Some call it "the pig in the python." It's the Baby Boomer generation, and it's quickly growing older -- and living longer than any previous generation. Along with this massive demographic shift, we're seeing significant cultural and societal shifts relating to aging. It's a time for advocacy, awareness, and new ideas.
In the midst of this change, you'll find the SCAN Foundation: on a quest for brilliant new ideas. Since 2008, the SCAN Foundation has been making grants that breathe life into great ideas that show promise in improving the whole range of healthcare for seniors. Bruce Chernof, MD, is president and CEO of the Scan Foundation and a leader in its inspiring work.
Exactly what is the mission and purpose of the SCAN Foundation?
BC: The SCAN Foundation seeks to ensure that all Americans can age with dignity, choice, and independence in the place they call home. We do this by providing grant support for activities that raise awareness and engage the public in this important dialogue, support knowledge development that provides insight into realistic policy options, and build on programs that bridge medical care with supportive services for seniors in ways that respect their individual needs and value their dignity and independence.
The SCAN Foundation's mission is to advance the development of a sustainable continuum of quality care for seniors. We will achieve this mission by encouraging public policy reform to integrate the financing of acute and long-term care; raising awareness about the need for long-term care reform; and working with others to promote the development of coordinated, comprehensive, and person-centered care.
Why is now an ideal time to reform long-term care as we know it?
BC: We believe that right now is the perfect time to transform the system of care for older adults. Baby boomers and their aging parents are facing the stresses and challenges of the current care system, and they have the power to move mountains by working together for positive change. For older Americans and the seniors of tomorrow, the following questions are becoming more urgent: Who will care for our parents? Who will care for us? How much care will we need? What will our lives be like? How much control will we have over decisions about our own lives?
Here are just a few of the common challenges and concerns people face:
How to manage chronic illnesses and the difficulties with daily living that come from them
How to get to the grocery store
How to cook meals and keep the house clean
How to stay active despite failing eyesight or hearing
Worries about falling down
Worries about falling behind on bills
Fears about leaving one's family home for a nursing home
Yet right now there is no consistent, coordinated system in place -- no continuum of care -- designed to support Americans who want to live independently as they age. The challenge becomes more pressing as the senior population rises, so it's imperative to take action now. That's why the SCAN Foundation exists, to encourage changes that will make a positive difference in each one of our lives and in the lives of those we love.
Entitlement reform is a hot topic in our current political climate. With the baby boomers aging and people living longer than ever before, what aspects of entitlement reform as it relates to long-term care are particularly critical for the average person to be aware of?
BC: A few things are very important for people to know. First, 70 percent of people over the age of 65 will need some form of long-term care for about three years. Second, many people mistakenly believe that Medicare covers long-term services and supports, when in reality it does not. Private insurance coverage for this kind of care is exceedingly difficult for people to access due to high costs, underwriting, and few carriers left in the marketplace. Long-term care is prohibitively expensive. National Figures from the MetLife Market Survey of 2011 show that a semiprivate room in a nursing home is approximately $214 per day and $78,110 annually. An in-home health aide costs about $21 per hour at an average annual cost of $21,840. Public policy in this area has moved little in the past 50 years since the passage of Medicare and Medicaid, and it hasn't created a viable solution to funding this type of care. However, average life expectancy has increased by nearly a decade, from 69 to 78 years. All of these factors leave people with relatively few options to responsibly plan for their needs as they grow older.
With essentially no other options, vulnerable older Americans, who commonly have substantial chronic illness and functional limitations, will spend out their personal resources, often in inefficient and disorganized ways that leave them and their caregivers bewildered and isolated. Once these resources are exhausted, these individuals ultimately rely on Medicaid for the rest of their lives to meet their daily support needs. These needs will only increase as baby boomers age, creating a snowball effect that threatens the viability of the entire health system. Addressing people's functional needs in tandem with chronic health conditions is the right step toward putting Medicare and Medicaid on more stable footing and, most importantly, giving these vulnerable adults the dignity and choice they deserve.
For more information about this important and timely issue, please read my latest Perspectives on Aging with Dignity commentary, titled "Creating Realistic Long-Term Care Solutions as Part of the Entitlement Reform Debate."
The SCAN Foundation awards grants to organizations focused on creating a coordinated, person-centered model of health care and services for seniors. What guides your decision making when determining which organizations to fund?
BC: Transforming health care and supportive services for seniors is a complex challenge, with countless moving parts and many voices to consider. As a result, we engage in multiple ways to achieve our goal. We support bringing established care-based programs to scale in California through promising programs, research that will affect the public and impact policy on the state and federal levels through our support of policy solutions, and initiatives that increase public awareness about aging with dignity and independence through our public engagement efforts. By encouraging change at every level -- individuals, families, communities, California, and the nation at large -- we will succeed in advancing a society where all of us can age with dignity, independence, and choice.
The Grants and Grantees section of our website gives a breakdown of the work we fund and the organizations with which we partner.
Share with us a success story from a previously funded organization.
BC: Rather than share a success story from a single previously funded organization, I'd like to take this opportunity to tell you about our Community of Constituents Initiative in California, which is an effort involving a number of local, regional, and statewide organizations working together to transform the state's system of care for seniors and individuals with disabilities. More than 60 organizations are working together, representing millions of Californians in this endeavor.
At the statewide level, consumer and provider organizations are working together as the California Collaborative for Long-Term Services and Supports to advance policy solutions to improve the system of care for older adults and adults with disabilities.
At the regional level, 12 aging and disability service and advocacy coalitions representing 48 percent of California counties are working to improve both quality and access to care for older adults and adults with disabilities.
At the local level, a diverse network of community-based organizations are working to engage older adults, their caregivers, and others to be "AGEnts for Change" by participating in social action to improve the care they receive.
Our site contains a full list of participating organizations in the Community of Constituents.
What types of information do you make available to help educate the general public?
BC: The SCAN Foundation makes a wide variety of educational materials available to the general public. Our 10 Things You Should Know series, available in both English and Spanish, is a set of user-friendly guides that offer pointers for individuals so they can start thinking about and planning for long-term care needs.
For those looking for more technical information, our website also features fact sheets highlighting important information on long-term care in California and on the national level, policy briefs that are produced in-house and by our grantees, and a series of Long-Term Care Fundamentals that describe the organization and financing of long-term care in California. We also hold webinars and briefings on key long-term care issues, which are free and open to the public. We post additional information in our Resources section, which contains a regularly updated Research Library providing up-to-date research and policy information about long-term services and supports and the continuum of care. We also provide Helpful Consumer Links featuring a list of resources for people to find general information on long-term care. To help educate those who provide direct, hands-on care to older adults in the home or in nursing homes, we supported five grantees to develop a series of continuing education curricula.
This is just a small sample of the work that the SCAN Foundation does to help educate and inform the public and our leaders on the importance of transforming the system of care to one that enables aging with dignity, independence, and choice. We invite you to visit us at www.TheSCANFoundation.org and to sign up to receive our email announcements.