Embracing the Future: Robotics Transforming Older Adult Care

Embracing the Future: The Role of Robotics in Transforming Older Adult Care

In the quiet corridors of modern older adult care centers, an unusual staff member is making its rounds. It’s not a doctor, nurse, or traditional caregiver—it’s a robot. Armed with sensors, artificial intelligence, and even sometimes a tray of snacks, these robotic aides represent the vanguard of a technological revolution sweeping through older adult care. As we grapple with an aging population and a concurrent shortage of care staff, robotics are emerging as a beacon of hope and a subject of debate.

The Evolution of Robotics in Older Adult Care

Imagine the first simple robots like those early vacuum cleaners that could move around a room on their own. Now, think about how much more complex our technology has become. In the realm of older adult care, what started as machines that could do little more than beep and move in straight lines, are now advanced helpers. These modern robots can do things like remind your grandfather to take his heart medication at the exact same time each day, help your grandmother stand up from a chair, or even offer a friendly chat to keep her company.

For a real-world example, let’s look to Japan, a country known for its technological innovations and a large population of older adults. The Japanese government has been a pioneer in bringing robots into the daily lives of its older citizens. These aren’t the cold, metal robots of science fiction; they are more like helpful electronic friends. Some look like pets and can provide companionship, responding to touch and voice. Others are more like assistants that can help carry groceries, clean, or even call for help if they detect a fall.

This progress in robotics is not just about creating gadgets. It’s about finding new ways to support the growing number of older adults in our communities, making sure they have the help they need and the company they enjoy, even when human helpers can’t be around all the time. This technology could be coming to your own neighborhood soon, offering new ways to care for those we love as they age.

Benefits of Robotics in Older Adult Care

The benefits of robotic intervention in older adult care are manifold. Physically, robots lend a non-intrusive helping hand, supporting daily activities ranging from lifting to monitoring vital signs. Emotionally, they offer a semblance of companionship, with studies suggesting that interaction with robots can alleviate feelings of loneliness—a silent epidemic among older adults.

For care staff, robots can be helpful and provide an extra hand, especially in an industry where workforce turnover is nearly 85% according to recent statistics shared at the National Investment Center for Senior Housing & Care (NIC) conference. In the fast-paced environment of long-term care centers, robots can deliver supplies, clean, and manage routine tasks, freeing human caregivers to focus on more complex and empathetic aspects of care. Administrators of assisted living facilities testify to the stress-relieving impact these mechanical aides have on their human colleagues.

Real-World Impact of Robotics in Older Adult Care

Think about a local older adult care center or a nursing home. In some of these places, robots are no longer just a part of the future; they’re here now, helping out in ways that are both heartwarming and helpful. For instance, imagine a friendly robot leading a group of older adults in a morning exercise class, gently guiding them through stretches and light aerobics, making sure everyone’s safe and getting a bit of healthy movement.

Then picture a cozy corner where another robot plays memory-stimulating games with older adults, helping them keep their minds sharp. These games are not just for fun; they’re specifically designed to engage the brains of those who might be facing memory challenges.

And consider how during recent times, when visiting older adults became difficult due to in-person restrictions posed by the Pandemic, some robots stepped in to help grandparents video call their families, keeping them connected despite the physical distance. It’s a touching scene — a grandmother chatting and laughing with her grandkids over a robot’s screen, not feeling quite so alone.

Residents of Bankstown City Aged Care center welcome Paro the robotic seal. Photo credit: https://bcac.com.au/paro-robotic-seal-welcomed-residents/

Around the world, there are unique robots like PARO, which looks like a cute seal pup and is used to comfort those with dementia, offering something to cuddle and talk to. Then there’s Eva, a robot you might have read about, which rolls around delivering snacks and supplies in older adult care centers, taking some pressure off the human staff who are always on the go.

These aren’t just stories; they’re real examples of how robots are already making life better for older adults and those who care for them. They show us that technology, when thoughtfully applied, can do more than just chores—it can bring smiles, companionship, and relief to everyday life in our communities’ care homes.

Understanding the Challenges and Concerns with Robotics in Older Adult Care

Imagine a robot in a care home designed to help residents move from their beds to the dining area. If this robot malfunctions and stops midway, a caregiver has to step in and fix the problem, which could mean more work than if they had assisted the older adult themselves from the start. This is what we mean when we say technological limitations can cause unexpected issues.

Now, let’s talk about the human side of things. Older adult care isn’t just about physical tasks; it’s also about companionship and a gentle touch. There’s a worry that if we start relying on robots too much, we might lose that human touch. Picture a robot sitting with an older adult playing a game or chatting through pre-programmed questions. It’s helpful, but it’s not the same as a conversation with a real person who listens and responds with genuine emotion, empathy, and spontaneity.

This is where the ethical questions come in. How do we strike the right balance? We want to embrace the help that robots can provide, especially for straightforward tasks like lifting or delivering items, but we don’t want our loved ones to miss out on the warmth and connection that only human caregivers can offer. It’s a delicate dance between using robots for what they’re good at while ensuring that the human element in care remains strong.

The Future of Robotics in Older Adult Care

Looking ahead, the horizon is alight with the glow of innovation. Robotics in older adult care is poised to leap forward with advancements in artificial intelligence, the Internet of Things, and more. The integration of these technologies promises robots that are not just functional but also empathetic and adaptable to the individual needs of their charges.

Yet, it is not technology alone that will determine the trajectory of robotics in older adult care. The policies enacted by governments, the ethical frameworks we adopt, and the value we place on human connection will shape this future just as profoundly.

As we stand on the cusp of a new era in older adult care, we are called upon not just to embrace the technological marvels at our doorstep, but also to engage in a thoughtful dialogue about the society we wish to build. It is a conversation that will require the wisdom of the very individuals we seek to care for and the collective efforts of technologists, ethicists, policymakers, and caregivers.

In conclusion, the interplay between robotics and older adult care is a testament to human ingenuity and our enduring commitment to caring for older adults. The promise of this technology is immense, but its successful integration into the fabric of older adult care will depend on our ability to balance innovation with humanity, ensuring that in our pursuit of the future, we do not lose sight of the past and the traditions of care that have sustained us for generations.


This article draws on a wealth of research, including studies that explore the impact of robots on older adults and analyses that scrutinize the ethical dimensions of this burgeoning technological integration. Below are key references that have informed the perspectives and insights presented:

  •  Bardaro, G., Antonini, A. & Motta, E. Robots for Elderly Care in the Home: A Landscape Analysis and Co-Design Toolkit. Int J of Soc Robotics 14, 657–681 (2022). https://doi.org/10.1007/s12369-021-00816-3. Bemelmans, Roger MS.
  • “Socially Assistive Robots in Elderly Care: A Systematic Review into Effects and Effectiveness.” Journal of the American Medical Directors Associations, vol. 13, Issue 2, 2012. https://doi.org/10.1016/j.jamda.2010.10.002
  • Fong, T. “Socially Assistive Robots in Elderly Care: A Systematic Review into Effects and Effectiveness.” Journal of the American Medical Directors Association, vol. 13, no. 2, 2012, Elsevier Inc. https://www.sciencedirect.com/science/article/abs/pii/S1525861010003476.
  • “Robotics in Elderly Healthcare: A Review of 20 Recent Research Projects.” arXiv, https://arxiv.org/abs/2302.04478.
  • Sawik B, Tobis S, Baum E, Suwalska A, Kropińska S, Stachnik K, Pérez-Bernabeu E, Cildoz M, Agustin A, Wieczorowska-Tobis K. Robots for Elderly Care: Review, Multi-Criteria Optimization Model and Qualitative Case Study. Healthcare. 2023; 11(9):1286. https://doi.org/10.3390/healthcare11091286
  • Trainum, Katie et al. “Robots in Assisted Living Facilities: Scoping Review.” JMIR aging vol. 6 e42652. 6 Mar. 2023, doi:10.2196/42652

Cultivating Empathy and Respect: The Keystone of Workplace Culture in Older Adult Care

Introduction: Nurturing the Soul of Older Adult Care

Imagine stepping into a place where warmth and understanding fill the air, where each smile and gentle word comes from a deep place of empathy and respect. This is what true care for our older adults should feel like. In older adult care across the globe, there’s a movement that goes beyond medical necessities and delves into the heart of what it means to care. This article is a journey through the nuances of such a nurturing culture, exploring the transformative ‘Guiding Lights’ framework and other pivotal elements. We will unfold relevant examples of professionals who, supported by their organizations, become the embodiment of compassion and respect, profoundly impacting the lives of the older adults they care for.

The Guiding Light of Workplace Culture: Simplified and Relatable

Think about an older adult care organization where every staff member shares a common goal: to provide compassionate and respectful care to each older adult. This is the essence of the ‘Guiding Lights’ framework, a concept from RCNi Journals that strives to create environments where both staff and older adults feel safe and valued.

