Aging Innovation Week (Taiwan) 銀浪新創力國際論壇-- 美國燈塔山村 By Laura Connors (英文版）

Thriving
A
Model
for
Ageing
in
Place
Laura
Connors,
MSW,
LCSW
Execu2ve
Director
Boston,
Massachuse9s
USA
Ageing
Innova2on
Week
Taiwan
17
November
2014

We
are
living
longer
…
• Two
people
turn
60
years
old
every
second
(58
million
60th
birthdays
per
year)
• The
number
of
CENTENARIANS
will
increase
from
450,000
today
to
more
than
3.2
MILLION
in
2050
• Within
10
years,
there
will
be
1
billion
older
adults
worldwide

There
will
be
more
of
us
…
GLOBAL
POPULATION
2050
22%
2012
12%
• In
2012,
there
were
810
MILLION
people
aged
60+
• By
2050,
the
number
will
reach
2
BILLION

And
fewer
to
take
care
of
us.
• In
2000,
number
older
adults
aged
60+
was
greater
than
number
of
children
younger
than
5
• By
2050,
those
60+
will
exceed
the
number
of
all
children
15
years
and
younger

U.S.
Healthcare:
Lowest
in
Healthy
Lives
EXHIBIT ES-1. OVERALL RANKING
Comparison
of
11
Developed
Countries
AUS CAN FRA GER NETH NZ NOR SWE SWIZ UK US
COUNTRY RANKINGS
Top 2*
Middle
Bottom 2*
OVERALL RANKING (2013) 4 10 9 5 5 7 7 3 2 1 11
Quality Care 2 9 8 7 5 4 11 10 3 1 5
Effective Care 4 7 9 6 5 2 11 10 8 1 3
Safe Care 3 10 2 6 7 9 11 5 4 1 7
Coordinated Care 4 8 9 10 5 2 7 11 3 1 6
Patient-Centered Care
5 8 10 7 3 6 11 9 2 1 4
Access 8 9 11 2 4 7 6 4 2 1 9
Cost-Related Problem 9 5 10 4 8 6 3 1 7 1 11
Timeliness of Care 6 11 10 4 2 7 8 9 1 3 5
Ef!ciency 4 10 8 9 7 3 4 2 6 1 11
Equity 5 9 7 4 8 10 6 1 2 2 11
Healthy Lives
4 8 1 7 5 9 6 2 3 10 11
Health Expenditures/Capita, 2011** $3,800 $4,522 $4,118 $4,495 $5,099 $3,182 $5,669 $3,925 $5,643 $3,405 $8,508
Notes: * Includes ties. ** Expenditures shown in $US PPP (purchasing power parity); Australian $ data are from 2010.
Source: Calculated by The Commonwealth Fund based on 2011 International Health Policy Survey of Sicker Adults; 2012 International Health Policy Survey of Primary Care Physicians; 2013 International Health
Policy Survey; Commonwealth Fund National Scorecard 2011; World Health Organization; and Organization for Economic Cooperation and Development, OECD Health Data, 2013 (Paris: OECD, Nov. 2013).

U.S.
Healthcare:
Lowest
in
Healthy
Lives
A
Closer
Look
JPN
UK
CAN
NETH
SWIZ
UK
US
Country
Rankings:
1
is
highest
11
is
lowest
OVERALL
RANKING
(2013)
4
10
5
2
1
11
Quality
Care
2
9
5
3
1
5
Access
8
9
4
3
1
9
Healthy
Lives
4
8
5
3
10
11
Health
Expenditures/Capita
(2011)
$3,213
$3,800
$4,522
$5,099
$5,643
$3,405
$8,508
Notes: ** Expenditures shown in $US PPP (purchasing power parity); Australian $ data are from 2010
Source: Calculated by The Commonwealth Fund based on 2011 International Health Policy Survey of Sicker Adults; 2012 International Health Policy Survey of Primary Care
Physicians; 2013 International Health Policy Survey; Commonwealth Fund National Scorecard 2011; World Health Organization for Economic Cooperation and Development, OECD
Health Data, 2013 (Paris: OECD, Nov. 2013)

