Tag Archives: senior services

Housing is the Platform to Improve Health

29 Oct

For several years our firm has advocated providing support services at home to ensure improved well-being and cost savings. In doing so we have run into the silo mentality that exists in most government organizations. The US Department of Housing and Urban-Development (USHUD) insisted until recently that housing was just a roof, whatever happened under that roof was not an issue for them. In 2003, with several successful projects under our belt, we approached both USHUD and the Department of Health and Human Services (HHS) to collaborate so that appropriate services could be combined with housing. It took several years for them to accept that this concept was vital to serving the very individuals for whom they existed. A recent article published by USHUD speaks of housing as the platform to improve health and that stable housing was essential in addressing the health needs of chronically homeless individuals. What a novel idea!

The article highlights several programs undertaken in Boston, New York and Chicago. In Boston it was revealed that health issues impeded the ability of residents to obtain and retain housing. New York Common Ground organization found that in order to meet the needs of the homeless population a partnership between health and services was essential. The Chicago project demonstrated that a strategy to marry healthcare and stable housing was successful and cost-effective by reducing unnecessary hospitalizations and emergency calls.

All of the collaborating institutions, however, realize the difficulty of establishing collaboration and integration among disparate systems, programs and organizations. They call for a focus on individual needs, system reforms and elimination of existing barriers to collaboration and integration. All is well you may say. However, in our experience there is a chasm between identifying the issues and doing something about them. Time will tell if we can do it right.


Elders Do Better at Home

19 Jun

 What accounts for reducing healthcare costs, faster recovery of seriously ill clients and improved physical and cognitive heatlh? You will never guess – bringing services to where these clients live.

The private assisted living industry is now fully engaged in servicing elderly clients in their homes. Most major assisted living chains are now caring for clients by dispatching caregivers to their homes at a cost of $240/day. Most have seen a growth of 20% in this line of service. The impetus to engage in this line of service may have come as a result of the stagnation that private facilities have been experiencing for the last five years; or, perhaps it may have been the result of several studies revealing that 89% of elders wish to remain at home as long as possible. Hospitals are finding out that seriously ill elders do better when medical services are provided in their homes.

John Hopkins University School of Medicine began the home-hospital movement back in 1996 as a pilot program. Research has proven that elders with potentially deadly diseases like congestive heart failure and cellulites can be safely treated at home with astonishing results. Not only was the care as safe and as satisfactory as hospital care, but recovery was faster and the cost much lower, 60% less.

There is no doubt that the trend in the future will be to provide as many services as possible to elders in their homes. A great idea!

Hispanic seniors

2 Mar

We live in an aging world with countries like Japan and Italy with 21.6% of their population 65 years and older.  Our nation is still relatively young with an elderly population of less than 13% but that is about to change.  The baby boomers who started turning 65 last year will add 75 million more seniors and the percentage of seniors in this country will rise to 20% within the next ten years.  This is good news  if you are getting older while remaining healthy.  Unfortunately for the large number of low and middle income seniors staying healthy and having access to services is not always an option.     The growing number of Hispanic seniors continues to experience a litany of problems when accessing services, among them, language and cultural barriers, a fragmented service delivery system and lack of trained bilingual staff.

Take for example my own state of Florida where over one million individuals are 65 years and older and few have access to critical healthcare services.  Luckly for our Hispanic community they are part of what is called the Hispanic paradox which means that despite their socioeconomic hurdles and lack of access they live longer than anyother ethinic or racial group by seven or more years.  This is because Hispanic seniors are much healthier than expected and the reasons for this paradox are a matter of debate.  Many suggest that factors such as diet, lifestyle choices and a strong social support network are key in understanding Hispanics’ better-than-expected health.  Another favorable condition of Hispanics in Florida include declining disability rates, lower rates of Medicaid use and low utilization of nursing home care.