Let’s break it down with real-world examples:

  1. Collective Leadership: Instead of a top-down approach, imagine an organization where every team member, from the head nurse to the newest caregiver, has a say in decision-making. This collective leadership approach ensures that the needs of both staff and older adults are heard and addressed. For example, a caregiver might suggest a new activity that helps residents living with dementia engage more with their surroundings. This suggestion is taken seriously and implemented, leading to happier older adults and a sense of accomplishment for the staff.
  2. Living Shared Values: In our hypothetical organization, everyone – staff and older adults alike – adheres to core values like compassion, respect, and dignity. These aren’t just words on a poster; they are principles that guide daily interactions and decisions. When an older adult feels lonely, staff members take the time to sit with them, listen to their stories, and provide comfort, reflecting these shared values.
  3. Safe, Creative Learning Environments: Consider a scenario where caregivers are encouraged to learn and grow. They participate in workshops on empathetic communication or creative problem-solving in older adult care, leading to innovative approaches to daily care challenges. For instance, a caregiver learns a new technique for gently persuading a resistant resident to take their medication, making the process less stressful for both.

Many experts reinforce these ideas with five key components of a strong workplace culture:

  1. Clear Vision and Mission:  Older adult care organizations have a clear goal: to improve the quality of life for the older adults they serve. This clear direction guides every action and decision within the organization.
  2. Employee Engagement: Staff members are actively involved in shaping the way the organization operates. Their feedback leads to changes that make their work more meaningful and enjoyable.
  3. Supportive Leadership: Leaders in the organization provide support and guidance, creating a nurturing environment for both staff and older adults. They lead by example, showing empathy and respect in their interactions.
  4. Work-Life Balance: The organization recognizes that staff members have lives outside of work. Flexible scheduling and mental health days are available, ensuring that employees don’t feel burnt out and can provide the best care to the older adults in their care.
  5. Diversity: A diverse staff brings a wealth of experiences and perspectives, which enhances the care provided. For example, staff members from different cultural backgrounds share their unique approaches to care, enriching the older adults’ experiences and broadening the perspectives of their colleagues.

In essence, these principles create a positive, nurturing environment that benefits everyone – staff feel valued and empowered, and older adults receive compassionate, personalized care. This is the heart of a strong workplace culture in older adult care.

Empathy and Respect: Making Soft Skills Tangible in Older Adult Care

In older adult care, soft skills like empathy, respect, and effective communication are not just nice-to-haves; they’re essential for providing quality care and creating a positive work environment. Let’s break down how these skills make a real difference:

  1. Empathy: Picture a caregiver named Sarah, who works with Mr. Jones. He often seems irritable and refuses to participate in activities. Instead of dismissing his behavior, Sarah spends time talking to Mr. Jones, discovering that he’s grieving the loss of his spouse. By showing empathy, Sarah can provide comfort and suggest specific activities that honor his memories, improving his mood and engagement.
  2. Respect: John, another caregiver, always makes sure to knock before entering a older adults’ room and asks for permission before assisting them with personal care. This simple act of respect preserves the dignity of the residents, making them feel valued and cared for.
  3. Effective Communication: In team meetings, caregivers are encouraged to share their observations and suggestions. For instance, a caregiver notices that Mrs. Smith is more responsive in the mornings. By effectively communicating this, the team can adjust her care plan to include more stimulating activities in the morning, enhancing her overall care.

Recent experts emphasize the importance of ongoing training in these soft skills. This isn’t just about attending a workshop; it’s about integrating these skills into everyday interactions. For example, caregivers might participate in role-playing exercises to practice empathetic responses or receive coaching on how to communicate more effectively with older adults and their families.

One of the ways that we’ve found this type of training particularly impactful is to provide a safe space for older adult care professionals to practice these soft skills in an environment where they’re encouraged to demonstrate respect when faced with older adults from diverse backgrounds, variable care needs, and unfamiliar environments.

One of the immersive ways that Engage with® Skills Training Programs does this is through their interactive online game, Demonstrating Respect—which provides participants a chance to engage in a virtual environment with several types of older adults of varying perspectives, experiences, and expectations and see how they respond to their approach.

If you’d like to learn how online virtual tools, like Demonstrating Respect, can help you and your team cultivate empathy and respect to improve the outcomes and care for the older adults in your care, we invite you to learn more about Engage with® Skills Training Programs—an online, virtual skills training world where participants learn key skills like empathy, respect, and effective communication with live, certified instructors.     Take a Virtual Tour | Request a Free Demo | Schedule a Meeting  

This safe environment gives the staff member a unique opportunity to reflect on cultural biases, stigmas, and other barriers that may unknowingly interfere with their ability to connect with older adults in a compassionate, and respectful way.

Jim Collins, Ph.D., author of The Person-Centered Way, supports this view, noting that a healthy culture in an older adult care isn’t just about the physical well-being of older adults; it’s also about their social and emotional health. Caregivers who engage in social conversations, show genuine interest in older adults’ lives, and create emotionally supportive environments contribute significantly to older adults’ overall well-being. This leads to happier older adults and a more fulfilling work environment for caregivers.

In summary, developing and nurturing soft skills like empathy, respect, and effective communication in older adult care settings leads to better care for older adults and a more positive, satisfying work environment for staff members. It’s about seeing each older adult as an individual with their own stories and needs and responding to them with understanding and kindness.

As we pivot from the core soft skills that shape the essence of caregiving, we venture into how technology magnifies our capacity to learn, understand, and innovate in the service of our older adults. Let’s discuss how Virtual Reality, Augmented Reality, and immersive virtual training worlds are reshaping the landscape of caregiver education and setting new benchmarks for excellence in older adult care.

Technology as an Enabler of Learning: Enhanced Through Virtual Realities and Online Training Worlds

The incorporation of technology in professional training has revolutionized the way skills are developed in the older adult care profession. Let’s explore how Virtual Reality (VR), Augmented Reality (AR), and immersive virtual training environments are making a significant impact.

  1. Virtual Reality (VR) for Empathy Training: Consider Lisa, who uses a VR headset to immerse herself in the life of an older adult with mobility issues and cognitive challenges. This VR simulation allows her to experience the daily struggles of older adults, fostering a deeper level of empathy. Such understanding enables Lisa to approach her caregiving duties with more patience and insight, leading to better care for her the older adults she works with.
  2. Augmented Reality (AR) for Skill Practice: For example, John employs AR glasses during training. These glasses provide real-time, overlaid instructions as he practices essential tasks like medication administration or mobility support. This technology not only enhances John’s learning but also ensures precision and safety in his work tasks, ultimately benefiting the older adults he cares for.
  3. Immersive Virtual Learning Environments: Virtual skills training environments, like Engage with® has pioneered an innovative virtual training world where professionals, through personalized avatars, interact in a digital environment. This platform, accessible without the need for specialized equipment, breaks down barriers to training accessibility. It allows staff members like Jenni to participate in live, interactive sessions led by certified skills trainers. This real-time engagement in a virtual world not only makes learning more dynamic but also fosters a community spirit among participants. They can share experiences and solutions, enhancing their collective skillset and readiness to address real-world challenges in older adult care.

Many experts underscore the importance of such technological advancements in developing both technical and soft skills in healthcare professionals. For instance, VR simulations of challenging interpersonal scenarios equip professionals with better communication and conflict-resolution strategies.

The integration of VR, AR, and immersive virtual training platforms like Engage with® represents a significant leap from traditional learning methods. They offer professionals not just education, but an engaging and interactive experience, crucial for mastering the complex demands of older adult care. This blend of technology and training ensures that staff members are well-equipped to understand and meet the nuanced needs of older adults, providing compassionate and effective care.

Simplifying the Impact of Caregiver-friendly Workplace Programs with Real-World Examples

Caregiver-friendly workplace programs are initiatives designed to support those who work in older adult care, recognizing their unique challenges and the importance of their well-being. Let’s break down how these programs impact caregivers and, by extension, the older adults they care for:

  1. Flexible Scheduling: Maria has two young children at home. Her workplace offers flexible scheduling, allowing her to start her shift later in the day when her children are at school. This flexibility reduces her stress and enables her to focus more on the older adults in her care. As a result, the older adults receive better attention and care, as Maria is not preoccupied with personal scheduling conflicts.
  2. Mental Health Support: Tom, regularly experiences the emotional toll of caring for older adults, some of whom are at the end of their lives. His workplace provides mental health support services, including counseling and stress management workshops. This support helps Tom cope with the emotional aspects of his job, ensuring that he remains compassionate and attentive to the older adults in his care, ultimately enhancing their quality of life.
  3. Professional Development Opportunities: An older adult care organization introduces regular training sessions for its staff, focusing on the latest care techniques and soft skills development. Emma, attends these sessions and learns new methods to better communicate with older adults living with dementia. This training not only boosts Emma’s confidence and job satisfaction but also directly benefits the older adults, as they experience improved interactions and care.

Peer-reviewed research highlights the effectiveness of such caregiver-friendly workplace programs, pointing out their role in increasing employee retention and satisfaction. When staff members like Maria, Tom, and Emma feel supported and valued by their employers, they are more likely to stay in their jobs and perform at their best. This, in turn, creates a stable and caring environment for the older adults in their care, ensuring consistent and high-quality support.

In essence, these programs are more than just employee benefits; they are a reflection of a workplace culture that prioritizes the well-being of its staff. When staff members are well-supported, it’s not just their own job satisfaction that improves — the quality of care they provide to older adults improves as well.

Clarifying Organizational Support and Relational Dynamics in Older Adult Care

Let’s unpack the concept of organizational support and relational dynamics in older adult care, using real-world examples to illustrate how they influence staff’s learning experiences and, consequently, the care provided to older adults.

