Sarah Thomas | Nexus Insights

When an older adult experiences a crisis that requires post-acute or long-term care services and supports, they and their caregivers must make critical decisions, fast. What awaits them, however, is a maze of dead ends and poor information that stand in the way of getting the help they need.

“Older adults and their families enter a maze of twists and turns, dead ends, and wrong way streets when a life crisis forces them to consider their care options. Critical decisions about long-term care must be made quickly, with scarce information or resources, let alone supportive guidance to assist them in their time of crisis.” – Bob Kramer, founder of Nexus Insights

In February 2022, Nexus Insights hosted their inaugural ‘Nexus Voices’ session with 18 leading experts in the fields of aging policy, long-term care, senior housing and caregiver advocacy to talk through and tackle this issue.

The Outcome: A Nexus Voices Report

The result is the recently published report, “Where Am I, Where Do I Go: The Missing Entry Point to Long-Term Care Solutions for Older Adults and Their Caregivers”. This comprehensive and actionable report highlights the lack of infrastructure to help guide older adults and their families to long-term care services. The report proposes “Navigation Hubs” to help families understand their long-term care needs and select the best options for them. These hubs would serve as central doorways to existing supports and services—whether it’s home-based care, transportation or meal services, senior housing or nursing home care. The hubs would have a national presence but a hyper localized focus with counselors, or navigators, who understand the resources available in their communities and how to help older adults and their families access them.

“The factors that shape care decisions vary from family to family, but all families need an easy-to-use, accessible hub of information that clearly communicates the options that are available to them in their community,” said Anne Tumlinson, CEO of ATI Advisory and a contributor to the report. “With a growing number of older adults needing care, we have to act now to build the care infrastructure families need.”

Discussion participants outlined four primary responsibilities of the Navigation Hubs. They are:

Discover & Assess the long-term care needs of older adults, their families, and caregivers.
Educate older adults, their families and caregivers on the housing and caregiving support available to them as well as funding sources.
Select & Connect older adults with the best long-term care setting, supports, and services that meet their needs.
Reevaluate the needs of older adults as their health and financial statuses change.

“You can’t solve a problem until you’ve identified it and defined it,” said Kramer.

“Then you’ve got to define what are the key components of any solution. And we’ve laid that out with the navigation hubs and their four functions. And then we asked what we could learn from the failures and the successes of programs to date, to create our criteria. Finally, the path forward must be a joint effort involving both the public and private sectors. We demonstrated that there are aspects of differing programs from government-funded resource centers to tech-enabled employer options to private-pay models that could be incorporated into this solution.”

An Urgent Problem

In its conclusions, the report urges quick and decisive action to build navigation services for older adults that put families in the center. The family in crisis needs help now and cannot wait for lawmakers and government agencies to overhaul the long-term care infrastructure. This requires a national commitment to increased funding and an openness to reimagine existing solutions. Existing public, private-pay and employer-based programs could work together to make these hubs a reality by combining their infrastructure, experience and delivery models.

The Nexus Voices Participants

Nexus Insights Host Committee

David Grabowski, PhD, professor, Harvard Medical School, fellow, Nexus Insights
Bob Kramer, founder & fellow, Nexus Insights, co-founder, former CEO & strategic advisor, National Investment Center for Seniors Housing & Care (NIC)
Caroline Pearson, senior vice president, health care strategy, NORC at the University of Chicago, fellow, Nexus Insights
Sarah Thomas, CEO, Delight by Design/MezTal, fellow, Nexus Insights
Anne Tumlinson, CEO, ATI Advisory, fellow, Nexus Insights

Discussion Participants

Gretchen E. Alkema, PhD, former vice president, policy and communications, The SCAN Foundation
Alice Bonner, PhD, senior advisor for aging, IHI, and adjunct faculty, Johns Hopkins University School of Nursing
Ryan Frederick, founder & CEO, Smart Living 360, fellow, Nexus Insights (facilitator)
Lindsay Jurist-Rosner, CEO, Wellthy
Ruth Katz, senior vice president for policy, LeadingAge
Sean Kelly, president & CEO, The Kendal Corporation
Suzanne Kunkel, PhD, executive director, Scripps Gerontology Center, Miami University
Katy Lanz, chief strategy officer, Personal Care Medical Associates
Brian Petranick, group president, Neighborly
Cheryl L. Phillips, M.D., president and CEO, Special Needs Plan Alliance
Paul Saucier, director, Office of Aging & Disability Services, Maine Department of Health and Human Services
John Schall, CEO, Caregiver Action Network
Bill Thomas, chief independence officer, Lifespark, fellow, Nexus Insights

Read the Long-Term Care Access Report

Read the full report
Read the executive summary
Read the press release

Nexus Insights

Nexus Insights is the online home for Bob Kramer’s thought leadership on all aspects of aging, including housing, caregiving, healthy longevity and ageism.

www.nexusinsights.net

“They’re coming for our space,” said Sarah Thomas, CEO of Delight by Design, and a Nexus Insights Fellow. Thomas is an accomplished leader of innovation and a global aging expert, advising startups, large corporations and investors. “Those of us in senior living and senior care need to lift our heads to see what’s coming. We need to see how we can be part of creating what’s ahead of us.”

Thomas recently joined Bob Kramer, Founder & Fellow at Nexus Insights and Co-founder and Strategic Advisor for NIC, for a conversation on Senior Living Foresight TV, entitled “Let’s Quit Talking to Ourselves: Moving the Conversation Outside Senior Living.”

The two discussed the increasing presence of investors and large corporations in the aging industry. Kramer and Thomas agreed that outside companies can be perceived as threats. But a wiser approach, they advise, is to see opportunities for productive partnerships.

“We must elevate our voice to be heard beyond our own walls,” said Thomas. “If we don’t want to partner with them, we may be replaced. So we need to look at what is not our domain expertise, and to identify gaps and consumer expectations that we’re not meeting.” Kramer agreed, observing that larger companies have greater logistical support, and greater expertise in certain domains. The key is to look for partners who can help close those gaps.

“We must elevate our voice to be heard beyond our own walls.” – Sarah Thomas

Thomas and Kramer discussed the importance of ageism, which is everywhere, and impacts everyone, and not just the older demographic. Thomas’s consulting work includes helping investors understand the marketplace, and to see the true needs and not the perceived needs “that are often misperceived,” and based on ageist ideas and stigmas. The two agreed that communities need to know their own value proposition, and to know how to communicate it, if they want to have a bigger seat at the table.

The discussion also touched on the value of universal design. “If we’re designing for all instead of designing for old, then we have beautiful designs that are also functional,” Thomas explained. Her experience includes work with the integration of robotics and fashion. The lesson for the aging industry, she suggested, is that beautiful designs help accelerate the adoption of new ideas, a philosophy that should be applied to senior living and senior care.

The two also talked out the potentially lasting impact of the pandemic on the industry. “The pandemic reinforced the idea that senior living is all about care,” Kramer said. “Ultimately we have to offer an experience that is aspirational, that is about a sense of belonging, about the joy of being alive, and not just making it through the day.”

See the whole conversation: