Nancy Zionts recalls her surprise at the answer from a group of millennials when the Jewish Healthcare Foundation quizzed them a few months ago about what most concerns them. She expected to hear that they worry about the environment, cost of living, affordable housing.
“It was amazing the number who said they’re concerned about their parents as they age, and what’s going to be their role when they age,” she says. “This is an issue people are thinking of in a variety of generations.”
Indeed, the advantages and pitfalls of aging in place are creeping up on baby boomers in Pittsburgh. Among U.S. counties with a population of at least one million, Allegheny County has the second highest proportion of seniors (ages 65 and older), according to a 2014 report by the University of Pittsburgh’s Center for Social and Urban Research. That percentage of seniors is projected to rise from about 18 to 22 by 2030.
On May 3, the Jewish Healthcare Foundation will host a charrette, or community planning session, to seek novel ideas for delivering primary care and making it more responsive to the needs of seniors and their caregivers. Through panel discussions and breakout sessions, attendees will talk about possible technology applications, community-based care programs and communication strategies that help seniors to live well and safely, says Zionts, the foundation’s chief operating and program officer.
“It’s an opportunity for us to look at various aspects of living well and independently in the community, with a goal of improving quality of life, preventing isolation, and really maximizing people’s golden years,” Zionts says. “Your senior years don’t need to be a negative.”
Technology such as Uber’s app can provide older people with a level of independence by ensuring reliable transportation, she says. Wearable fitness devices can measure a range of bodily functions. A health care provider might utilize electronic records or communication technologies to be alert to early warning signs of problems, such as unfilled prescriptions.
“Then there’s the technology that can connect information,” Zionts says, since many seniors have more than one health care provider. “Is there a way for them to communicate, or you to communicate with them, to share information in a meaningful way?”
The foundation invited thought leaders and practitioners from health care, insurance, technology, government, philanthropy, legal services, academia, architecture and hospitality to brainstorm during morning or evening sessions at its QIT Center on Smithfield Street, Downtown. More than 80 people registered, a “heartwarming” response that indicates people care, Zionts says.
“We’re not coming in with a model that we’re asking them to endorse. We’re asking them to do ‘blue sky thinking’ with us—Who might be the team we need to assemble? How would they be trained, and how would they be paid?” she says.
“Many other countries have community health workers, for example, people who are not necessarily clinically trained but have life experience and understanding of resources and can be present to identify some low-hanging warning signs. That might mean connecting a senior to a food pantry in the neighborhood, or knowing if they had a change in their family situation, such as an adult child who moved away or a death in the family, that could affect their physical, mental and social health.”
Established in 1990 with proceeds from the sale of Montefiore Hospital, the Jewish Healthcare Foundation has provided more than $100 million in grants to improve health and health care in the region. In 2016, the foundation kicked off its Senior Connections initiative that aims to strengthen services and supports for older adults, such as adequate housing and transportation, exercise and recreation, geriatric-friendly health care, and caregiver supports.
This charrette on health care follows one on creating networks for people to get services and one on exercise and recreational opportunities. The goal is to make the community more supportive of seniors, whether they are in good health or dealing with chronic conditions and cognitive challenges, says Zionts.
“It’s always been our belief that aging does not need to be a period of straight-line deterioration,” she says. “There are opportunities for early intervention and support systems that can help people age well and avoid deterioration, and often that’s not the default mechanism in our society. The default mechanism is based on an immediate need, but we rarely stop to think about a framework that could help people have a higher quality life.”
When people begin to need more services, it’s easy to think about providing those in a hospital or nursing home, Zionts says, but as boomers age, more people want to live safely and satisfactorily in their homes.
“We haven’t figured out a way to take services to them, and they often have to give up independence. They become patients, as opposed to being people who are aging in our community,” she says. “If we had a robust system in the community that could address people’s needs as they age, it would provide them with more choices and could be potentially cheaper for the system.”
As an example, she points to the Community HealthChoices initiative the Pennsylvania Department of Human Services will offer starting next January. It will use managed care organizations to coordinate physical health care and long-term services and supports for seniors, people with disabilities, and those with dual eligibility for Medicare and Medicaid.
For its community planning sessions, the Jewish Healthcare Foundation reaches out to people in many disciplines, including some who lead companies and others who are “closest to the front line,” Zionts says. During the sessions, graphic illustrator Leah Silverman will capture the essence of conversations—a real-time way to give people a picture of their shared experience.
“This is not a traditional day—there’s no talking heads and PowerPoint,” Zionts says. “We create an experience where all of them can express their visions. That’s what makes this interesting. It doesn’t take long for us to leave our professional hats aside and say, ‘I had the same experience with my mom last week.’ We all are no more than one or two degrees away from a good story or a disaster story that we want to share.”