  1. Organizational Support for Education: Consider an organization providing older adult care, ‘Harmony Haven’, that invests in ongoing educational programs for its staff. For example, Anna is can attend workshops on the latest dementia care techniques, thanks to the support of her organization. This not only enhances her skills but also directly benefits the older adults she cares for. With her new knowledge, Anna can implement more effective care strategies, leading to a noticeable improvement in the well-being of those she cares for who are living with dementia.
  2. Professional Development Opportunities: ‘Harmony Haven’ also encourages its staff to pursue further education and certifications. James takes advantage of this opportunity and completes a course in palliative care. As a result, he’s better equipped to provide compassionate end-of-life care, significantly impacting the quality of life for older adults in their final stages.
  3. Relational Dynamics Among Staff: The organization fosters a collaborative environment where nurses and all staff members regularly share insights and experiences. This open communication leads to a deeper understanding and better teamwork. For instance, Lisa shares her observations about an older adult’s changing behavior with Anna. Together, they adjust the care plan to better suit the older adult’s needs, demonstrating effective teamwork and mutual respect.

PubMed’s systematic review highlights the importance of such organizational support and relational dynamics. By providing clear systems that encourage education and professional development, older adult care organizations like ‘Harmony Haven’ create an environment where learning is valued. This not only enhances the skills of the staff but also fosters a culture of empathy and respect.

When staff are supported in their professional growth and work in an environment that encourages collaboration and respect, the quality of care for older adults improves. The staff feel valued and capable, and the older adults receive care that is both compassionate and informed by the latest best practices in older adult care.

Conclusion: Building a Future on the Foundation of Empathy and Respect:

As we draw the curtains on our exploration, it’s evident that the core of older adult care is nurtured by more than just procedures and policies. It’s crafted through the empathy of caregiver’s listen, the understanding in their voice, and the respect in their voice. Organizations that embrace this don’t just provide care; they create a sanctuary of dignity and warmth for older adults. This culture of excellence, shaped by innovative training, supportive workplace programs, and a communal spirit, is where the true essence of older adult care thrives. It’s a reminder that in the tapestry of older adult care, each thread of empathy, respect, and effective communication weaves together to create a picture of unparalleled care and compassion. As we move forward, let’s carry with us the conviction that nurturing such a culture is not just our responsibility but our privilege in honoring and caring for the older generation.


  1. PubMed. (2016). The influence of workplace culture on nurses’ learning experiences. Retrieved January 21, 2024, from https://pubmed.ncbi.nlm.nih.gov/27532660/
  2. PLOS ONE. (2021). Effectiveness of a caregiver-friendly workplace program. Retrieved January 21, 2024, from https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0250978
  3. Esoft Skills. (n.d.). Creating a Culture of Learning: Developing Organizational Training Programs in Healthcare. Retrieved January 21, 2024, from https://esoftskills.com/healthcare/creating-a-culture-of-learning-developing-organizational-training-programs-in-healthcare/
  4. Huron Consulting Group. (n.d.). Building a Culture of Learning to Evolve the Healthcare Workforce. Retrieved January 21, 2024, from https://www.huronconsultinggroup.com/insights/building-a-culture-of-learning-to-evolve-healthcare-workforce
  5. Collins, J. (n.d.). 10 Benefits of a Healthy Organizational Culture in Senior Care. Retrieved January 21, 2024, from https://www.drjimcollins.com/10-benefits-of-a-healthy-organizational-culture-in-senior-care/
  6. Pineapple Academy. (n.d.). 5 Components of a Strong Workplace Culture in Senior Living and Healthcare. Retrieved January 21, 2024, from https://pineappleacademy.com/blogs/5-components-of-a-strong-workplace-culture-in-senior-living-and-healthcare
  7. RCNi. (2022). Guiding Lights for effective workplace cultures: enhancing the care environment for staff and patients in older people’s care settings. Retrieved January 21, 2024, from https://journals.rcni.com/nursing-older-people/cpd/guiding-lights-for-effective-workplace-cultures-enhancing-the-care-environment-for-staff-and-patients-in-older-peoples-care-settings-nop.2022.e1377/print/abs

Embracing Person-Centered Care: A Journey to the Heart of Older Adult Individuality Through Care


Picture a world where the care we give our older adults is as varied and vibrant as their own life stories. This is the promise of person-centered care (PCC)—a philosophy that paints every older adult’s care with the brush of their unique preferences, histories, and dreams. As we step into this world, we find ourselves at a crossroads. While the merits of PCC light the way, there lies a gap wide and deep—the caregivers and healthcare providers, the unsung heroes in the lives of our older adults, are reaching out for the tools and knowledge to turn this promise into practice. This article unfolds the reality of PCC, exploring the vibrant potential it holds for older adults and the collective effort needed to climb the learning curve and infuse every act of care with deep personal significance.

The Heart of Person-Centered Care

Person-centered care (PCC) revolves around a simple yet powerful idea: every older adult is unique, with their own set of preferences, life stories, and needs. This approach is about recognizing and respecting these differences to provide care that’s tailored to each individual.

A significant challenge in implementing PCC, as highlighted in a systematic review by BMC Geriatrics, is that many who provide care to older adults—be it healthcare providers or caregivers—often lack the necessary knowledge and skills for this specialized approach. The review points out, “Older people, healthcare providers, and caregivers lack professional knowledge and skills to implement effective PCC”​​. This statement is a wake-up call, emphasizing the need for more comprehensive training and education in PCC.

So you may be asking yourself why is this training important? Imagine an older adult person who loves music. In a PCC model, caregivers would integrate music into their daily care, perhaps by playing their favorite songs or encouraging musical activities. This is PCC in action— aligning care with personal likes and histories. However, without proper training in PCC principles, caregivers might miss these opportunities to connect care with personal interests.

Take, for example, the case of an older adult with a deep love for gardening. In a PCC approach, caregivers and healthcare providers would recognize this passion and find ways to integrate it into her daily care routine, perhaps by ensuring she has access to a garden or bringing potted plants for her to tend. This not only honors her individuality but also promotes emotional and mental well-being.

Similarly, consider a scenario where an older adult individual strongly values independence. In this case, PCC would focus on empowering him with choices in his daily routine, from selecting meals to deciding on his activity schedule, thereby respecting and upholding his desire for autonomy.

However, to effectively implement such personalized care, a significant gap needs to be bridged. The lack of professional knowledge and skills in PCC, as highlighted by the BMC Geriatrics review, suggests that caregivers and healthcare providers often find themselves unprepared to deliver such nuanced and individualized care.

To address this, there is a need for targeted training programs that not only educate caregivers about the principles of PCC but also equip them with practical tools to apply these principles. This could include training in communication skills to better understand each older adult’s preferences, workshops on creative problem-solving to tailor care plans, and even courses on cultural competence to ensure caregivers are sensitive to the diverse backgrounds of the older adults they serve.

In essence, the heart of person-centered care beats to the rhythm of individuality, calling for a healthcare paradigm shift that sees and treats each older person not just as a patient, but as a unique individual with their own story, preferences, and dignity.

The Six Domains of Person-Centered Care

The concept of person-centered care (PCC) is not a one-dimensional approach but rather encompasses multiple facets that together form a comprehensive model of care. Alexis Coulourides Kogan and colleagues, through their extensive literature review, have distilled PCC into six key domains: holistic care, respect, choice, dignity, self-determination, and purposeful living​​.

  1. Holistic Care: This domain involves addressing not just the physical health needs of older adults but also their mental, emotional, and social well-being. For example, a holistic care plan for an older adult might include regular physical exercise, mental stimulation activities like puzzles or reading, and social interactions through community programs.
  2. Respect: Respecting older adults means acknowledging their life experiences and treating them with the dignity they deserve. This could be as simple as caregivers taking the time to listen to their stories or ensuring their opinions are considered in everyday decisions.
  3. Choice: Empowering the older adult with choices in their daily lives is crucial. This can range from choosing what to wear each day to making decisions about their care plans or activities they wish to participate in.
  4. Dignity: Maintaining the dignity of older adults involves actions like ensuring privacy during medical treatments or personal care activities, and addressing them respectfully.
  5. Self-Determination: This is about enabling the older adult to have a say in how they live their lives. For instance, allowing them to decide their daily routine or involving them in setting goals for their health and care.
  6. Purposeful Living: Helping older adults find purpose and joy in their lives is essential. This could be through encouraging hobbies, facilitating participation in community events, or even providing opportunities for volunteering.

These six domains emphasize a care approach that is deeply rooted in empathy, understanding, and collaboration between caregivers, healthcare providers, and the older adults themselves. By incorporating these domains into care practices, we can ensure a more respectful, dignified, and fulfilling experience for our aging population.

Challenges in Implementation

Implementing person-centered care (PCC) comes with its own set of challenges, despite its clear benefits. The BMC Geriatrics study has identified some key barriers that can make it often challenging to put PCC into practice effectively.

  1. Lack of Knowledge and Skills: Many caregivers and healthcare providers simply don’t have enough training in PCC. For instance, a caregiver might not know how to create a care plan that truly reflects an older adult’s interests and preferences. They might be used to a standard routine that doesn’t consider what the older adult actually enjoys or finds meaningful.
  2. Negative Attitudes Towards Shared Decision-Making: Another challenge is a reluctance to involve older adults in decisions about their own care. Think of a situation where healthcare decisions are made without consulting the older adult it affects. This goes against the PCC principle of respecting and valuing the individual’s choices.

