Empowering Aging in Place: Transforming Elder Care through Expanded Home and Community-Based Services

In an era where the aging population is rapidly growing, the demand for home and community-based services (HCBS) is more critical than ever. These services, designed to support older adults in their preferred living environments, are not just a matter of comfort but of necessity. However, despite the clear need, access to HCBS remains limited for many, leaving a significant portion of the older adult population underserved.

The Unmet Needs and the Call for Expansion

A recent report from the Schwartz Center for Economic Policy Analysis highlighted a startling reality: nearly 20% of adults aged 55 and older struggle with activities of daily living (ADLs), with approximately 8.3 million not receiving the necessary help. ADLs encompass the essential tasks required for independent living, such as bathing, dressing, eating, and moving around the home. Imagine the plight of an older woman who, due to arthritis and mobility issues, finds it increasingly difficult to bathe herself or a veteran who, after serving his country, struggles with the basic task of preparing meals. These are not isolated incidents but represent a significant portion of the aging population.

The report underscores the prohibitive costs of professional care, which often include services like in-home nursing, physical therapy, and round-the-clock assistance. These services, while invaluable, come with a hefty price tag, often running into thousands of dollars monthly, a cost too steep for many older adults and their families. For instance, the average cost of assisted living facilities can range from $3,600 to $6,800 per month, depending on the level of care and location, putting it out of reach for many.

Moreover, the risks associated with unmet care needs are profound. Without adequate support, older adults are more prone to accidents, such as falls that can lead to severe injuries or even fatalities. For example, a simple task like climbing stairs or reaching for an item on a high shelf can become perilous without proper assistance. Additionally, the lack of care can exacerbate existing health conditions, leading to higher disability levels and a diminished quality of life. An older adult recovering from surgery might face a slower and more complicated recovery process without access to physical therapy or proper wound care at home.

This situation puts a spotlight on the urgent need to expand HCBS access, a sentiment echoed by researchers and policymakers alike. Expanding HCBS means not just more availability but also affordability and tailored services to meet diverse needs. It’s about creating a support system that includes meal delivery services for those who cannot cook, transportation services for those who can no longer drive, and personal care aides to assist with daily routines. It’s about ensuring that a grandmother who has spent her life caring for others can receive the care she needs in her own home, surrounded by memories and the comfort of familiarity.

The call for expansion is not just a call for more services but a call for a more compassionate, comprehensive approach to aging. It’s a recognition that supporting our older adults is not just a responsibility but a moral imperative, one that reflects the values of a caring and inclusive society.

The Economic and Social Implications of HCBS Expansion

Expanding Home and Community-Based Services (HCBS) isn’t just about improving individual lives; it has broader economic and social implications that ripple through communities and healthcare systems. A study published in the Journal of the American Geriatrics Society illuminated this by revealing that a 1% increase in HCBS spending was associated with significant reductions in the state nursing home population and institutional Medicaid long-term services and supports (LTSS) spending. This finding is a game-changer, suggesting that every dollar invested in HCBS can lead to savings from decreased nursing home use. As Brian E McGarry, one of the study’s authors, astutely notes, “States that expand Medicaid HCBS are able to use these additional dollars to serve more LTSS recipients.”

Let’s break this down with tangible examples. Consider a scenario where a state decides to increase its HCBS funding, thereby enhancing services like in-home personal care, meal delivery, and transportation for medical appointments. As more seniors access these services, the need for nursing home placements diminishes. For instance, an older couple might be able to continue living in their home with the help of a visiting nurse and meal delivery services, rather than moving to a nursing home. This not only preserves their independence and connection to their community but also significantly reduces the cost burden on Medicaid, as in-home services are generally less expensive than institutional care.

The economic implications are profound. Reduced nursing home populations mean lower healthcare costs for states and federal programs like Medicaid. For example, if a state spends $5,000 per month on each nursing home resident and can reduce this population by 100 through expanded HCBS, it saves $500,000 monthly. These funds can then be redirected to support additional HCBS for more residents, creating a positive feedback loop of savings and improved care.

Beyond the dollars and cents, the social implications are equally significant. Expanding HCBS fosters a more inclusive society where older adults can age with dignity in their communities. It acknowledges the deep value of allowing individuals to stay in familiar surroundings, maintain social connections, and live with a sense of autonomy. This shift not only improves the quality of life for older adults but also reduces the emotional and financial strain on families who might otherwise face difficult decisions about long-term care for their loved ones.

Moreover, by keeping older adults more engaged in their communities, we promote intergenerational interaction and the sharing of wisdom and experiences that enrich the social fabric. Communities with robust HCBS programs often see increased volunteerism and civic participation among their older populations, contributing to a vibrant, diverse, and supportive community life.

