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WHO Adopts Global Strategy and Action Plan on Ageing and Health

The World Health Organization (WHO) has adopted a Global Strategy and Action Plan on Ageing and Health. This is a significant step forward in establishing a framework for Member States, the WHO Secretariat and partners to contribute to achieving the vision that all people can live long and healthy lives.

The Strategy (2016 – 2020) has two goals:

• five years of evidence-based action to maximize functional ability that reaches every person; and
• by 2020, establish evidence and partnerships necessary to support a Decade of Healthy Ageing from 2020 to 2030.

Specifically the Strategy focuses on five strategic objectives:

• commitment to action on Healthy Ageing in every country;
• developing age-friendly environments;
• aligning health systems to the needs of older populations;
• developing sustainable and equitable systems for providing long-term care (home, communities, institutions); and
• improving measurement, monitoring and research on Healthy Ageing.

Healthy ageing” is defined by theWorld report on ageing and health as the process of developing and maintaining the functional ability that enables well-being in older age.

U.S. Census Bureau and WHO Releases New Report: An Aging World 2015

New Resource! The U.S. Census Bureau and the World Health Organization (WHO) recently released An Aging World 2015. This report covers demographic, health, and economic aspects of global population aging, and is the fifth in the Aging World series – with other reports published in 1987, 1993, 2001, and 2008.

A unique and invaluable aspect of this report is that it offers user-friendly charts and statistics that compare across countries and regions, including both developed and developing nations. (If you are limited on time, you can skip to Chapter 8 which provides a comprehensive overview of each section in the report.)

In the words of the late Dr. Richard M. Suzman, Director of the National Institute on Aging Division of Behavioral and Social Research, to whom the report is dedicated:  “Aging is reshaping our world.”

Emi Kiyota Announced As 2017 Loeb Fellow

Congratulations to IAHSA Board Member and Ibasho Founder, Emi Kiyota, who was awarded a Loeb Fellowship at the Harvard University Graduate School of Design.  Emi will be joining the class of 2017 fellows to explore and expand on her current work in creating communities that value elders and providing opportunities for seniors to make meaningful, long-lasting contributions.

Emi’s work and goal within the program is described as follows:

Born in Japan and working internationally from Washington, DC, Emi Kiyota founded the non-profit Ibasho to foster places of belonging and purpose for seniors. She recognized that while elders are a vulnerable population, especially in times of disaster, they also want to remain connected and useful to their communities. With that in mind, following the 2011 Japan tsunami she designed and built the first Ibasho café, where all generations come together for services and support. While replicating the model in other countries, she will also be working on reimagining communities to enhance the functional competence and engagement of older adults and promote cross-cultural multigenerational learning.

Emi will join nine other leaders in residence from around the globe, sharing a common purpose of strengthening and enhancing “their ability to advance positive social outcomes and to makethe world a better place for all.”

Congratulations again, Emi!

Click here to learn more about this prestigious program and the 2017 Fellows.

Dementia: Gender Disparity

A recent study by the Milken Institute entitled “The Price Women Pay for Dementia” pointed out the “pernicious gender-based health disparity” presented by dementia in the United States.There is an indisputable disproportionate burden on women as both patients and caregivers.

A few facts:

  • Women account for two-thirds of the 6.4 million Americans with dementia.

  • Women make up the majority of informal caregivivers for those with dementia.

  • The cost of treatment of women is ore than twice that of men

  • The prevalence of dementia is projected to grwow to over 8.3 million women by 2040, widening the prevalence between men and women even further.

Milken offers five policy prescriptions: 1) widen access to healthcare, 2) expand the scope and flow of services, 3) raise awareness and expand caregiver training, 4) provide support in the workplace and 5) increase funding for research.

IAHSA members know too well that this is a global concern. The opportunities to learn from one another across borders are widespread and critically important as we address dementia throughout the world.

$1 Million Resilience Awards Focus on Helping Older Adults Live at Home

Four innovative entrepreneurs will share almost $1 million in financial awards for their innovative solution during the 2016 Swiss Re Foundation Resilience Award competition. This year’s award recognizes innovative solutions that enable older adults to live independently at home.

Online applications are due by 22 May by 24.00 Central European Time (21 May at 6 p.m. EDT).

The annual Resilience Award recognizes innovative approaches to building resilient societies. Each year the award focuses on entrepreneurial initiatives in a different field.