To overcome these obstacles, a collective effort is needed. This means training caregivers, professionals who engage and interact with older adults to understand and apply PCC principles in their daily work. For example, a training program could include workshops on how to communicate effectively with older adults and involve them in decision-making, or it could offer guidance on developing care plans that align with an individual’s unique needs and preferences.

Additionally, the overall older adult care system needs to support this shift towards PCC. This could involve policy changes, like requiring PCC training for certification, or providing resources to older adult care providers to help them adopt a more person-centered approach.

By addressing these challenges head-on, we can make PCC not just an ideal to strive for, but a reality in the care of older adults. This will not only improve the quality of care but also ensure that the care is respectful, dignified, and tailored to each individual’s needs.

Benefits: A Dual Advantage

The concept of person-centered care (PCC) offers significant benefits that extend beyond the well-being of older adults to positively impact those caring for them.

It’s often discovered that PCC not only improves the quality of life for older adults but also enhances satisfaction for caregivers and families. Let’s unpack this concept with a real-world example of how the benefits of PCC can often extend beyond the older adults being cared for:

  1. For Older Adults: Imagine an older woman named Joan who loves painting. In a PCC approach, her care plan would include time for her to paint, maybe even organizing visits to local art galleries. This not only brings joy to her daily life but also encourages mental engagement and emotional expression, directly improving her quality of life.
  2. For Caregivers: On the other side, there’s Mike, one of Joan’s caregivers. By helping Joan with her painting, he feels a sense of fulfillment and pride in his work. He’s not just performing tasks; he’s making a real difference in someone’s life. This job satisfaction is a key aspect of PCC—it can lead to lower turnover rates among staff and a more positive work environment.
  3. For Families: Joan’s family members are also impacted. Seeing Joan’s spirits uplifted through her personalized care, they feel more at ease and confident in the care she’s receiving. They can enjoy their time with Joan, knowing that her individual needs and passions are being honored and encouraged.

This “dual advantage” means that PCC is beneficial for everyone involved. Older adults like Joan live a life that’s still full of the activities and choices they love. Caregivers like Mike enjoy more meaningful work. And families are assured that their loved ones are cared for with dignity and respect, echoing the holistic impact of PCC.

The Future of Older Adult Care

Looking forward, it’s essential that those caring for and engaging with older adults embrace the principles of person-centered care (PCC). To make this happen, we need a clear and common understanding of what PCC means and what it requires—like a recipe that all caregivers, older adult care professionals and health professionals can follow.

For example, picture a GPS system for older adult care. Just as a GPS guides you to your destination, a standardized definition of PCC would guide caregivers in providing the right kind of support. This would be a set of clear directions that every care professional could use to ensure that every older adult, like Mr. Thompson who lives with diabetes and loves jazz music, receives care that keeps him healthy while also allowing him to enjoy his favorite music every day.

And what about the essential elements? Think of these like the main ingredients in a dish. The literature review by Kogan and colleagues suggests we need to identify these “ingredients” for good older adult care. For Mr. Thompson, this could mean making sure his dietary plan for diabetes includes his preferred flavors, or that his exercise routine is set to the rhythm of Louis Armstrong.

This approach acts as a transformational roadmap, ensuring that older adults care systems can consistently deliver care that’s not only medically sound but also personalized to each individual’s life and joys. This way, older adult care can be a journey that respects each person’s preferences and needs, making the experience as comfortable and joyful as possible for them and their families.

Conclusion: Embracing the Full Spectrum of Elderly Care

As the narrative of older adult care unfolds, PCC stands out as the thread that weaves personal identity into the fabric of care. It’s a vibrant mosaic that comes alive when every piece—every older adult’s wish and will—is placed with intention and care. The challenge before us is not insurmountable; it’s an invitation to enrich our skills, to turn empathy into action, and to ensure that the journey through one’s twilight years is as respected and cherished as the decades that came before. Together, we stand on the brink of a care revolution, one where the joy and autonomy of older adults become the touchstone of quality care. Let’s step forward, forging a path where each older adult’s story guides our hands and hearts in their care.


  1. BMC Geriatrics. (2023). Experiences of older people, healthcare providers and caregivers on implementing person-centered care for community-dwelling older people: a systematic review and qualitative meta-synthesis. BMC Geriatrics. Retrieved January 25, 2024, from https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-023-03915-0 .
  2. Kogan, A. C., Wilber, K., & Mosqueda, L. (2015). Person-Centered Care for Older Adults with Chronic Conditions and Functional Impairment: A Systematic Literature Review. Journal of the American Geriatrics Society https://doi.org/10.1111/jgs.13873

Rethinking Aging: A Journey Toward Inclusivity and Respect

In a world where youth is often celebrated, the narrative around aging has been narrowly defined and riddled with stereotypes. However, a closer look at recent research and expert insights reveals a compelling case for redefining how we view older adults. It’s time to shift our perspective from one of decline to one of appreciation and understanding.

Understanding the Depth of Ageism

Ageism extends far beyond a collection of stereotypes; it’s an insidious force that permeates many aspects of society, deeply affecting the mental and physical well-being of older adults. Lisa Borrero Ph.D., in her insightful article “Transforming the Narrative About Aging,” sheds light on the widespread nature of ageist attitudes. These attitudes are often trivialized or dismissed as harmless banter or traditional thinking. However, the impact of these seemingly innocuous views is anything but trivial.

Consider the common portrayal of older individuals in media as forgetful or technologically inept, or the casual jokes about ‘senior moments.’ These stereotypes, while often intended as light-hearted, contribute to a narrative that undervalues and marginalizes older adults. They reinforce the notion that aging is a phase of loss and decline, ignoring the diversity of experiences and contributions of the older population.

The consequences of such a narrative are not just hurtful; they’re harmful. Research by Jina Han provides empirical evidence of the damage wrought by ageist perceptions. The study found a direct correlation between perceived age discrimination and an increase in depressive symptoms among older adults. This isn’t just about hurt feelings; it’s about a measurable decline in mental health, which can have far-reaching implications for physical health, social engagement, and overall quality of life.

For instance, an older adult who internalizes negative stereotypes might be less likely to seek medical care or engage in social activities, fearing discrimination or believing they’re no longer capable. This can lead to a cycle of isolation, physical decline, and worsening mental health. On a societal level, ageism can lead to inadequate policymaking and resource allocation for the aging population, further exacerbating the challenges they face.

The link between perceived age discrimination and mental health is a stark reminder of the urgent need to address and dismantle ageist attitudes. It’s not just about changing how we talk about aging; it’s about transforming how we think about, interact with, and create policies for older adults. By challenging ageist stereotypes and embracing a more inclusive and appreciative view of aging, we can begin to mitigate the detrimental effects of ageism and create a society that values and supports individuals at every stage of life.

The Power of Self-Perception

The way older adults perceive themselves and their aging process plays a critical role in shaping their overall health and longevity. Far from being a mere feel-good factor, a positive self-perception of aging is a crucial element of healthy and successful aging. It’s not just about feeling good about getting older; it’s about the tangible, positive impact this mindset can have on one’s physical health and lifespan.

Dana Kotter-Grühn’s research provides compelling evidence of this phenomenon. The study found that individuals who maintained a higher satisfaction with their aging process were at a lower risk of mortality. This isn’t a coincidence or a minor correlation; it’s a powerful testament to how one’s mindset can influence their biological health outcomes.

Consider, for example, two individuals of the same age. One views aging as a time of decline and loss, while the other sees it as a period of growth, wisdom, and continued contribution. The latter is likely to engage in more health-promoting behaviors, stay active, and maintain a richer social life. They might see each birthday not as a marker of decline but as an opportunity for new experiences and growth. This positive outlook can lead to better stress management, a more robust immune system, and a greater sense of purpose—all factors that contribute to a longer, healthier life.

Conversely, an individual with a negative view of aging might disengage from social activities, give up on learning new skills, or neglect their health, believing it’s too late to make a difference. This mindset can lead to a self-fulfilling prophecy where the individual’s health and well-being decline because they’ve internalized and accepted negative stereotypes about aging.

The implications of self-perception on aging extend beyond the individual. Societal attitudes that promote a positive view of aging can encourage older adults to stay engaged and active, contributing their skills and wisdom to their communities. Programs and policies that celebrate aging and encourage lifelong learning, volunteerism, and intergenerational interaction can help foster these positive self-perceptions.

In essence, cultivating a positive outlook on aging isn’t just about making older adults feel better about getting older; it’s about empowering them to lead healthier, more fulfilling lives. By recognizing and harnessing the power of self-perception, society can unlock the potential for a more vibrant, active, and healthy older population.

The Role of Society and Environment

The societal and environmental context in which we live profoundly shapes our perceptions of aging. It’s not an individual’s perspective alone that determines how they view aging, but also the collective attitudes and physical surroundings that influence these views. Julia K Wolff’s research illuminates the significant impact regional differences in population aging have on individual perceptions. In regions where the population is aging more rapidly, there’s a tendency for more negative perceptions of aging to prevail. This phenomenon underscores the critical role that society and environment play in shaping how we view older adults and the aging process.

Consider a community where the majority of the population is young, and facilities and activities are primarily geared toward this demographic. Older adults in such an environment might feel marginalized or out of place, leading to a sense of isolation and a more negative perception of their aging process. Conversely, in a community where older adults are a significant and visible part of the population, with access to senior centers, age-friendly public spaces, and community activities that include all ages, the perception of aging can be much more positive.

The design of our physical environment also plays a crucial role. Cities and towns with accessible public transportation, safe walkways, ample public seating, and other age-friendly features enable older adults to remain active and engaged in their communities. When older adults can easily access and participate in social, cultural, and physical activities, it reinforces a positive perception of aging and their role in society.

Policymakers and community leaders are in a unique position to influence these perceptions through the development and implementation of policies and programs that recognize the value and contributions of older adults. For instance, intergenerational programs that bring together young people and older adults can foster mutual understanding and respect, breaking down stereotypes and building more positive perceptions of aging.

Media representation is another powerful tool in shaping societal attitudes. When older adults are portrayed in diverse roles that go beyond the stereotypical depictions of decline and dependency, it can help shift public perception to a more nuanced and positive view of aging.

In essence, the role of society and environment in shaping perceptions of aging is multifaceted and powerful. By creating environments that celebrate and support aging, we can foster a more inclusive and positive view of older adults. This, in turn, can lead to healthier, happier, and more engaged older populations who continue to contribute to their communities in meaningful ways.

Challenging Stereotypes with Counter-Narratives

Combatting ageism isn’t just about addressing negative stereotypes; it’s about actively countering them with positive images and stories that reflect the diverse realities of aging. Deirdre A Robertson’s study underscores the power of counter-narratives in reshaping public perceptions. By showcasing older adults in prestigious and influential positions, society is prompted to reconsider its preconceived notions of aging and recognize it as a period of continued growth and contribution.

Consider the impact of seeing older adults in roles typically associated with vitality and innovation. When an older adult is featured as a tech entrepreneur launching a new startup, or an artist gaining recognition in their later years, it challenges the stereotype of older adults being out of touch or unproductive. Public figures like Sir Ian McKellen, who continues to captivate audiences with his acting prowess well into his 80s, or Carmen Dell’Orefice, who at 92 is still a celebrated fashion model, serve as living counter-narratives to the idea that aging equates to a decline in relevance or capability.

In the realm of everyday life, there are countless older adults who break the mold of what society expects aging to look like. They’re starting new careers, engaging in extreme sports, pursuing education, and leading community initiatives. These stories, when shared and celebrated, have the power to reshape how society views aging.

Educational programs and media campaigns can also play a significant role in disseminating these counter-narratives. For instance, documentaries focusing on the lives of older adults achieving remarkable feats, or advertising campaigns that feature older adults as active, vibrant individuals, can help to shift public perception.

Moreover, literature and films that explore the complexity and richness of older characters can offer nuanced perspectives that challenge one-dimensional stereotypes. When older characters are portrayed with depth, agency, and in diverse roles, it contributes to a broader understanding and appreciation of the aging process.

By actively promoting and embracing these counter-narratives, society can begin to dismantle the ageist stereotypes that have long defined what it means to grow older. This shift in perception is not just beneficial for older adults; it enriches the entire society by fostering a more inclusive and accurate understanding of what it means to age. Through these efforts, aging can be redefined not as a period of decline but as a stage of life characterized by continued vibrancy, growth, and contribution.

Crafting a New Narrative

Transforming the narrative of aging is a comprehensive journey that requires a collective shift in mindset and action. It’s about moving beyond mere awareness to actively challenging our biases, educating future generations, and implementing policies that honor and support the aging population. As Lisa Borrero suggests, instilling a sense of value and respect for older individuals in children is a critical step toward dismantling ageist stereotypes.

Challenging Personal Biases

Each of us holds preconceived notions about aging, often influenced by societal norms and media portrayals. To craft a new narrative, we must first reflect on and challenge these personal biases. This might involve questioning our assumptions when we encounter an older person in a learning environment or leadership position, recognizing the implicit biases that might lead us to underestimate their capabilities or contributions.

Educating the Younger Generation

Education plays a pivotal role in shaping perceptions. Integrating stories and lessons about the achievements and contributions of older adults into school curriculums can foster respect and admiration from a young age. Programs like intergenerational dialogues, where children and older adults share experiences and learn from each other, can break down barriers and build mutual understanding. By seeing older individuals as mentors, sources of wisdom, and active contributors to society, children can grow up with a more inclusive and appreciative view of aging.

Creating Supportive Policies and Environments

Governments and organizations have the power to influence societal attitudes through policies and the design of public spaces. Age-friendly policies that ensure access to healthcare, lifelong learning opportunities, and protection against discrimination are fundamental. Similarly, creating public spaces that are accessible and welcoming to individuals of all ages encourages continued participation and interaction among different generations, reinforcing the value of older adults in the community.

Celebrating Aging in Media and Culture

Media and cultural representations significantly influence public perception. Promoting and celebrating films, books, and programs that depict older adults in diverse, complex roles can help shift the narrative. Highlighting real-life stories of older individuals leading fulfilling, dynamic lives serves as powerful evidence against the stereotype of aging as a time of decline.


The narrative of aging is indeed ripe for change. By embracing research, listening to experts, and reflecting on our attitudes, we can begin to build a society that truly values and respects its older members. The transformation is not a distant goal; it’s a present opportunity. Let’s commit to a world where aging is celebrated, where every stage of life is valued, and where every individual is respected for who they are, not just their age. Together, we can craft a new narrative of aging—one that recognizes the dignity, contribution, and potential of older adults and enriches our communities for all generations.


This article advocates for a transformative view of aging, shifting from stereotypes of decline to a narrative of appreciation and respect. It delves into the pervasive impact of ageism, as highlighted by experts like Lisa Borrero and supported by research from Jina Han, showing how societal attitudes significantly affect the mental and physical well-being of older adults. The article emphasizes the power of self-perception in aging, citing studies by Dana Kotter-Grühn that link positive self-views to better health and longevity. It also explores the role of society and environment in shaping these perceptions, with Julia K Wolff’s research indicating how regional aging demographics influence individual attitudes. The article champions the use of counter-narratives, as shown in Deirdre A Robertson’s study, to challenge stereotypes and promote a more vibrant, productive view of aging. Concluding with a call to action, it urges a collective effort to reshape how we view and treat aging, emphasizing education, policy, and media representation as key tools in this transformative journey.


  1. Borrero, L. (2023). Transforming the Narrative About Aging. Psychology Today. Retrieved December 22, 2023, from https://www.psychologytoday.com/us/blog/aging-redefined/202302/transforming-the-narrative-about-aging
  2. Han, J. (2015). The relationships among perceived discrimination, self-perceptions of aging, and depressive symptoms. Aging & Mental Health, 19(8). https://doi.org/10.1080/13607863.2014.962005
  3. Kotter-Grühn, D. (2009). Self-perceptions of aging predict mortality and change with approaching death. Psychology and Aging, 24(3). https://doi.org/10.1037/a0016510
  4. Wolff, J. K. (2018). Regional Impact of Population Aging on Changes in Individual Self-Perceptions of Aging: Findings From the German Ageing Survey. The Gerontologist, 58(1). https://doi.org/10.1093/geront/gnx058
  5. Robertson, D. A. (2017). In the eye of the beholder: Can counter-stereotypes change perceptions of older adults’ social status? Psychology and Aging, 32(6). https://doi.org/10.1037/pag0000199

Navigating the Later Years: The Evolving Landscape of Aging in Place in America

In the twilight of life, the concept of ‘home’ takes on a profound significance. As the American population ages, with more people expected to be over 65 than under five by 2030, the question of where older adults live and how they receive care is not just a matter of personal choice but a significant societal concern. This article delves into the current trends, challenges, and innovations shaping the way older adults live in the United States, with a particular focus on the growing preference for aging in place.

The Heart of the Matter: What Does Aging in Place Really Mean?

“Aging in place” isn’t just a buzzword; it’s a movement. It’s about maintaining the independence and comfort of living in one’s own home for as long as possible. The National Institute on Aging defines it as staying in your own home as you get older, but it’s more than just a living arrangement. It’s about dignity, familiarity, and the profound emotional connection one has with their personal space.

However, as idyllic as it sounds, aging in place comes with its own set of challenges. The National Institute on Aging advises that “living at home as you age requires careful consideration and planning.” This isn’t just about medical care. It’s about adapting homes for safety, securing personal and health care support, and ensuring ongoing access to community and services.

The Reality of Aging in America

The landscape of aging in America is as diverse as its population. A study published in Health Affairs highlights a pressing issue: “Our health care system is unprepared…” This statement reflects the growing concern among experts about the need for more comprehensive, accessible, and adaptable care solutions for the elderly.

Moreover, a recent report from the National Center for Biotechnology Information (NCBI) underscores the psychological and physical benefits of aging in place, noting that while it’s preferred by the vast majority of adults, it requires substantial community support and resources. The report suggests a holistic approach, considering not just the health but also the social and emotional well-being of older adults.

The Cost of Comfort: Financing Aging in Place

One of the most daunting aspects of aging in place is the financial burden it can impose. The National Institute on Aging candidly asks, “How much will it cost to age in place?” and rightly so. Personal funds, government programs, and private financing all play roles, but the complexity and variability of costs can be overwhelming for many families.

Health Affairs sheds light on this, emphasizing the need for a healthcare system that not only understands the unique needs of the older population but also provides the financial structures to support them. As the article suggests, a shift in policy and practice is essential to meet the growing demands.

Innovations and Solutions: Paving the Way Forward

Despite the challenges, there are glimmers of hope and innovation. Community resources, technology, and policy changes are converging to make aging in place a more viable and safe option for many. Health.gov discusses the importance of social determinants of health and how understanding these can lead to better support for older adults.