In essence, the expansion of HCBS is not just a policy adjustment; it’s a societal investment with the potential to transform how we care for our aging population. It’s about building a future where economic and social systems align to support the well-being and dignity of every individual, regardless of age. As we continue to navigate the challenges and opportunities of an aging society, the expansion of HCBS stands out as a beacon of progress, promising a better quality of life for older adults and a more sustainable, compassionate approach to long-term care.

Cultural Sensitivity and Tailored Services

Access barriers to Home and Community-Based Services (HCBS) aren’t solely financial; they’re deeply rooted in cultural and informational contexts as well. A cross-sectional survey of caregivers of older Korean Americans shed light on this issue, revealing that the most frequently reported barriers to accessing HCBS were a lack of awareness about the services and care recipient refusal. This isn’t just a statistic; it’s a reflection of the nuanced challenges faced by diverse communities in accessing care.

Consider the case of an older Korean American woman who needs assistance with daily activities but is unaware of the available services due to language barriers and limited outreach in her community. Even if she’s aware, cultural norms valuing self-reliance and family caregiving might lead her to refuse outside help. Similarly, a Latino family might be hesitant to seek services due to fears about immigration status or a lack of culturally competent providers.

These examples underscore the need for HCBS programs to not only be available but also culturally sensitive and tailored to meet the unique needs of diverse populations. It’s about more than translating brochures into different languages; it’s about understanding and respecting cultural norms, building trust within communities, and ensuring that services are delivered in a way that feels respectful and appropriate.

For instance, in communities where there’s a strong preference for family caregiving, HCBS programs might focus on providing respite care and support for family caregivers, rather than just direct services for the older adult. In areas with significant immigrant populations, providers might partner with trusted community organizations to help navigate fears about legal status and confidentiality.

Moreover, training for HCBS providers should include cultural competency modules to ensure they’re equipped to handle the varied beliefs, practices, and needs of the people they serve. For example, a caregiver working with Muslim clients should understand the dietary restrictions and privacy concerns that might arise during care.

Collaborative efforts are crucial in this regard. Healthcare providers, community leaders, and policymakers must work together to develop and implement plans that not only expand HCBS programs but also tailor them to the cultural nuances of the populations they serve. This might involve community focus groups to understand specific needs, partnerships with local organizations to increase outreach and trust, and ongoing feedback mechanisms to continually improve services.

In essence, recognizing and addressing the cultural and informational barriers to accessing HCBS is not just about providing care; it’s about providing care that is respectful, appropriate, and effective. It’s about ensuring that every individual, regardless of their cultural background, has the opportunity to receive the support they need in a way that honors their values and preferences. As our society becomes increasingly diverse, the success of HCBS programs will increasingly depend on their ability to meet these complex and varied needs.

Policy Intentions vs. Practical Implementation

While policy efforts to expand Home and Community-Based Services (HCBS) are crucial, they don’t automatically translate into increased access or improved outcomes. This disconnect between policy intentions and practical implementation was starkly illustrated in a study examining the Veterans Health Administration’s post-2001 Millennium Act efforts. Despite the policy’s aim to expand access to HCBS, the study found no significant differences in the probability of veterans using institutional long-term care or receiving paid help with activities of daily living after the policy’s implementation. This gap between the lofty goals set by policymakers and the on-the-ground reality experienced by service users underscores the critical need for robust implementation strategies.

Consider the case of a veteran who, after the Millennium Act, was theoretically eligible for expanded HCBS but continued to struggle to access needed services due to bureaucratic red tape, lack of available providers in his area, or simply not being aware of how to navigate the system to request these services. Or imagine a rural community where the policy promised increased HCBS access, but the lack of local healthcare infrastructure and professionals made this promise impractical.

These scenarios are not just hypothetical; they reflect the real challenges faced by many individuals in need of care. They highlight the multifaceted nature of implementing HCBS expansion policies, which requires more than just legislative action. It requires a detailed understanding of the logistical, administrative, and human factors that can facilitate or hinder access to services.

For instance, effective implementation might involve targeted outreach and education campaigns to ensure that those eligible for services are aware of them and understand how to access them. It might require investment in training and recruiting a workforce capable of meeting the increased demand for HCBS, particularly in underserved areas. It could also necessitate the development of streamlined processes and systems to reduce bureaucratic barriers and make it easier for individuals to receive the services they need.

Moreover, practical implementation requires ongoing monitoring and evaluation to understand the impact of policies and identify areas for improvement. For example, if data shows that certain communities or groups are not benefiting from HCBS expansion as intended, policymakers and administrators can investigate the reasons and adjust their strategies accordingly.

