In a corner of Lipscomb University’s Ezell Center, a skeleton crew led by Charla Long and Beverly Patnaik is juggling a host of initiatives aimed at improving the well-being of the country’s fast-growing ranks of senior citizens.
Their goal: To radically innovate our society’s approaches to caring for its oldest members, be that via government-led programs, entrepreneurial ventures or partnerships that tie in faith-based groups and other volunteers. Medical care is a part of the equation but social, nutritional and spiritual services also play an important role in their vision.
The School of TransformAging was launched in mid-2011, with care provider Tennessee Health Management signing on early to have 40 of its nursing home administrators take a combination of online and on-site instruction. The school offers a Master of Professional Studies and a graduate certificate in aging services leadership. But at the core of what Long, dean of the College of Professional Studies, and Patnaik, academic director of the School of TransformAging, are doing is the belief that a holistic and proactive approach to transitioning people into and leading them through senior care will greatly improve their quality of life, reduce their acute health events and cut costs.
Long is an attorney who focuses on service industries and spent a decade in the amusement park sector before teaching at Lipscomb. This is her second stint at the university and, after co-teaching a class with President Randy Lowry, she launched the Institute for Law, Justice and Society. Patnaik has more than three decades of experience in the field of aging issues and has been, among other things, the director of technical assistance for the Community Partnerships for Older Adults, which was funded by a $25 million Robert Wood Johnson grant.
Long and Patnaik view themselves as “neutral conveners” who can provide a productive setting for various stakeholders to exchange ideas and hash through any issues that come up. But that description sells short the number of ways in which they are working to improve care for seniors in Tennessee. The TransformAging platform today breaks down into four buckets: policy initiatives, innovation, thought and executive leadership and resources/partnerships. Here’s a rundown of what each includes.
• Long and Patnaik early this year published a report for TennCare officials that moves forward the agency’s QuILTSS long-term services and supports initiative and offers up suggestions for industry standards for various quality measures. Since then, providers, patients and advocates have huddled around Long to thrash out the details of those standards — many of which are not clinical but focused more on patient satisfaction and staff competency.
• Long chaired the The Governor’s Task Force on Aging, which in March presented a strategic plan to promote healthy aging — best characterized by seniors being able to stay in their communities — as well as creating livable communities and supporting family caregivers. Among the plan’s goals are elevating the Tennessee Commission on Aging and Disability to a cabinet-level post, developing a statewide well-being infrastructure along the lines of Healthways’ Blue Zones projects and pushing legislation that limits volunteers’ liability during transportation and expands exploitation protections.
• Leveraging their hub status, Long and Patnaik also regularly host budding businesses catering to the senior market. Among the ventures that have been put through test runs via the School of TransformAging is local start-up Evermind, which markets a system that monitors electronic appliances of people who live alone and communicates to family members if there’s a change in their everyday routine.
• Patnaik helps budding entrepreneurs run prototypes through exercises that might simulate a loss of vision or hearing, neuropathy — imagine walking with split peas in your shoes — or arthritis issues.
• Along the lines of the classic “No money, no mission” mantra, the TransformAging team derives a good bit of its funding by deploying its expertise to fix struggling treatment centers across the region. When nursing homes are put on the clock with a so-called directed plan of correction, Patnaik recruits teams to right the ship, put in place protocols, train caregivers (often using the same simulations prototypes run through) and recruit effective leaders.
• Patnaik also has drawn on her experience to land several contracts with QSource, a 41-year-old nonprofit health care quality improvement consultancy based in Memphis. Among her work there has been the development of measures used to guide care transitions, focusing on the transfer of knowledge that often doesn’t happen. The main goal there is to lower hospital readmissions costs, which QSource says totaled $113 million in the Nashville area in 2010.
• The Middle Tennessee Faith and Health Coalition has recruited 80 local church ministry groups and is training them to identify and handle nonclinical needs for seniors admitted to a facility. That can range from making hospital visits to tasks as mundane as mowing a yard or walking a dog while the patient is hospitalized.
“Lots of churches want to get involved but are unprepared to respond,” Long says. “We’re teaching them new tools, strategies and worship opportunities.”
The coalition is based on the Congregational Health Network in Memphis, which guides patients from the hospital to their homes or to rehab centers. Locally, Saint Thomas and Vanderbilt Hospital have said they will jump on board and the Tennessee Hospital Association is working to bring on other hospitals and build scale.
• Circled prominently on Long and Patnaik’s calendar is the 2014 Leading Age annual meeting, which will draw more than 8,000 people to the Music City Center in mid-October. There, they plan to host a hackathon geared to producing technology solutions for the senior living market. They’re also looking at organizing an expo to showcase providers, products and educators focusing on aging issues.
• And then there is what Long says would be “the ultimate expression of our work.”
The established neighborhoods surrounding Lipscomb’s campus form what’s called a NORC, a naturally occurring retirement community. Within 1.5 miles of campus live some 6,000 people over the age of 65, presenting Long and her team with a golden opportunity to build a system that integrates all the services they’re working on. Deploying those resources — corporate, educational and volunteer — and delivering real improvements in the quality of life for the local population would set the stage for the model to be exported and replicated.
“A lot of businesses adopt schools,” Long says. “If they would think about the older generation in the same way and embrace them, it’s amazing what we could do. We have our gifts to contribute but we do need the gifts of others to make it work.”
Corporate initiatives might include grocery stores providing discounted packaged meals or delivery services. Or, Long says, taxi operators could let neighborhoods buy blocks of time so that residents can move about the city as needed. And from within the university, students working on exercise nutrition or food sciences degrees could take their knowledge into the community.
Such an integrated approach — which includes incorporating older adults into the community as much as bringing the community to them — can help break down people’s psychological barriers, says Betsy Jones, a partner at Nashville-based Countdown Group who has worked on TransformAging projects with Long. Lipscomb is on the right track, she says, in emphasizing the spiritual, financial and social aspects of aging. It can help, she adds, to remember that many of today’s older adults were in their 20s during the 1960s.
“There’s this perception that they’re so much different than we are,” Jones says. “But if you think of the music they were likely listening to when they were of college age, it changes your perspective quite a bit.”
Changing attitudes to a degree that a NORC can get built out in Nashville will take time. But upheaval in the industry is opening the door to dialogs that can better educate all the stakeholders, says Jesse Samples, executive director of the Tennessee Health Care Association, which represents long-term care facilities.
“The playing field has changed so dramatically and there are huge opportunities for us as providers and for the state and others,” Samples says. “That’s why it’s so helpful to have providers’ eyes opened to the need to provide multiple levels of service.”
Long’s outreach to-do list remains long and the academic side of the School of TransformAging also needs work: Only about 45 people have been through the graduate degree program, a number Long says should be tripled or quadrupled to meet the market’s needs. She’s looking to tweak the curriculum to boost attention.
But when it comes to the engagement shown by other community stakeholders, Long says the initiatives she’s leading have gone way beyond her early expectations. And while the public sector does play a role here and there, she’s emphatic that truly changing how we handle the demographic tidal wave of aging will be the result of an entrepreneurial drive.
“Government is not the solution, although it can be part of a solution,” Long says. “But we cannot defer our responsibility as business leaders, community leaders and nonprofit leaders. It’s going to require all of our participation.”
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