From home modifications to telehealth services, from community caregiving initiatives to policy reforms, the landscape is evolving. The key is to ensure that these innovations are accessible and equitable, truly serving the diverse needs of America’s older adult population.

In Conclusion: A Call for Thoughtful Action

As we stand on the cusp of a demographic shift, the need for thoughtful, proactive, and compassionate approaches to older adult care has never been more critical. Aging in place isn’t just a personal preference; it’s a complex societal issue that requires the collaboration of individuals, families, communities, and governments.

The journey through the later years can be one of dignity, comfort, and joy. But making that a reality for all requires not just understanding and empathy but also action and innovation. As we look to the future, let’s envision a society where aging in place isn’t just an option but a well-supported, well-respected, and well-managed choice for America’s older adults.


As the American population ages, the concept of ‘aging in place’—staying in one’s home while growing older—gains importance, reflecting a desire for independence, dignity, and comfort. This article explores the multifaceted nature of aging in place, highlighting its benefits, the challenges of adapting homes for safety and care, and the financial considerations involved. It addresses the unpreparedness of the healthcare system and the need for comprehensive solutions, including community support and technological innovations. The piece concludes with a call for proactive, compassionate approaches to elder care, advocating for a society where aging in place is a well-supported choice for America’s seniors.


  1. National Institute on Aging. (2023). Aging in Place: Growing Older at Home. Retrieved from https://www.nia.nih.gov/health/aging-place/aging-place-growing-older-home
  2. Health Affairs. (2020). Actualizing Better Health And Health Care For Older Adults. Retrieved from https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.01470
  3. National Center for Biotechnology Information (NCBI). (2022). Aging in Place. PMC. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495472/
  4. health.gov. (n.d.). Social Determinants of Health and Older Adults. Retrieved from https://health.gov/our-work/national-health-initiatives/healthy-aging/social-determinants-health-and-older-adults

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.


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.


  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.


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.


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 Later Years: Pioneering Strategies for Enhancing Well-Being in Older Adults

In the face of a demographic revolution, the well-being of older adults has emerged as a pivotal concern for societies worldwide. As we stand on the brink of 2050, with an estimated 2.1 billion older adults, predominantly residing in developing nations, the imperative to understand and enhance the well-being of this rapidly growing demographic is more pressing than ever. This article delves into the heart of pioneering research and strategies aimed at fostering well-being and positive aging among the older aduts, reflecting a paradigm shift from merely surviving to thriving in the later years.

Expanding the View: Understanding the Complex Landscape of Aging and Well-Being

The landscape of aging and well-being is far more intricate and varied than traditionally understood. Recent studies have shed light on this complexity, revealing insights that challenge many of our preconceived notions about aging. These findings are not just academic; they have profound implications for how societies prepare for an increasingly older population.

The Dual Reality of Well-being in Older Adults:

A pivotal study published in the Journal of the American Geriatrics Society has brought to light a critical aspect of this complexity. It found that while the average well-being among older adults tends to remain relatively stable over time, the disparity in well-being between individuals is growing. This means that while some older adults enjoy high levels of well-being, others experience significant challenges. Interestingly, this growing inequality in well-being is observed globally but is less pronounced in high-income countries. This suggests that economic factors, along with social and health policies, play a significant role in determining the well-being of older adults.

Navigating Demographic Shifts:

As we navigate the demographic shift toward an older population, it’s becoming clear that we’re not just facing challenges; we’re also encountering unique opportunities. The increase in the older adult population can lead to a wealth of experience and knowledge that can enrich communities. However, it also calls for a reevaluation of various societal sectors to ensure they are equipped to meet the changing needs.

Implications for Society and Policy:

The findings from recent research compel us to examine closely several critical sectors:

  1. Health Care: There’s a need for health systems that not only treat illnesses but also focus on maintaining and enhancing well-being. This includes preventive care, mental health services, and support for managing chronic conditions.
  2. Migration Trends: As people age, their location preferences and needs may change. Understanding these trends can help in planning age-friendly communities and services.
  3. Employment Patterns: With many older adults living healthier for longer, there’s potential for extended working lives and new career phases. Societies might need to rethink retirement ages, job training, and workplace accommodations.
  4. Social Safety Nets: Adequate social support systems are crucial for ensuring that older adults can live with dignity and security. This includes pension systems, access to affordable housing, and community support services.

Positive Aging: A Multifaceted Approach

In recent years, the concept of positive aging has emerged as a transformative approach, advocating for a comprehensive understanding of the aging process. This perspective doesn’t just focus on the physical aspects of growing older but encompasses a broader spectrum of factors that contribute to a fulfilling and vibrant later life. It’s about shifting the narrative from aging as a period of decline to one of opportunity and continued growth.

At the heart of positive aging is the recognition of its multidimensional nature. It’s not just about maintaining physical health but also about nurturing cognitive abilities, staying active, managing emotional well-being, and ensuring a robust level of physical fitness. Each of these dimensions plays a crucial role in the overall quality of life as one ages.

Liora Bar-Tur, in an insightful article from PubMed Central, captures the essence of this approach by describing positive aging as “a broad set of biopsychosocial factors.” This means that positive aging is influenced by a complex interplay of biological, psychological, and social elements. Biological factors might include genetics and physical health, psychological factors encompass mental health and cognitive abilities, and social factors involve relationships and community engagement. Together, these elements provide a comprehensive view of what it means to age well.

To assess how well an individual is aging positively, both objective and subjective indicators are used. Objective indicators might include measurable factors such as blood pressure, mobility, or cognitive function tests. Subjective indicators, on the other hand, are based on personal perceptions and might involve questions about life satisfaction, happiness, or perceived quality of life.

Central to the concept of positive aging is the Mental Fitness Program for Positive Aging (MFPPA). This innovative program is designed to enhance older adults’ quality of life by fostering their vital involvement and active engagement in life. It’s not just about adding years to life but about adding life to years. The program encourages seniors to engage in activities that stimulate their minds, maintain their physical health, nurture their emotional well-being, and stay connected with their communities. By doing so, it aims to empower older adults to lead fulfilling lives, filled with purpose, joy, and continued personal growth.

In essence, positive aging is about embracing the later years as a time of potential and possibility. It’s a holistic approach that recognizes the diverse experiences of aging and seeks to optimize well-being at every level. As we continue to explore and understand this multifaceted concept, we open the door to a more supportive, empowering, and positive view of aging.

Strategies for a Better Tomorrow

The journey toward enhancing the well-being of older adults is a dynamic and multifaceted endeavor, characterized by a range of innovative strategies and interventions. These approaches are designed not just to address the challenges associated with aging but also to capitalize on the opportunities it presents. The goal is to shift the paradigm from merely managing decline to actively promoting a thriving and fulfilling later life.

Comprehensive Assessments in Primary Care:

One of the foundational strategies involves comprehensive assessments in primary care settings. These assessments are far more than routine check-ups. They are detailed evaluations that look at a wide range of factors affecting an older person’s health and well-being. This includes physical health checks, cognitive function tests, emotional well-being assessments, and social support systems reviews. By taking this holistic approach, healthcare providers can develop personalized care plans that address the unique needs and circumstances of each individual, ensuring that they receive the most effective and appropriate support.

Promoting Positive Health Programs:

In addition to comprehensive assessments, there’s a growing emphasis on promoting positive health programs. These initiatives are designed to empower older adults to take an active role in maintaining and enhancing their health and well-being. They might include exercise classes tailored to various mobility levels, nutrition workshops, cognitive training sessions, and mental health support groups. These programs not only help to improve physical and mental health but also provide opportunities for social interaction, reducing feelings of isolation and loneliness.

Empowering Older Adults:

A critical aspect of these strategies is empowering older adults to recognize and utilize their resources and strengths. This means helping them to identify the skills, knowledge, and experiences they have accumulated over a lifetime and finding ways to apply these assets in their current situation. It’s about encouraging them to take an active role in their health and well-being and providing them with the tools and support they need to do so effectively.

Support for Balanced Living:

As the PMC article suggests, it’s essential that “Older adults should be provided with the necessary support to maintain a good balance between their decreased physical ability and increased transcendence.” This statement highlights the need for a support system that acknowledges the physical changes that come with aging while also recognizing the potential for continued growth and development. Transcendence here refers to the ability to rise above the everyday challenges and find meaning, purpose, and joy in life. It’s about supporting older adults in a way that acknowledges the whole person — their physical, mental, emotional, and spiritual needs.

Fostering Community and Connectedness in a Digital Age

In today’s digital era, the importance of fostering a sense of community and connectedness, especially among older adults, cannot be overstated. As we navigate through an increasingly online world, the potential of modern media and the internet to transform the lives of the older adults is becoming more evident. Studies have consistently highlighted how these digital tools can be powerful allies in reducing feelings of isolation and enhancing a sense of autonomy and independence among older adults.

Reducing Isolation with Digital Tools:

Isolation and loneliness are significant concerns for older adults, often leading to various mental and physical health issues. However, the advent of modern media and the internet has opened new avenues for connection. Video calls, social media, and online communities can bring people together regardless of physical distances. For many older adults, these tools provide a lifeline to the outside world, allowing them to maintain relationships with family and friends, join interest-based groups, or even make new connections online.