In essence, bridging the gap between policy intentions and practical implementation is a complex but essential task. It requires a comprehensive approach that considers the diverse needs and circumstances of those the policy is intended to serve. It involves collaboration between policymakers, service providers, and the community to ensure that policies are not just well-intentioned but also well-executed. Ultimately, the success of HCBS expansion efforts will be measured not by the policies themselves but by the real, positive changes they bring to the lives of those in need of care.

The Role of Awareness and Social Exposure

Awareness is a critical factor in the utilization of Home and Community-Based Services (HCBS). It’s the bridge that connects potential users with the services designed to support them. A study shedding light on this issue found that an estimated 53% of U.S. adults reported not knowing anyone who had used HCBS, indicating a significant lack of awareness and exposure. This lack of awareness isn’t just a statistic; it’s a barrier preventing many from accessing the support they need to live independently and with dignity.

Imagine a scenario where an older man, let’s call him John, lives alone and is starting to struggle with mobility. He’s unaware that services like in-home care assistants or transportation services exist and continues to try to manage on his own, risking falls and isolation. Or consider Maria, a daughter caring for her aging mother, who doesn’t know that respite care is available to give her a much-needed break. These individuals represent the many who could benefit from HCBS but are left in the dark due to a lack of awareness.

Increasing public awareness of HCBS is crucial and can take many forms. For example, healthcare providers can play a key role by discussing HCBS as part of routine care for older adults and their families. Community workshops and informational sessions can be held in local libraries, senior centers, and places of worship to educate the public about available services. Even something as simple as brochures in a doctor’s office or posters in a community center can make a difference.

Social exposure is equally important. People are more likely to utilize services if they know others who have also used them. This can be facilitated through community support groups where individuals can share their experiences and provide recommendations. For instance, a support group for caregivers might invite members who have used respite care to speak about their experiences, providing real-life testimonials that can encourage others to explore similar options.

Moreover, stories and testimonials from HCBS users can be shared through local media, social media, and community newsletters. Hearing or reading about a neighbor or fellow community member’s positive experience with HCBS can demystify the services and make them seem more accessible and acceptable.

Enhancing readiness for aging in place is another critical aspect of increasing awareness. Educational campaigns can emphasize not just the immediate benefits of HCBS but also how these services can contribute to a longer-term strategy for maintaining independence and quality of life. For example, a campaign might feature stories of individuals who, thanks to HCBS, were able to remain in their homes and communities, continuing to participate in activities they love and maintain connections with friends and family.

In essence, increasing awareness and social exposure to HCBS isn’t just about disseminating information; it’s about fostering a community culture that recognizes and values the support these services provide. It’s about ensuring that every individual knows that if they ever need support, there are options available to help them maintain their independence and quality of life. As we strive to create a society that supports its aging population, the role of awareness and social exposure in HCBS utilization cannot be overstated. It’s the foundation upon which accessible, compassionate, and effective care is built.

Moving Forward: A Call to Action

The evidence is clear: expanding access to Home and Community-Based Services (HCBS) can significantly impact the well-being of older adults and the broader healthcare system. However, realizing this potential requires a multifaceted approach involving increased funding, public education, culturally sensitive outreach, and robust policy implementation. As we look to the future, it’s imperative that stakeholders across the spectrum — from policymakers to healthcare providers to community organizations — work collaboratively to ensure that all older adults have the support they need to live with dignity and independence in their communities.

Increased funding is the bedrock of expanding HCBS. Consider the potential impact if states increased their investment in HCBS, not only enhancing the quantity but also the quality of services. For example, additional funds could be used to train caregivers in specialized care for conditions like dementia or to provide more comprehensive services, including nutrition counseling and physical therapy.

Public education is equally crucial. Imagine a nationwide campaign that informs older adults and their families about the benefits of HCBS, how to access them, and success stories of those who have improved their quality of life through these services. Such initiatives could significantly increase utilization and support for HCBS.

Culturally sensitive outreach is essential to ensure that HCBS are accessible and relevant to all communities. This might involve partnering with community leaders and organizations to develop and deliver services that respect and incorporate cultural values and preferences. For instance, an HCBS program in a predominantly Hispanic community might include Spanish-speaking caregivers and culturally appropriate meals.

Robust policy implementation is the final piece of the puzzle. It’s not enough to pass laws expanding HCBS; these policies must be effectively implemented to make a real difference. This involves ongoing monitoring, evaluation, and adjustment to ensure that services are reaching those in need and having the intended impact. For example, if a new policy aims to reduce the waiting time for HCBS, regular assessments are needed to ensure that this goal is being met and to identify any barriers to timely service delivery.