The 2016 award will focus on various aspects of aging in place:

  • Smart homes, including health monitoring, social connectivity, and activity support and monitoring.

  • Intergenerational support, including time contribution and consumption, time credit, and community work and integration.

  • Redesign of health care delivery, including home care delivery, remote medical e-health, and promoting holistic medical support.

  • Healthy aging and preventive health, including activity incentives, nutrition incentives, pharmacy involvement, and preventive screening.

  • Long-term care intervention, including the intervention team, crisis intervention, support for relatives, and case management.

  • Financial solutions, including pensions for long-term care, and protection incentives.

Financial and Non-Financial Awards

Four finalists will be invited to pitch their ventures during a November event attended by award jury members, subject matter experts, Swiss Re clients, and Swiss Re employees. The total prize money of 800,000 Swiss francs (approximately $833,000) will be divided among a winner and three runners-up.

Depending on the nature of the initiative, winners and runners-up might also receive help in developing and strengthening their ventures from Swiss Re employees who are resilience experts.

Selection Criteria

Applicants for the Swiss Re Foundation Resilience Award should:

  • Be established as formal, growing start-ups that are on a clear path to full or partial financial sustainability, but still depend on grants and other support to improve their business model and/or reach full financial sustainability.

  • Bring a new solution to a problem through technology, a product, service, or delivery model.

  • Be equipped to find strategic ways to draw value from being associated with Swiss Re and to leverage its expertise.

  • Have a social purpose at the heart of their mission, while using commercial mechanisms to achieve sustainability and scale.

Selection Process

The Resilience Award selection process consists of 4 phases. Applicants are informed at the end of each phase whether they have been selected to proceed to the next one. Candidates will:

  • Complete an initial online application.

  • Be interviewed by staff of the Swiss Re Foundation.

  • Host a representative of the Swiss Re Foundation during a site visit.

  • Participate in a coaching session to prepare for November’s event in Hong Kong.  Award winners will be announced during that event.

How to Apply

Candidates should complete the online questionnaire by 22 May by 24.00 CET. For more information:

My Home Life: Research and Reflection On The Role of Care Providers

How should we think about our roles as providers vis a vis the people we serve? Professor Julienne Meyer of City University of London reflects on My Home Life, a research-based initiative focused on what older people want and what it demands of us as providers:

“Developing best practice together comprises 8 themes: two link to quality of leadership (Transformation themes – Keeping workforce fit for purpose and Promoting positive cultures), three to quality of life (Personalisation themes – Maintaining identity, Sharing decision-making, Creating community) and three to quality of care (Navigation themes – Managing transitions, Improving health and healthcare, Supporting good end-of-life)[1].  Unfortunately in UK, we have been educated in silos.  Social care staff think about the quality of life themes and health care staff think about the quality of care themes.  Older people want all staff to think about all of the themes, not just one subset.  Again, because we are educated in silos, managers think about quality of leadership (Transformation themes), but don’t always have a vision of what older people want (Personalisation and Navigation themes).   The eight best practice themes are helpful at the organisational level to keep in mind what we are all trying to achieve when caring for older people.

At the core of this vision, is the need to focus on relationships – not only enhancing the relationships between residents, family/friends and staff; but also, relationships between care homes and their local community and the wider health and social care system.  To do this, research suggests we should not only think about the needs of older people living and dying in care homes, but also the needs of family/friends who visit and the staff who work in care homes.  We need to help each group feel a sense of security, continuity, belonging, purpose, achievement and significance[2].  This is helpful when planning individual outcomes for older people, family/friends and staff.

Being appreciative is the way in which My Home Life (www.myhomelife.org.uk) encourages practice improvement through reflection.  The starting point is understanding what people ‘want’ and ‘what works’, before moving on to think about what more needs to happen to make it even better, more of the time. The focus is on capabilities and assets, not deficits[3].

Finally the above will only be achieved if we change the way we talk with each other.  Having caring conversations[4] is at the heart of My Home Life and encourages us in our conversations to be courageous, connect emotionally, be curious, collaborate, consider other perspectives, compromise and celebrate.”