Enhancing Autonomy through Technology:

Beyond just keeping in touch, technology can significantly enhance the sense of autonomy among older adults. With access to information, online services, and various tools at their fingertips, older adults can manage many aspects of their lives independently. From online shopping and virtual doctor’s appointments to accessing entertainment and educational content, the digital world offers numerous opportunities for older adults to maintain control over their lives and make informed decisions.

Teaching Fundamental Digital Skills:

To truly harness the benefits of the digital world, it’s crucial to teach older adults the fundamental techniques and skills needed to navigate it confidently. This includes understanding how to use devices like smartphones and tablets, ensuring online safety and privacy, and guiding them on how to access and use various online platforms and services. Community centers, libraries, and even family members can play a significant role in providing this education.

Promoting Optimism and Meaningful Participation:

Equipping older adults with digital skills does more than just open up a world of convenience; it can lead to greater optimism and a renewed sense of purpose. Being able to connect with others, pursue interests, and continue learning can significantly enhance their overall quality of life. Whether it’s joining a virtual book club, participating in online forums, or sharing their wisdom and stories with younger generations, there are endless ways for older adults to engage meaningfully with their communities and the wider world.

Looking Ahead: Navigating the Complexities of Aging and Well-Being

As society progresses, the complexities of aging and well-being become increasingly apparent. It’s evident that the traditional one-size-fits-all approach is no longer sufficient to meet the varied needs of the older population. The diversity in experiences, health conditions, cultural backgrounds, and personal preferences among older adults calls for a more nuanced and tailored approach to care and support. This section expands on the challenges and opportunities we face as we strive to enhance the well-being of older adults.

Tailored Interventions for Diverse Needs:

Research consistently underscores the necessity for interventions that are as unique as the individuals they aim to support. Older adults are not a homogeneous group; their needs vary widely based on a multitude of factors. Some may require assistance with physical health issues, while others might need support for mental well-being or social isolation. Tailored interventions consider these diverse needs, offering personalized strategies that can range from physical activity programs and nutritional advice to cognitive therapies and social engagement activities. By customizing these interventions, we can provide more effective support that truly resonates with the individual needs of each older adult.

Shifting the Focus from Illness to Wellness:

A significant shift in perspective is needed in how we view aging and well-being. As highlighted by recent studies, the focus in psychological research and interventions should transition from illness to wellness. This means moving away from solely treating diseases and ailments to promoting overall health, happiness, and fulfillment. It’s about proactive prevention, enhancing quality of life, and encouraging older adults to engage in activities that bring joy, purpose, and connection. This wellness-focused approach not only improves the individual lives of older adults but also reduces the long-term burden on healthcare systems.

Embracing a Community-Centric Approach:

The role of the community is paramount in supporting the well-being of older adults. A community-centric approach involves creating supportive, age-friendly environments where older adults can thrive. This includes accessible healthcare services, opportunities for social interaction, safe and comfortable living conditions, and avenues for continued learning and engagement. Communities can foster intergenerational connections, encourage volunteerism, and provide platforms for older adults to share their knowledge and skills, further enhancing their sense of purpose and belonging.

The Imperative to Foster Well-Being:

As the global population ages, the imperative to foster well-being among older adults has never been more critical. We stand at a crossroads where the decisions we make today will significantly impact the lives of millions of older individuals. By combining ongoing research, innovative strategies, and a community-centric approach, we have the opportunity to transform the later years into a period of growth, fulfillment, and active engagement.

As we continue to push the boundaries of what it means to age positively, we must recognize and celebrate the journey of each older adult from merely surviving to thriving. This journey is a testament to the resilience and potential that lies within every individual, regardless of age. By addressing the challenges and seizing the opportunities ahead, we can ensure that the later years are not just a time of life but a time for living to the fullest.


As the global population ages, with an estimated 2.1 billion older adults by 2050, understanding and enhancing their well-being is crucial. This article explores research and strategies for positive aging, advocating a shift from survival to thriving in later life. It highlights the rise of well-being inequality, except in high-income countries, and the need for a multifaceted approach to aging that includes health, cognition, activity, affect, and fitness. Central to this is the Mental Fitness Program for Positive Aging, aiming to improve life quality through active engagement. The article also emphasizes the importance of community and technology in reducing isolation and enhancing life quality. As we face the complexities of aging, tailored interventions and a focus on wellness over illness are key to transforming the later years into a period of growth and active engagement.


  1. Fischer, K. (n.d.). Study probes well-being in older adults — and how it differs globally. McKnight’s Long-Term Care News. Retrieved December 22, 2023, from https://www.mcknights.com/news/clinical-news/study-probes-well-being-in-older-adults-and-how-it-differs-globally/
  2. Bar-Tur, L. (2021). Fostering Well-Being in the Elderly: Translating Theories on Positive Aging to Practical Approaches. Frontiers in Medicine, Lausanne. PubMed Central (PMC). Retrieved December 22, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8062922/
  3. Huang, D., Wang, J., Fang, H., Wang, X., Zhang, Y., & Cao, S. (2022). Global research trends in the subjective well-being of older adults from 2002 to 2021: A bibliometric analysis. Frontiers in Psychology. PubMed Central (PMC). Retrieved December 22, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9500504/

Navigating the New Workforce: Understanding and Embracing the Rise of Gen Z

In the ever-evolving landscape of the modern workplace, a seismic shift is on the horizon. Generation Z, a cohort defined by its technological fluency and progressive values, is set to overtake older adults in the U.S. workforce by 2024, according to a recent Glassdoor trend forecast report. This demographic shift is not just a numerical change; it’s a transformation that carries “pretty sweeping implications for what employers prioritize,” as noted by Glassdoor chief economist Aaron Terrazas.

The Gen Z Influence: A New Era in the Workplace

The ascent of Generation Z into the workforce heralds a transformative era, one characterized by a set of values and expectations starkly different from their predecessors. Having grown up amidst political turmoil and the Covid-19 pandemic, Gen Z enters the professional world with a unique perspective. They are not just looking for a job; they are seeking roles that allow them to make an impact, with a preference for employers demonstrating a strong social conscience, upward mobility, and creative opportunities.

For instance, in the realm of older adults care nursing, this translates to a desire for roles that go beyond traditional caregiving. Gen Z nurses might seek positions where they can implement innovative care strategies, participate in policy advocacy for older adult health issues, or engage in community outreach programs that enhance the well-being of older adults. They might be drawn to employers who support continuous learning and offer opportunities to specialize in gerontology or palliative care, reflecting their aspiration for upward mobility and specialization.

A study on illegitimate tasks and work withdrawal behavior among Generation Z employees reveals a critical insight: Gen Z is sensitive to tasks they perceive as illegitimate or beneath their qualifications, leading to higher turnover or disengagement. This finding underscores the need for employers to align job roles and responsibilities with Gen Z’s expectations and values to maintain a motivated and engaged workforce.

In the context of older adult care nursing, this could mean reevaluating job descriptions and duties to ensure they are meaningful and align with Gen Z’s values. For example, a Gen Z nurse might find it disengaging to perform repetitive administrative tasks that could be automated or streamlined. Instead, they would find value in roles that allow them to interact meaningfully with patients, contribute to treatment planning, and participate in interdisciplinary teams to improve patient outcomes.

Employers might also consider offering rotational programs where Gen Z nurses can experience different aspects of older adult care, from in-home care settings to specialized dementia units, to align with their desire for diverse experiences and continuous growth. Providing platforms for Gen Z nurses to lead or contribute to projects, such as developing new care protocols or community health initiatives, can also satisfy their need for creativity and impact.

In embracing the Gen Z influence, older adult care facilities and healthcare organizations must recognize and adapt to these new expectations. By doing so, they can foster a work environment that not only attracts and retains this new generation of healthcare professionals but also enhances the quality of care provided to older adults. As Gen Z nurses bring their tech-savviness, empathy, and innovative thinking to the forefront, the potential to revolutionize older adult care and create a more holistic, patient-centered approach is immense.

Adapting to Change: What Employers Need to Know

As Generation Z becomes a more dominant force in the workforce, particularly in critical sectors like older adult care, employers must adapt to accommodate their distinct needs and preferences. The traditional hierarchical structures and rigid work environments are unlikely to appeal to this new generation of workers. Instead, they value flat organizational structures, seek meaningful engagement, and prefer flexible work arrangements that allow for a healthy work-life balance.

For example, in eldercare nursing, a flat organizational structure might mean more collaborative decision-making processes where Gen Z nurses feel their opinions and insights are valued and considered in patient care strategies. This could involve regular team huddles where all staff, regardless of rank, are encouraged to share ideas and feedback. Employers might also establish nurse-led councils that empower Gen Z nurses to spearhead initiatives or improvements in patient care.

Meaningful engagement for Gen Z in older adult care could involve opportunities to connect with patients on a deeper level. This might include assigning nurses to the same patients over time to build relationships and provide continuity of care, or creating roles focused on patient advocacy and family liaison, which allow nurses to work closely with patients’ families and other healthcare providers to coordinate holistic care.

Flexible work arrangements are particularly crucial in the demanding field of nursing. Employers might offer Gen Z nurses more control over their schedules, such as self-scheduling systems, flexible shift options, or part-time positions that allow for a better work-life balance. Some facilities might explore job-sharing arrangements or offer opportunities for remote work in roles that don’t require direct patient care, such as case management or telehealth services.

