamic conversations underway at any given time, it appeared that that goal was met or exceeded.
Paul Tang, M.D., vice president and chief innovation and technology officer for PAMF’s Innovation Center presented on the health care system in the United States, including the changes required to adapt for the Affordable Care Act of 2010 and accommodate the needs of the enormous and growing aging population.
“Already about 13 percent of the U.S. population are seniors, the vast majority of whom are covered by Medicare,” Dr. Tang said. “The U.S. faces several challenges somewhat unique in the world: a fee-for-service care delivery model, the lack of universal health care, and health information systems that are not connected or, in some places, nonexistent.”
“In Denmark, 16 percent of our people are 65 or older,” explained Mikkel Bülow Skovborg, Research Attaché, Danish Ministry of Science, Innovation and Higher Education, outlined the health care system and focus on care for the elderly in Denmark. “We have a highly structured and well-funded system to provide long-term care at home for our elders. We haven’t built a nursing home in our country since 1987.”
Comparing Senior Support in the United States and Denmark
In Denmark, a high percentage of the gross domestic product is spent on social services and a lower percentage on health care. All health care policies are set on a national level but are implementing regionally via hospitals, clinics, rehabilitation centers and other health service centers. The municipal level tends to home care and preventive care services. Because of this comprehensive system, people rarely if ever “fall through the cracks.” There is a continuum of care with coordinated services.
Danish seniors have access to a wide range of services provided at the local, regional and national level, by people whose specific job it is to care for the elderly and support their ability to live in the community. A number of meeting attendees, however, observed that the high-level benefits, free at the point of delivery, may create a level of dependence on the system that enables families to “check-out” of their important caregiver roles. This relates particularly to their role in providing emotional support, the absence of which may contribute to isolation.
By contrast, the United States spends a low percentage of its gross domestic product on social services and a high percentage is spent on health care. The burden of care is on the family, not the government – basically, a private sector approach in which every person or family must research available options. The system is more fragmented, with some communities and cultures more adapted to solutions for elder care than others.
The attendees were divided into several groups, each of which discussed a different query and then reported out to the entire group at the end of the afternoon. Lively, engaging discussions covered these questions:
- What are the drivers of isolation?
- How does isolation impact aging?
- Who has the responsibility for tackling social isolation of seniors?
- What solutions to social isolation are being implemented?
- What are your “dream” solutions?
The discussions yielded a variety of perspectives and suggestions for the need to:
- Reduce health care and senior care costs. For example, in the United Stages, five percent of the people use 50 percent of the care.
- Reduce hospitalizations through overall improved health
- Become more community-centered, with more multigenerational composition, and nurture the spirit of volunteerism
- Improve transportation systems that effectively alleviate isolation, and use IT systems that support natural human interfaces
- Focus on seniors as people, not patients
- Embrace and support advanced care planning, beginning at an earlier age
“Seniors seek to maintain their independence and to live out their lives in the community,” Dr. Tang said. “We are committed to keep the dialog about successful aging going.”
Learn more about the Innovation Center at the Palo Alto Medical Foundation.
Contingent to Explore Successful Aging Ideas
On Wednesday, October 10, 2012, from noon to 5 p.m., the Palo Alto Medical Foundation’s Druker Center for Health Systems Innovation is hosting a delegation of 15 leaders from Denmark who work in diverse capacities to address current challenges in health care, particularly with issues relevant to aging. Attendees include C-level executives and directors from large health systems, universities and private corporations in Denmark.
The focus of the visit is to exchange information and knowledge around challenges related to aging, from the diverse perspectives and approaches of Denmark and the United States.
The population of Denmark is 5.5 million, comparable to the San Francisco Bay Area’s more than six million residents (Alameda, Contra Costa, San Francisco, San Mateo and Santa Clara counties). Life expectancy for women is 81 years and men 77 years. According to the United States Census Bureau, American life expectancy is only slightly lower: women averaging 80 years and men 75 years.
“We feel that advancing cross-cultural leadership engagement in exchanges of shared knowledge will allow us to broaden the scope of our thinking as we work to address the needs of our fast growing and increasingly vulnerable, older adult population,” said Paul Tang, M.D., vice president and chief innovation and technology officer for PAMF’s Innovation Center.
The event has the endorsement of Liz Kniss, Chair of the Santa Clara County Board of Supervisors. Scott Strickland, Kniss’ Senior Policy Analyst, will kick off the event with a welcome on her behalf.
After a meet-and-greet lunch, there will be a presentation by Mikkel Bülow Skovborg, Research Attaché, Danish Ministry of Science, Innovation and Higher Education, who will outline the health care system and focus on care for the elderly in Denmark.
Addressing elder care and aging in the United States will be PAMF’s Paul Tang, M.D, and Albert Chan, M.D., PAMF chief medical information officer, and medical director for the Innovation Center.
The speakers will introduce issues and potential solutions to social isolation among seniors, and then the group will break into teams for a series of workshops, culminating in a panel discussion to share the different perspectives.
Guests for this special gathering also include leaders from the public sector, other hospital systems, senior centers, foundations and nonprofits.