[1] NCHR&D Forum (2007) My Home Life: Quality of life in care homes – Literature review, London: Help the Aged (Available at: http://myhomelife.org.uk/wp-content/uploads/2014/11/mhl_review.pdf)

[2] Nolan, M., Brown, J., Davies, S., Nolan, J. and J. Keady. (2006). The Senses Framework: Improving care for older people through a relationship-centred approach. University of Sheffield. ISBN 1-902411-44-7.

[3] Reed, J (2007) Appreciative Inquiry. Research for Change, London: Sage.

[4] Dewar B and Nolan M (2013) Caring about caring: Developing a model to implement compassionate relationship centred care in an older people care setting, International Journal of Nursing Studies, 50(9):1247-58.

Reflections from Kenya

I had the good fortune to visit Kenya recently. It is a beautiful country full of sharp contrasts – bustling, loud cities and vast, quiet grasslands; rugged mountains and miles of empty beaches; Land Rovers and donkeys; Masai tribesmen clothed in red blankets and modern outfits from the local department store.

It reminded me of how important it is to step out of our comfort zone and see the world through an entirely different lens.

I was struck by many things, but one thing in particular stayed with me: life expectancy in Kenya is just 61.

“Old” has an entirely different meaning than it does in the developed world. Kenyan life expectancy TODAY is what the U.S. life expectancy was in 1935 – more than 2 generations ago.

While in some parts of the developed world we are focused on reimagining the notion of “retirement,” most Kenyans and many from other countries will never have the opportunity to reimagine, much less experience, the years after they leave the formal or informal workforce. There will not likely be “years” to live.

It is a sobering and stark reminder of the relationship between place and income, and longevity.

While the concept of good fortune varies in the developed world — close to half (45%) of U.S. adults 65+ have incomes less than $23,500 for example — they do have time and resources on their side. The average life expectancy is closer to 78, allowing for more time to spend with family and pursue post-work dreams. There is also an infrastructure — albeit imperfect — in place to care for the most vulnerable older adults as they age.

And yet, as the Journal of the American Medical Association recently reported,”The gap in life expectancy [in the U.S] between the richest 1% and poorest 1% of individuals was almost 15 years for men and 10 years for women.

At IAHSA, we have an important role to play and are actively working to improve the aging experience for all.

  • We advocate for human rights protections for the elderly.

  • We lead discussions about quality and integrated models of services so older people, regardless of income, can live safely and securely.

  • We develop leadership skills to guide and imagine communities, services, and supports.

  • And, we bring applied researchers together with providers to answer burning questions and integrate evidence-based practices into our daily operations.

As I learn about the vast array of services and supports provided by so many IAHSA members around the world, creating opportunities to touch more lives in different ways, I know that we are all playing an important role in improving the aging experience.

Overlaying an understanding of how location and income contribute to that experience adds complexity and opportunity to our missions.    

I urge you to find opportunities to step out of your comfort zones whenever possible.

Take advantage of your experiences and apply a new lens to the work you do every day. Learn from your peers in your country and in communities around the world. We have much to learn.

My trip to Kenya was my reminder that while we are lucky in the developed world to live longer and have access to services, we must continually strive for improved systems and more protections for all of our aging citizens here, and around the globe.

Art-viewing Improves Cognition & Well-being in Dementia Patients and Caregivers

A recent study conducted by the Canterbury Christ Church University in the UK shows that regular art-viewing sessions via touchscreen tablets may cause significant cognitive improvement and boost the overall wellbeing of dementia patients and their caregivers.

The study was published online in the December issue of the Journal of Applied Gerontology. 12 volunteer pairs of dementia patients and their caregivers were provided a touchscreen tablet loaded with an art-viewing application along with a list of discussion questions. The pairs were instructed to view and discuss the art showcased within the application together five times a day for two weeks.

Participants reported not only increased happiness and engagement, but also a strengthened bond through the shared activity of viewing and discussing the art.

Read the full article here.

Case Study: Are There Enough Care Providers for Canada’s Future Elders?

Dan Levitt, IAHSA Board Member and Executive Director of Tabor Village in Vancouver, Canada, shares his thoughts and insights about Canada’s rapidly ageing population and the shrinking number of care providers and aged-friendly resources to help them. The solution? A geriatric care system just as robust as the pediatric care model brought about by a now ageing generation of baby boomers.