In the words of Jordan M Harrison, author of a study on Medicaid-supported expanded access to HCBS, “The findings suggest that implementation of mandatory [HCBS] was associated with less nursing home use among dual enrollees with dementia and that [HCBS] may help prevent or delay nursing home placement among older adults.” This sentiment captures the essence of the HCBS mission: not just to care, but to empower and enable a life of quality and dignity.

As we move forward, it’s crucial that this call to action is heeded. It’s not just about improving individual lives; it’s about creating a society that values and supports its older members, recognizing that their well-being is integral to the health and vitality of the community as a whole. By working together, we can ensure that HCBS are not just an option but a cornerstone of aging with dignity and independence.

TL;DR

The rapidly growing aging population urgently needs expanded access to Home and Community-Based Services (HCBS) to live with dignity and independence. Despite the clear demand, many older adults struggle with daily activities and face prohibitive care costs, leaving them underserved. Expanding HCBS has profound economic and social benefits, reducing institutional care costs and fostering inclusive communities. However, challenges like cultural barriers and policy implementation gaps must be addressed. A multifaceted approach involving increased funding, public education, and culturally sensitive outreach is essential. Stakeholders must collaborate to ensure effective policy implementation and increased awareness, ultimately empowering older adults to age in place gracefully.

Sources:

  1. Schwartz Center for Economic Policy Analysis. (2023). Addressing the unmet care needs of older adults: A pressing need for expanded access to home and community-based services. Retrieved December 22, 2023, from https://www.economicpolicyresearch.org/
  2. McGarry, B. E. (2023). Medicaid home and community-based services spending for older adults. Journal of the American Geriatrics Society. Retrieved December 22, 2023, from https://pubmed.ncbi.nlm.nih.gov/37326313/
  3. Casado, B. L. (2012). Access barriers to and unmet needs for home- and community-based services among older adults. Home Health Care Services Quarterly. Retrieved December 22, 2023, from https://pubmed.ncbi.nlm.nih.gov/22974082/
  4. Jacobs, J. C. (2021). Long-term care service mix in the Veterans Health Administration: Mandating access to HCBS does not necessarily imply access. Health Services Research. Retrieved December 22, 2023, from https://pubmed.ncbi.nlm.nih.gov/34085283/
  5. Siconolfi, D. (2023). Low Exposure to Home- and Community-Based Services Among Older Adults. Journal of Applied Gerontology. Retrieved December 22, 2023, from https://pubmed.ncbi.nlm.nih.gov/36193894/
  6. Harrison, J. M. (2023). Changes in Nursing Home Use Following Medicaid-Supported Expanded Access to Home- and Community-Based Services for Older Adults With Dementia. JAMA Network Open. Retrieved December 22, 2023, from https://pubmed.ncbi.nlm.nih.gov/37428503/

Bridging the Gap: The Urgent Need to Reform America’s Older Adult Care System

In the older years of life, every individual deserves the dignity of care and support. Yet, in the United States, a silent crisis is unfolding. A significant portion of aging adults face their daily struggles alone, without the necessary care and assistance. This issue, deeply rooted in the systemic reliance on family for Older Adult Care, leaves those without family or sufficient wealth particularly vulnerable.

The Stark Reality of Unmet Needs

Imagine a day in the life of an older adult struggling with basic tasks like dressing or preparing meals. Now, picture that person reaching out for help, only to find no one there. This is the reality for 8.3 million people, or 42 percent of adults who have difficulty with these tasks and did not receive any help in 2020. This alarming statistic from a policy note by the Schwartz Center for Economic Policy Analysis is like a canary in a coal mine, signaling a deeper, more pervasive issue in the U.S. Older Adult Care system.

The consequences of unmet care needs are profoundly serious and far-reaching. Older adults lacking essential support are more prone to accidents, such as falls that can lead to hip fractures, a common and severe injury among older adults that often leads to long-term disability and increased dependency. Without help for daily tasks, these individuals might struggle with medication management, leading to preventable hospitalizations due to incorrect dosages or missed treatments.

They also face more negative health outcomes, including a higher incidence of chronic conditions worsening due to neglect or improper care. Increased disability levels are another significant concern, as older adults might find their mobility and independence rapidly diminishing when they don’t receive the necessary assistance, turning once-manageable tasks into insurmountable challenges. This lack of support not only diminishes their quality of life but also places a heavier burden on healthcare systems.