Healthy
Aging
…
Healthy
Life
Expectancy
In
addi2on
to
access
to
affordable,
effec2ve
and
efficient
health
care,
healthy
aging
also
requires
access
to
non-‐medical
long-‐term
services
and
supports
(LTSS):
• Personal
care
for
ac2vi2es
of
daily
living
(ADLs),
such
as
bathing,
dressing,
using
the
toilet
• Help
with
instrumental
ac2vi2es
of
daily
living
(IADLs):
shopping,
managing
money
or
medica2ons,
doing
laundry
• Exercise
and
nutri2on
70%
of
all
• Transporta2on
• Social
ac2vi2es
older
Americans
will
eventually
need
some
type
of
LTSS*
*
Center
for
Health
Care
Strategies,
Inc.
May
2010

Long-‐Term
Services
and
Supports
(LTSS)
Delivery
Out
of
Balance
$140
Billion
VS
60%
40%
USD
InsTtuTonal
Care
Home-‐
and
Community-‐Based
Services
• Network
of
long-‐term
services
and
supports
that
allows
individuals
to
live
with
dignity
and
independence
at
home
and
in
community
• Widely
preferred
by
older
adults
• Most
cost-‐effecNve
way
to
deliver
services
• State-‐regulated
residenNal
long-‐term
care
nursing
faciliNes
• Congregate
living,
limited
to
no
choice;
decisions
made
by
staff
• Expensive
(average
cost
>$80,000USD
per
year)
Less
than
40%
of
Medicaid
LTSS
expenditures
are
spent
on
HCBS

AXtudes
towards
ageing
are
changing

Beacon
Hill
Village
–
InnovaNon
in
the
making
“Many of us have glimpsed the future and
wish to make changes” – BHV
Developed
by
a
group
friends
and
neighbors
who
wanted
to:
• Avoid
the
challenge
their
parents/friends
faced
• Keep
control
of
their
lives
and
design
their
own
futures
• Make
informed
choices/decisions
about
where
and
how
they
live
• Create
their
own
solu2ons
Founder

Aging
in
Place
Defined
The ability to live in
one’s own home and
community safely,
independently and
comfortably,
regardless of age,
income, or
level of ability.

OperaNng
Principles
of
a
Village
• Grass-‐roots,
member-‐driven,
self-‐suppor2ng,
self-‐governed
-‐
For
older
adults
…
By
older
adults
• Consumer-‐driven,
person-‐centered
and
focused
on
the
whole
person
–
mind,
body,
and
soul
• Consolida2ng
and
coordina2ng
programs
and
services
• Promo2ng
a
sense
of
purpose
through
engagement
• Partnering
with
exis2ng
community
resources
and
services

Beacon
Hill
Village
Mission
…
Enable
members
to
lead
ac0ve,
independent
and
healthy
lives
and
successfully
navigate
the
transi0ons
of
growing
older
by
providing
ac2vi2es,
programs,
services,
opportuni2es
for
social
and
community
engagement,
and
access
to
assistance
when
needed.

AcNve,
Independent,
Healthy
Ageing
Living
• Programs
and
ac2vi2es
that
focusing
on
the
whole
person:
mind,
body
and
soul
• Access
to
services
and
supports:
wide
variety
of
household
and
homecare
services
• Community
engagement:
volunteer
opportuniNes
to
support
the
Village
and
each
other

Beacon
Hill
Village
Today
• 340
members
(270
memberships)
§ 38%
in
households;
62%
individuals
§ 31%
men;
69%
women
• Annual
Dues:
$110-‐$975USD
• 20%
are
Membership
Plus
(low-‐mod
income)
§ 82%
are
women
§ 95%
of
whom
live
alone
AGE
(63
to
98
years)
All M+ Men Women
Average: 77.5 76.2 77 76.1
Median: 77 75 77 75

