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Elder Care in the United States: Voices from the Field

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The ACCESS Health team conducted a series of in depth interviews on elder care and optimal aging in the United States. Each interview provides a comprehensive look at a specific model or initiative that can improve the quality of life and care for an aging population. As a group, these interviews provide a broad understanding of new discoveries and innovations in the field of elder care, as well as ongoing challenges that remain. The interviews were conducted by ACCESS Health Project Manager Jean Galiana. Please check this page frequently, as it will be updated with new interviews and topics of discussion on a regular basis.
Innovative and Inclusive Housing

As the population of the United States ages, more and more attention is being paid to age friendly housing and community design. Some communities are naturally growing older together and are adapting by creating membership organizations or committees to help provide services to ensure that community members can age in place. Traditional retirement communities are also evolving, designed now to build intergenerational and community connections while keeping seniors physically and mentally active.

Building Socially Integrated and Sustainable Communities: An interview with Emi Kiyota (NEW!)

Lifelong Living and Learning: An interview with Lasell Village

Community Living for all Ages: An interview with Joani Blank

Person Centered Dementia Care 

With an aging population and increasing cases of dementia in the United States, families and providers are seeking better care and support for those living with dementia. Providers are moving toward more person centered approaches in the home and institutional settings. Person centered dementia care puts the person in the center of their care circle, honoring the priorities, preferences, and personalities of each individual. This type of care is founded in the relationship between the care partner and the person living with dementia.

The Art of Alzheimer’s Caregiving: An interview with Jed Levine, CaringKind

Living with Dementia: An interview with Brian LeBlanc

Redefining Living With Dementia: An interview with the Dementia Action Alliance

Person Directed Dementia Living: An interview with Beatitudes Campus

Dementia Beyond Disease: An interview with Allen Power

Healthcare at Home

In the shift toward value over volume, healthcare systems are increasingly looking for ways to deliver high quality care at home. Quality home based care provides increased access, improves outcomes for patients, and lowers healthcare costs. For older adults, home based care allows individuals to age in place and follow a care plan unique to their needs and wishes. Health care at home – whether it be primary care, palliative care, or emergency and acute care – also helps avoid the high costs and adverse health events that often occur when frail elders are treated in hospital settings and at emergency departments.

Disrupting Emergency Medicine: An interview with DispatchHealth

A Model for Acute Care at Home: An interview with Bruce Leff, Hospital at Home

Aging in Place: An interview with Allan Teel, Full Circle America

Delivering the Right Care at the Right Time in the Right Setting: An interview with Kristofer Smith, Northwell Health Solutions

Person Centered Care

Person centered care puts the needs and wishes of a long term care resident before those of the provider organization. This type of care prioritizes value over volume and has recently become a goal for many long term care providers. Some leaders within the field of elder care have adapted the phrase, using person directed care and person directed living instead. Whether discussing person centered care or person directed living the main tenets are the same: engage residents and their families; honor the preferences of the resident; employ dedicated staff for each resident; understand the resident as a person first, before their physical or mental challenges; and recognize that their behaviors communicate unmet needs.

Changing the Culture of Elder Care: An interview with Christopher Perna, The Eden Alternative

Embracing Life’s Experiences: An interview with Rebecca Priest, St. John’s Living

Patient Centered Medical Home

The Patient Centered Medical Home is a healthcare delivery model in which treatment for patients is coordinated through a primary care team that helps ensure that patients receive the necessary care when and where they need it, in a manner they can understand. The Patient Centered Medical Home is part of a global movement toward value based care. The goal of the Patient Centered Medical Home model is to produce better health outcomes and cost savings compared to traditional models of care.

Quality Assurance: An interview with Erin Giovannetti and Michael Barr

Palliative Care

In the past century, life expectancy has increased by thirty years. In these “bonus” years, most people will be living with at least one chronic condition. Many will have multiple chronic conditions. The healthcare system in the United States has not effectively adapted to serve this growing population. Seniors are regularly cycling in and out of emergency departments, hospitals, and skilled nursing facilities because these are their only options for same day or after hours care. Palliative care is a model of chronic disease management that puts the priorities of the patients at the forefront of the care plan. Palliative care provides access to care when and where the patient needs it, whether it is after hours, in the community, or at home. A good palliative care system greatly reduces care costs by lowering emergency department visits and hospital readmissions and improves the quality of life for the patient.

Systems of Care: An interview with Diane E. Meier, Center to Advance Palliative Care

Aging in Place: An interview with Allan Teel, Full Circle America

Delivering the Right Care at the Right Time in the Right Setting: An interview with Kristofer Smith, Northwell Health Solutions

Caregiver Support, Education, and Training

Formal and informal caregivers of older adults require special education, training, and support in their work. For example, special education and training can help caregivers of those living with dementia create more comfortable living environments and reduce the use of antipsychotic medications. Specialized support can also help caregivers deal with stress, plan for the future, and, in some cases, enable them to keep loved ones at home for longer.  Greater support for caregivers is in the financial interest of the entire health system. More than sixty five million people in the United States spend on average twenty hours per week providing informal care to someone with a chronic illness or disability, which equates to approximately 375 billion dollars each year. As the number of older adults living at home or in long term care continues to rise, so will the need to ensure that caregivers are trained, educated, and supported to meet this increasing demand.

Supporting the Informal Caregiver: An interview with Mary Mittelman, NYU Caregiver Intervention

Changing the Culture of Elder Care: An interview with Christopher Perna, The Eden Alternative

Jean Galiana

Jean Galiana

Jean Galiana conducts qualitative research on innovative elder care delivery, community inclusion, age friendly cities, and the integration of healthcare systems across disciplines.

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We are no longer active in Elder Care in the United States: Voices from the Field. Projects and resources are available in the archive.