The Dependency Dilemma

America’s Older Adult Care system is heavily dependent on unpaid family caregivers. This model, while rooted in familial responsibility, overlooks the changing dynamics of modern society. With declining marriage and fertility rates, and higher divorce rates, the future looks bleak for aging individuals without a family support system. The policy note highlights that “there are 7.2 million adults over the age of 55 who have no spouse and no living offspring,” underscoring the growing segment of the population at risk of neglect. It’s like expecting a garden to thrive without a gardener to tend to it.

Wealth: Not a Guarantee for Care

Contrary to what many might assume, having wealth does not necessarily guarantee care. The research reveals a counter-intuitive result: significant shares of people across all wealth quartiles do not receive the care they need. It’s like owning a car but not having access to a mechanic. “Only 23 percent of adults aged 55 and older who have difficulty with one or more ADLs or IADLs received some care from a paid professional,” the policy note states. This finding indicates that the issue transcends economic boundaries, affecting individuals across the wealth spectrum.

A Call for Systemic Reform

The current state of affairs calls for urgent systemic reform. Expanding Community Medicaid is proposed as a viable solution. This program provides financial subsidies for care services in homes or communities, yet its accessibility varies significantly across states. The policy note argues for expanding access and raising enrollment caps, especially in states with long waiting lists or low-income and asset-eligibility caps. It’s akin to opening more lanes on a congested highway to allow more traffic to flow.

The Path Forward

As America grapples with this growing crisis, it’s clear that a multifaceted approach is needed. Expanding Community Medicaid is just the start. The nation must also invest in innovative care solutions, support caregiver networks, and foster a culture that values and supports its aging population. It’s like repairing a bridge while also building new ones to ensure everyone can cross safely.

In the words of Forden and Ghilarducci, “Expanding access to benefits like Community Medicaid will help Americans across the wealth spectrum get help without having to rely on unpaid family caregiving or pay for high-cost professional care.” It’s a poignant reminder that in the pursuit of a more caring society, no one should be left behind.

As policymakers, stakeholders, and communities ponder the future of Older Adult Care in America, the time for action is now. By bridging the gap in care, we can ensure that the later years are marked by dignity, support, and compassion, not neglect and struggle. It’s about building a society that holds every life as precious, supporting each other from the first steps to the last.

TL;DR

In the U.S., a crisis in Older Adult Care leaves millions of aging adults without necessary support, leading to serious health consequences and increased dependency. Despite the common belief, wealth doesn’t guarantee care, with many across all economic levels struggling to receive needed assistance. The system’s heavy reliance on unpaid family caregivers fails those without close family ties, a situation exacerbated by changing societal dynamics. Urgent systemic reform is needed, with expanding Community Medicaid proposed as a key solution to provide financial aid for care services. A multifaceted approach is essential, including innovative care solutions and support networks, to ensure a dignified, supported, and compassionate environment for all aging individuals.

Sources:

Forden, J., & Ghilarducci, T. (2023). U.S. Caregiving System Leaves Significant Unmet Needs Among Aging Adults. Schwartz Center for Economic Policy Analysis at The New School for Social Research. Retrieved December 22, 2023, from https://www.economicpolicyresearch.org/images/Retirement_Project/Policy_Notes/2023/December_Caregiving/Unmet_Care_Needs_Among_Aging_Adults.pdf

Embracing the Older Adult Workforce: The Untapped Potential of Older Workers

In an era of rapidly changing demographics and evolving workplace dynamics, a crucial segment of the workforce demands our attention – older workers. As we grapple with the challenges and opportunities presented by an aging population, it’s time to shed light on the immense value and untapped potential of this often-overlooked demographic.

Rising Numbers, Rising Opportunities

According to a study by Bain & Company, by 2030, older workers will fill an astounding 150 million jobs globally, exceeding a quarter of the workforce in high-income countries. This shift reflects a broader trend: fewer young people entering the workforce and a trend toward later retirement. In countries like Japan, Italy, and Germany, older workers are expected to make up around 30% to 40% of the workforce by the end of the decade. Even in nations like China and Brazil, the proportion of workers over 55 is noticeably increasing​​​​.

Busting Myths: The Reality of Older Workers

Contrary to prevalent myths, older workers are not a liability but an asset. The National Center for Productive Aging and Work underlines that older workers bring experience, know-how, reliability, work ethic, professionalism, and loyalty. Misconceptions such as older workers being frequently sick or less productive are countered by evidence showing their adaptability, safety-consciousness, and valuable contributions to organizational citizenship​​​​.

Legal and Policy Implications

Despite these positives, age discrimination remains a concern. A striking example is the recent case where pharmaceutical company Lilly USA agreed to pay $2.4 million to settle a nationwide age discrimination lawsuit. This highlights the ongoing legal and ethical implications of not adequately integrating older workers into our workplaces​​.