Benefits
to
Members
Community
• Social
engagement
• Cultural
acNviNes
• Lifelong
learning
• Peer
Support
Ac0ve,
Independent,
and
Healthy
Lives
Empowerment
• Engaged
in
Village
governance
and
opera2ons
• Sense
of
purpose
Improved
Access
to
InformaTon
and
Services
§ Support
for
household
and
personal
care
needs
§ Reliable,
ve^ed
providers
§ Reduced
cost
for
services

Economic
Benefits
to
Society
Falls
ER
Visits
Hospital
Stays
Hospital
Readmissions
Use
of
residen2al
care
Family
Cost
Savings
Volunteer
Growth
Produc2ve
Ac2vity
A.
Scharlach,
PhD
and
C.
Graham,
PhD,
UC
Berkley
2013

CriNcal
Success
Factors
• Human
Capital
(leadership,
members,
volunteers)
§ Energy
and
passion
for
“ageing
in
place”
§ Entrepreneurial
spirit
and
tolerance
for
risk
• Financial
Resources
§ Start-‐up
financing:
$500
-‐
$80,000USD*
§ Culture
of
philanthropy
–
community
giving
§ Family
Trust/Private
Founda2on
Support
*
Start-‐up
cost
for
family
grocery
store:
$10,000
-‐
$50,000USD

CriNcal
Success
Factors,
conNnued
• Strategic
Partnerships
§ Service
and
Health
Providers
§ Private/Corporate
Enterprises
§ Government
• Pa2ence
§ 2-‐3
years
average
start-‐up
Nme

Challenges
to
Sustainability
1. Growth
(Self-‐suppor2ng,
Member-‐driven)
§ Aging
of
membership
– Grow
membership;
a9ract
“younger”
older
adults
§ Ageism
and
baby
boomer
“independence
“
– Address
the
“not
ready
yet”
percep2on
– Reframe
value
of
Villages
–
from
“Ageing
in
Place”
to
“Thriving
in
Community

Challenges
to
Sustainability
2. Financial
Support
§ Tighter
community/founda2on/corporate
support
– Demonstrate
value
of
Villages
as
“good”
investment
– Expand
movement
to
evaluate
model
effec2veness
§ Lack
of
government
support
– Make
Village
membership
more
accessible
(reduc2ons
in
income
tax
&
health
insurance
premiums)
– Reallocate
funding
from
ins2tu2onal
care
to
community-‐based
care
to
fund
new
Village
development
§ Need
for
new
strategic
partnerships
and
revenue-‐
producing
opportuni2es

Challenges
to
Sustainability
3. Visibility/Recogni2on
of
Village
Model
§ Lack
of
broad
awareness
across
the
na2on
– Develop
strategic
marke2ng
campaign
and
advocacy
plan
§ Lack
of
government
recogni2on
– Seek
invita2on
for
Village
movement
representa2ves
to
2015
White
House
Conference
on
Aging
– Include
Village
model
in
reauthoriza2on
of
Older
Americans
Act

Villages
Build
Strong
CommuniNes
Purposeful
Engagement
Health
and
Wellness
Livable,
Age
Friendly
Community
VILLAGE
Economic
and
Community
Development
Plaporm
for
local
policy/program
innova2on
Model
for
successful
aging
in
community
Support
individuals
to
reach
highest
poten2al
Resources
to
s2mulate
growth

The
InternaNonal
Village
Movement
• 140
Villages
in
40
states
and
5
countries
• >25,000
older
adult
members
• Variety
of
opera2ng
models
§ Tradi2onal
grass-‐roots,
small
professional
staff;
paid
providers
§ Volunteer-‐first
(services
provided
primarily
by
volunteers)
§ Parent
organiza2on
providing
opera2onal
support
and
fiduciary
responsibility

Heart
of
the
Village
is
its
Members

Thank You
Laura
M.
Connors,
MSW,
LCSW
Beacon
Hill
Village
Boston,
MA
+1
617
723
9713
laura.connors@beaconhillvillage.org

Aging Innovation Week (Taiwan) 銀浪新創力國際論壇-- 美國燈塔山村 By Laura Connors (英文版）

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Aging Innovation Week (Taiwan) 銀浪新創力國際論壇-- 美國燈塔山村 By Laura Connors (英文版）