“The baby boom generation that was served well with a robust pediatric system are now caring for their aging and increasingly frail parents, they will insist the older generation have access to frail elderly home and community based programs supported by geriatricians who have expertise in the care of the most complex older adults. What is needed is a revolutionary different approach to elderhood as a life with meaning to shape a better world for children, adults and elders.”

Read the full article here.

How to Combat Loneliness in Residential Care Settings

By Geralyn Magan

Resident engagement and peer support can be more effective than traditional activities programs in addressing loneliness and depression among residents of nursing homes, assisted living settings, and retirement communities.

That’s the conclusion of a new paper co-authored by Robyn Stone, executive director of the LeadingAge Center for Applied Research.

“The Need for a Social Revolution in Residential Care” appears in the December 2015 edition of the Journal of Aging Studies. Stone wrote the paper in collaboration with 5 experts in the fields of medicine, rehabilitation science, and social work from Yale University, the University of British Columbia, and Trinity College Dublin.

Engagement Instead of Entertainment

The authors describe an approach to psychosocial care – called Resident Engagement and Peer Support or REAP – that they say could revolutionize how nursing homes, assisted living settings, and retirement communities address residents’ mental health concerns.

The approach represents a marked shift away from the traditional practice of trying to ease loneliness among residents by filling the day with formal, task-oriented recreation programs. These superficial activities often make residents feel lonelier and more isolated, the authors maintain.

As an alternative, the authors call for a new approach that focuses on providing opportunities for “emotional and meaningful social engagement” that are developed in collaboration with residents and tap those residents as sources of peer support.

Long-Standing Concerns about Loneliness

The Journal of Aging Studies article begins by describing a 50-year old study, conducted in homes for the aged in England and Wales, which identified the negative effects associated with residential living, including:

  • Loss of occupation.

  • Isolation from family, friends, and community.

  • Tenuousness of new relationships.

  • Loneliness.

  • Loss of privacy and identity.

  • Collapse of self-determination.

“The same concerns are still prevalent today and in some ways have become magnified within institutional settings with the increasing frailty and chronic health conditions of residents,” write Stone and her co-authors. “Residents report frustration around their lack of influence and independence, and paternalistic communication styles among staff.”

To back up their claim, the authors cite more recent research studies in which 29% to 55% of older adults living in residential care settings reported feeling lonely. Loneliness is linked with depression and impaired mental health among older people, they say.

Traditional recreation programs don’t ease these feelings of loneliness because they are:

  • Planned, scheduled, and implemented without input from residents.

  • Often intended to entertain and distract, rather than foster meaningful connections or engagement.

  • Based on the assumption that simply attending an activity – rather than having a space to speak and be heard – is what promotes better quality of life among residents.

Resident Engagement and Peer Support

REAP has 3 features that the authors say “have potential to reorganize institutional recreation practices” for all residents, including those who are living with dementia. Those features include:

  • Meaning: Residential communities implementing REAP assess and clarify what forms of group participation are meaningful for each resident. An integral part of this process includes the exploration of how residents can actively engage in those groups and how they might contribute to those groups.

  • Participation: Existing or new groups following the REAP model foster relationships among residents and help those residents discover and value their shared identity.

  • Service: REAP encourages residents to develop and participate in groups or membership clubs that focus on being of service and helping others.

Benefits Outweigh Obstacles

Residential care communities will undoubtedly encounter obstacles as they attempt to implement an approach to psychosocial care that features social identity, productivity, and peer support principles, write the authors. These obstacles include:

  • Apprehension about potential liability associated with autonomy.

  • Lack of support from health professionals for programs that deviate from a biomedical approach.

  • Low staffing levels or lack of staff competence with non-pharmacological alternatives.

  • Resident difficulty tolerating and embracing diversity and dissent among their peers.

  • Limited incentives for change among staff, due to lack of funding, low wages, or difficult and demanding work.

Despite these challenges, the REAP model can be successfully implemented and can bring about a seismic shift in how residents and staff see themselves, say the authors.

Staff members will begin to see the value of collaborating with residents to develop opportunities for meaning and contribution, they predict.

Residents will begin to see themselves as experts on what constitutes meaningful experience, and as active participants in reform and change.

“Through reaching out and tending to the needs of others, residents may regain a sense of self and purpose, view themselves and their problems from a new perspective, and find that they are not alone,” conclude the authors. “With the right supports in place, residents can actively engage in their own psychosocial care, thereby improving quality of life for themselves and their peers.”