The Business Case for Older Workers

The business case for hiring older workers is strong. Boston Consulting Group found that companies with diverse management teams, including age diversity, report significantly higher innovation revenue. Gary A. Officer, president and CEO of the Center for Workforce Inclusion, emphasizes the unique skills older workers bring, such as relationship building, negotiating, and leadership. These skills are increasingly vital in an era dominated by artificial intelligence and rapid technological advancement​​.

Strategies for Integration

To fully leverage the potential of older workers, companies need to rethink their recruitment and retention strategies. This involves offering flexibility, remote working opportunities, and considering the specific needs of older workers. Skills-based hiring, rather than focusing on age, can attract a diverse range of applicants with valuable experience. By embracing age diversity, companies not only foster a more inclusive culture but also enhance their performance and adaptability in a competitive market​​.

A Call to Action

As Elizabeth White, author and aging solutions advocate, aptly puts it, “We’re stuck in a time warp about what it means to be an older adult.” It’s time to change our framework and perception. With the right policies and attitudes, the older adult workforce can be a goldmine of talent and experience, ready to be tapped into for the betterment of our businesses and society at large​​.


This article is not just a call to action but a roadmap to embracing the full spectrum of workforce diversity. By valuing and integrating older workers, we not only address a pressing societal need but also unlock a wealth of knowledge, experience, and stability that can drive our businesses and economies forward. The future of work is not just about the young; it’s about the young at heart, the experienced, and the wise. Let’s build a workforce that truly reflects the richness and diversity of our society.

TL;DR: The article “Embracing the Older Adult Workforce: The Untapped Potential of Older Workers” highlights the increasing role of older workers in the global workforce, projected to fill 150 million jobs by 2030. It debunks myths about older workers, showing they bring valuable experience and adaptability to the workplace. Despite this, age discrimination remains a challenge, as seen in legal cases like Lilly USA’s $2.4 million settlement. Businesses benefit from diverse age representation, with evidence of higher innovation revenue in such companies. The article calls for a shift in recruitment and retention strategies to embrace older workers’ unique skills and needs, emphasizing the strategic advantages of an age-diverse workforce for business success and societal progress.

Sources:

  1. Bain & Company. (2023). Older workers will fill 150 million more jobs globally by 2030, exceeding a quarter of the workforce in high-income countries. Retrieved from https://www.bain.com.
  2. HR Dive. (2023). Employers in ‘time warp’ about older workers. Retrieved from https://www.hrdive.com/news/employers-in-time-warp-about-older-workers/697289/
  3. National Institute for Occupational Safety and Health (NIOSH). (2023). Clearing Up Myths About Older Workers While Understanding and Supporting an Aging Workforce. Retrieved from https://blogs.cdc.gov.
  4. Society for Human Resource Management (SHRM). (2023). Why Companies Should Hire Older Workers. Retrieved from https://www.shrm.org.
  5. White, E. (2023). Remarks on older workers. Quoted in “Workforce equity: Employers stuck in ‘time warp’ about older workers”.

Amplifying Voices: The Legacy and Significance of Residents’ Rights Month

In the bustling world of long-term care, October stands out as a beacon of reflection, celebration, and advocacy. This month, known as the Residents’ Rights Month, is not just another mark on the calendar but a powerful reminder of the commitment we owe to our elderly and the rights they deserve.

A Journey Back in Time

The inception of Residents’ Rights Month can be traced back to 1981. It began as the Residents’ Rights Week during a pivotal meeting of the Consumer Voice. A group of visionary nursing home residents, representing various parts of the U.S., felt the pressing need for a dedicated time to celebrate their rights. Their passion and determination led to a successful petition to Congress, resulting in the designation of a “Residents’ Rights Day.” Senators Claude Pepper (D-FL) and David Pryor (D-AR) championed their cause, introducing a Congressional Resolution to cement this initiative.

Fast forward to 2011, and the week-long celebration was expanded to an entire month, giving it the gravitas and attention it rightfully deserved.

The Heart of the Matter

But why is this month so crucial for leaders and caregivers in long-term care centers? Residents’ Rights Month serves as an annual reminder of the Nursing Home Reform Law of 1987. This landmark legislation promises quality of life, quality of care, and unalienable rights for each resident. It’s a testament to the tireless efforts of thousands who collaborate daily to ensure that dignity, privacy, and other basic human rights are not just words on paper but a lived reality for residents.

