OpenIDEO is an open innovation platform. Join our global community to solve big challenges for social good. Sign Up / Login or Learn more

Conversations, Yes -- but Practical Help Also, Especially for the Long Course of Chronic Conditions in Old Age

Take waste from Medicare, invest it in supportive services, so people can count on food, shelter, hygiene, and relationships when old, frail

Photo of Joanne Lynn
1 0

Written by

1. Recognize that a years-long period of declining capabilities in old age has become the most common path to death, not "terminal illness."

2. Ensure that elders and families have their priorities and possibilities recognized in the plan for therapies and services - an elder-driven care plan

3. Change medical care to adopt geriatric principles - slow changes, astute diagnosis, weighing of the burden of treatments, mobilizing services to the home, avoiding drugs with side effects, and making decisions in light of the elder's priorities.

4. Enhance the ready availability of supportive services - home-delivered food, disability-adapted housing, door-to-door transportation, support for volunteer caregivers, and keeping the elder engaged in the community.

5. Since so much of what matters depends upon the local community (not the payer or medical care provider), we need a new layer of community engagement with monitoring progress and managing their local system, and this includes setting priorities for investments.

6. At this time in the U.S., these reforms can be financed from the savings that prudent medical care will earn, compared with what Medicare now spends.  In the long run, we need communities to be proud of their eldercare and comparing performance over time and with other communities, but to start, we just need the will to move ahead.

What is a provocation or insight that might inspire others during this challenge?

Tell stories about long dependency in old age and the effect upon elders and families. We have almost no stories of this part of life - not in the movies, newspapers, or on-line. People think they will get a "terminal illness" and die, but that is no longer true. We will mostly live a long time disabled and worsening. Needs and the costs must come "out of the closet" and build political power.

Tell us about your work experience:

I have attended more than 2000 people who died--about half in conventional care and hospice, and half in long-term care. I have learned much from their suffering and their joys. LTC is the challenge.

1 comment

Join the conversation:

Photo of OpenIDEO

Great to have you onboard! We noticed your post is currently unpublished. Was this your intention? We'd love to have it be included in the challenge. You can publish it by hitting the "Publish" button at the top of your post. You can also update your post by clicking on the "Edit Contribution" on top. We're looking forward to seeing your contribution in this challenge.