However, this doesn’t mean Gen Z is shying away from in-person interactions. Studies show that despite their digital nativity, many Gen Zers favor face-to-face interactions, albeit in more flexible settings like coffee shops or co-working spaces. This paradoxical preference highlights the complexity of catering to this generation’s needs and the importance of offering diverse and adaptable working environments.

In older adult care, this might translate to creating more welcoming and versatile staff areas that mimic the comfort of a coffee shop or co-working space, where nurses can relax, collaborate, or catch up on administrative tasks. Employers might also consider how technology can facilitate better in-person care, such as using tablets or mobile devices to allow nurses more mobility and time with patients instead of being tethered to a stationary nursing station.

Additionally, providing opportunities for Gen Z nurses to engage in community outreach or health education programs can offer the in-person interaction they crave while also promoting public health and strengthening the bond between healthcare providers and the communities they serve.

In adapting to these changes, it’s crucial for employers in older adult services to recognize the unique blend of digital fluency, desire for meaningful work, and need for flexibility that characterizes Gen Z. By creating a supportive, adaptable, and collaborative work environment, older adult centers can not only attract and retain this new generation of nurses but also enhance the quality of care and innovation in the services they provide.

Leadership and Development: Key to Retention

In the realm of nursing and services for older adults, one of the most critical areas for employers to focus on is leadership and development. The study “Improving Millennial Employees’ OCB” provides valuable insights that can also be applied to Gen Z. It found that ethical leadership positively predicts Organizational Citizenship Behavior (OCB), with the mediating effects of ethical climate and affective well-being playing significant roles. This suggests that Gen Z, much like Millennials, will respond positively to ethical, transparent, and supportive leadership.

For instance, in older adult care settings, ethical leadership might manifest as administrators who not only uphold high standards of patient care but also actively advocate for the well-being and professional growth of their staff. This could involve implementing transparent communication channels where nurses feel heard and respected, or establishing ethical guidelines that ensure patients and staff are treated with dignity and compassion.

Moreover, continuous feedback and professional development opportunities are non-negotiable for Gen Z. They are not afraid to leave a job where they feel undervalued or where their growth is stifled. In older adult care, this might mean offering regular one-on-one meetings with supervisors where nurses can discuss their career goals, receive constructive feedback, and map out a clear path for advancement. It could also involve providing access to continuing education courses, workshops, and seminars that keep staff updated on the latest in older adult care research, technology, and best practices.

As noted in the research examining job satisfaction among millennial nurses, fostering a workplace that nurtures empathy, respect, and continuous learning is crucial for retention and engagement. In practical terms, this could translate to mentorship programs where experienced nurses guide newer staff, sharing knowledge and offering support as they navigate the complexities of older adult care. It might also involve recognizing and rewarding staff who go above and beyond in their care for patients, whether through formal awards, bonuses, or simple acknowledgments in team meetings.

Creating a culture of continuous learning and improvement can also be achieved through regular team debriefs where staff can collaboratively discuss what went well and what could be improved in their care delivery. This not only fosters a sense of team cohesion and mutual support but also encourages a proactive approach to enhancing the quality of care.

In essence, for older adult care centers and service providers for older adults, investing in ethical, supportive leadership and robust development opportunities is not just a strategy for retention; it’s a commitment to creating a work environment where Gen Z nurses and caregivers can thrive, grow, and continue to provide compassionate, high-quality care to the older adults they serve. By doing so, employers not only retain their workforce but also enhance the overall standard of care and well-being for both staff and patients alike.

Conclusion: Embracing the Future

The rise of Generation Z in the workforce, particularly in sectors like older adult care nursing and services for older adults, represents not a challenge but a profound opportunity. It’s a chance for healthcare centers, nursing homes, and service providers to innovate, to redefine their corporate cultures, and to build a more dynamic, inclusive, and forward-thinking workplace. By understanding and embracing the values and expectations of Gen Z, employers can unlock a new wave of productivity, creativity, and growth.

For example, in older adult care, embracing the future might mean integrating technology in ways that resonate with Gen Z’s digital fluency. This could involve using advanced health monitoring systems that allow for more efficient patient care or adopting communication platforms that enable staff to collaborate more effectively and share insights in real-time.

Redefining corporate culture in older adult care could involve creating more inclusive and diverse environments that reflect the values of Gen Z. This might mean actively promoting diversity in hiring, providing cultural competency training to staff, and ensuring that all patients, regardless of their background, receive care that is respectful and sensitive to their needs.

Building a dynamic and forward-thinking workplace in older adult care also means being open to new ideas and innovations. Employers can encourage Gen Z staff to contribute their perspectives and suggestions, perhaps through regular innovation labs or brainstorming sessions where all team members are invited to propose new ways to enhance patient care and operational efficiency.

By embracing these changes, older adult care centers and service providers can not only attract and retain Gen Z talent but also improve their services and care for older adults. This generation’s drive for meaningful work, their technological savvy, and their fresh perspectives can lead to improved patient outcomes, more efficient operations, and a more positive and supportive work environment for all staff.

As we stand on the brink of this new era, the message is clear: adapt, engage, and thrive. The future belongs to those ready to embrace the change. For older adult care providers, this means recognizing the unique contributions Gen Z can make, valuing their input and ideas, and creating a workplace that not only meets their needs but also leverages their strengths. In doing so, the sector can ensure that it not only survives but thrives in the years to come, providing compassionate, innovative care to the older adults who depend on it.


The entry of Generation Z into the workforce, especially in eldercare nursing and services for older adults, is a pivotal opportunity for innovation and cultural transformation. Gen Z’s unique values, technological fluency, and desire for meaningful work necessitate a shift from traditional hierarchical structures to more inclusive, flexible, and collaborative work environments. Employers must adapt by offering ethical leadership, continuous development, and opportunities for meaningful engagement. Embracing these changes will not only attract and retain Gen Z talent but also enhance the quality of care and service for older adults, ensuring a dynamic, productive, and compassionate future in eldercare.


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  2. Fan, P. (2023). Do Illegitimate Tasks Lead to Work Withdrawal Behavior among Generation Z Employees? Behavioral Sciences (Basel, Switzerland), 13(9). Retrieved December 22, 2023, from https://pubmed.ncbi.nlm.nih.gov/37753980/
  3. Waltz, L. A. (2020). Exploring job satisfaction and workplace engagement in millennial nurses. Journal of Nursing Management, 28(3). Retrieved December 22, 2023, from https://pubmed.ncbi.nlm.nih.gov/32068932/
  4. Hedden, L. (2020). Modern work patterns of “classic” versus millennial family doctors and their effect. Human Resources for Health, 18(1). Retrieved December 22, 2023, from https://pubmed.ncbi.nlm.nih.gov/32958028/
  5. Su, W. (2021). Improving Millennial Employees’ OCB: A Multilevel Mediated and Moderated Model. International Journal of Environmental Research and Public Health, 18(15). Retrieved December 22, 2023, from https://pubmed.ncbi.nlm.nih.gov/34360430/

Engage with® Reflects on a Milestone Presentation at LeadingAge 2023

At Engage with®, we’re still buzzing from the exhilarating experience at the LeadingAge 2023 Annual Meeting, held in the vibrant city of Chicago at McCormick Place from November 5-8, 2023. It was our honor to have Amanda Krisher, LCSW-C, our esteemed Senior Director, share her expertise in a presentation that resonated deeply with over 100 long-term care leaders.

The session, titled “Evidence-Based Workforce Training: A Tool to Tackle Turnover,” held on November 6th, was a proud moment for our team. Amanda, alongside Coley Rainbolt, a Nursing Home Administrator at Wind Crest, showcased the transformative power of our evidence-based workforce training programs through sharing Wind Crest’s long-term outcomes and inspiring success stories.

Highlights That Made Us Proud:

  1. Impressive Outcomes: Amanda’s presentation highlighted the compelling results from three independent studies, focusing on the impressive outcomes in Colorado. Additionally, during this presentation, Coley shared with participants that an astounding 78% of Wind Crest trained staff members remained employed for over a year post-training, a testament to the effectiveness of the Engage with® Skills Training programs.
  2. Setting Industry Standards: The success story of Wind Crest, with its remarkably low vacancy rate, was a highlight. This accomplishment is a direct reflection of the positive impact of our training methodologies in real-world settings.
  3. Empowering Tools for the Industry: We were thrilled to introduce LeadingAge conference participants to our free membership workforce toolkit during the session. This toolkit, featuring a turnover cost calculator, CMS-created surveys, competency assessments, and a resource library, is our contribution to empowering long-term care leaders across the nation tackling turnover.
  4. Extending Our Support: The session concluded with an invitation to explore more about our training outcomes and opportunities. We’re always here to support organizations who engage with and/or support older adults to enhance their workforce training strategies.

Our heartfelt gratitude goes to the organizers and supporters of LeadingAge 2023 for providing us with this platform. Having Amanda represent Engage with® was not only an honor but also an opportunity to connect with and contribute to the broader community of long-term care professionals.

We left the event inspired and motivated, knowing that our efforts in workforce training are making a real difference. The conversations we had, the connections we made, and the feedback we received have been invaluable.

At Engage with®, we remain committed to advancing workforce training in long-term care. We believe that our methods can significantly reduce turnover rates and improve staff satisfaction, ultimately leading to better care for residents. The LeadingAge 2023 Annual Meeting was a significant milestone in our journey, and we’re excited about the future as we continue to innovate and support those we care for and engage with older adults at every stage of their aging journey.