This Year’s Clarion Call: “Amplify Our Voices”

The theme for this year, “Amplify Our Voices,” is a rallying cry for the community of long-term care residents. It’s an invitation for residents to be vocal about their preferences, share their rich tapestry of experiences, and narrate their unique stories. After all, their voices are the most crucial at the decision-making table.

For leaders and caregivers, this theme underscores the importance of active listening, fostering an environment where residents feel empowered to express themselves, and ensuring that their choices and preferences are always at the forefront.

Join the Movement

Consumer Voice, the torchbearer of this tradition since 1981, encourages everyone involved in long-term care to make Residents’ Rights Month special. Whether it’s through educational programs, festive events, or personal reflections, there’s an opportunity for everyone to contribute.

For those who are planning celebrations or initiatives, Consumer Voice is keen to highlight these efforts on their platform. It’s a chance to showcase best practices, innovative ideas, and heartwarming stories that can inspire others in the community.

A Few Resources to Get Started With

  • 2023 Edition of the Residents’ Rights Month Enrichment Booklet—this complimentary booklet for long-term care residents has a variety of activities aiming to keep residents mentally engaged, prompt self-reflection, and helping residents meet and get to know the community of people around them. You can download a free printable copy to distribute in your care center by visiting this link.
  • Fact Sheet: Communication Tips—this complimentary fact sheet can be made available to serve as a starting point for opening lines of clear and direct communication between families, residents and their caregivers. You can download a copy of this fact sheet by visiting this link.
  • Fact Sheet: 6 Steps for Getting Quality Care in a Nursing Home— a downloadable fact sheet that’s perfect for handing out to both residents and their families. You can download this free fact sheet by visiting this link.
  • Resident Worksheet: My Personal Directives of Quality Living—this downloadable worksheet can be printed and distributed to residents and provides an opportunity to celebrate the dignity and rights of every individual receiving long-term services and supports. You can download this free worksheet by visiting this link.

In Conclusion

Residents’ Rights Month is more than a celebration; it’s a commitment. As leaders and caregivers, let’s take this opportunity to reaffirm our dedication to the rights and well-being of our residents. Let’s amplify their voices, honor their stories, and ensure that every day in our care centers resonates with the spirit of this significant month.

For more information or to share your Residents’ Rights Month celebrations, reach out to Consumer Voice at info@theconsumervoice.org.

Ageism in America: A Silent Epidemic Impacting Our Elders

In the heart of American society lies a silent epidemic, one that begins its insidious spread from the tender age of three and continues to cast its shadow well into our twilight years. This is the epidemic of ageism, a deeply entrenched bias that not only affects the self-worth and health of our elders but also has profound economic and societal implications.

The Early Roots of Ageism

Research reveals that age stereotypes are internalized astonishingly early. By the age of three, children are already familiar with age-related stereotypes. These perceptions, often negative, are reinforced throughout their lives, shaping their views and interactions with the elderly.

The Multifaceted Impact of Ageism

Ageism isn’t just about hurt feelings or misconceptions. It intersects with other biases like racism, sexism, and ableism, amplifying their harmful effects. The health implications are startling. Older individuals with a positive self-perception of aging live an average of 7.5 years longer than their counterparts who view aging negatively, according to a recent study by Becca Levy, PhD, a leading researcher on the effects of ageism from Yale University.

But the harm isn’t just personal. Ageism has a broader economic toll. AARP’s recent findings suggest that the U.S. economy lost a staggering $850 billion due to involuntary retirement, underemployment, and unemployment among older workers. Moreover, the World Health Organization reports that ageism added an estimated $63 billion to healthcare costs in just one year.

Ageism in the Spotlight: Media and Healthcare

The media plays a significant role in perpetuating ageist stereotypes. A mere 1.5% of characters on U.S. television are older individuals, often relegated to minor or comedic roles. This portrayal starkly contrasts with the rise of older influencers on platforms like TikTok, who are amassing significant followings and challenging ageist narratives.

Healthcare, a sector that should ideally be free of biases, isn’t immune to ageism. Older adults often find themselves excluded from clinical trials and are less likely to receive preventive care. The demand for geriatricians is set to surge to 30,000 by 2030. Yet, the U.S., with its 7,300 geriatricians, which only 50% practice full-time, is ill-prepared to meet this demand.

A Call to Leaders and Caregivers of Long-Term Care Centers

For leaders and caregivers in long-term care centers, this research is a clarion call. Ageism isn’t just a societal issue; it’s a pressing concern that affects the very individuals under your care.

It’s crucial to challenge and change ageist perceptions within your institutions. This begins with education and awareness, ensuring that staff recognize and counteract their biases. It also involves advocating for better representation of the elderly in media and pushing for more inclusive research in healthcare.

Resources for Leaders and Caregivers of Long-Term Care Centers

Ageism & Culture Advisory Council:

The Ageism & Culture Advisory Council, comprising members of the American Society on Aging, is leading the way, developing anti-ageism resources and championing the recognition of older adults in the arts. Their efforts underscore the importance of a collective approach to tackling ageism.

Age and Ability Inclusion Toolkit for Senior Living

This toolkit has been developed to help guide organizations and individuals toward creating inclusive environments for senior living. Within this toolkit, you will find resources both for individual staff members as well as an organization-wide assessment.

Community Dialogue Guide: Prompting Discussion About Age and Ageism

This practical guide by Leading Age leverages dialogue to prompt community discussion about age and ageism. Unlike debate, dialogue requires that participants listen for meaning by suspending personal opinions. The dialogue process invites participants to grow in understanding and perhaps decide to act together with common goals.

The Story of Reframing Aging: Quick Start Guide

Download or print this colorful, new flyer that tells The Story of Reframing Aging. This handy resource provides a brief overview of why ageism harms all of us, what ageism sounds like, some suggestions for what you can do to confront the injustice of ageism, and a handy Quick Start Guide that underscores the need to choose our words wisely.

Harvard: Project Implicit—Participate in an Implicit Association Test (IAT)

Project Implicit is a 501(c)(3) non-profit organization and international collaborative of researchers who are interested in implicit social cognition. The mission of Project Implicit is to educate the public about bias and to provide a “virtual laboratory” for collecting data on the internet. Project Implicit scientists produce high-impact research that forms the basis of our scientific knowledge about bias and disparities. Take an online Implicit Association Test (IAT) to discover and understand underlaying stereotypes or biases that you may experience.

Turning the Tide: Empowering Voices in America’s Nursing Homes

In the heart of America’s nursing homes, where the wisdom of ages resides, a transformative movement is taking root. It’s a movement driven by care, respect, and above all, listening. The recent report by the Long Term Care Community Coalition, titled “They Make You Pay”: How Fear of Retaliation Silences Residents in America’s Nursing Homes, is not just a call to action—it’s an invitation to lead with empathy and integrity.

A New Chapter Begins

This comprehensive 141-page report, while shedding light on the fears that residents of long-term care facilities have about speaking out, is also a beacon of hope. It’s a roadmap that guides us, the administrators and caretakers, to foster environments where our residents not only feel heard but cherished.

The Heart of the Matter

One of the report’s poignant narratives involves a Resident Council meeting, where staff inadvertently disrupted the residents’ privacy. As the report states, “The residents in attendance stated that they preferred to meet without the staff present. However, staff still came in and out of their meetings without regard to the sign placed on the door. The residents stated that this was a violation of their privacy, and they had made reports to the nursing home’s staff” (Page 70).

The Power of Positive Change

For administrators of long-term care centers, this report is an inspiring challenge. It’s an opportunity to champion a culture of openness and respect. Here’s how we can be the heroes our residents need:

  1. Cultivate Trust and Openness: Let’s create spaces where residents feel safe and encouraged to express themselves, knowing they are respected and valued.
  2. Educate and Inspire Our Teams: Let’s invest in our staff with training that emphasizes empathy, active listening, and the residents’ rights to dignity and autonomy.
  3. Stand Firm for Justice: Let’s enact and uphold strict non-retaliation policies, making it clear that our residents’ voices are sacrosanct.
  4. Embrace Transparency: Let’s work hand-in-hand with regulatory bodies, showcasing our commitment to excellence and our proactive approach to continual improvement.
  5. Engage Heart-to-Heart with Residents and Families: Let’s not just meet with our residents and their families—let’s truly connect with them, inviting their insights and honoring their role in our community.

The Future is Bright

The title of the report, “They Make You Pay”, is a stark reminder of the emotional toll that fear can take. But as administrators, we have the power to rewrite this narrative. We can turn our facilities into havens of respect, trust, and love.

In the words of a wise resident, as quoted in the report: “We are not here to be silenced. We are here to be cared for”. For all of us in long-term care administration, this is our moment. It’s our time to listen, to act, and to be the change-makers our residents deserve.

This article is inspired by the report “They Make You Pay”: How Fear of Retaliation Silences Residents in America’s Nursing Homes by the Long Term Care Community Coalition. Administrators and stakeholders in long-term care are encouraged to read the full report for a comprehensive understanding of this critical issue.


Let this be our guiding star: In our hands, we hold the power to transform lives through care, compassion, and unwavering respect. Let’s rise to this noble calling.