By Geralyn Magan
It’s been a busy year for the LeadingAge LTSS Center @UMass Boston. Here’s an overview of our accomplishments during 2018.
2018 was marked by successful endings and promising beginnings at the LeadingAge LTSS Center @UMass Boston. Researchers published findings from 6 major research studies, began work on 4 new studies, and served as thought leaders in several areas affecting both consumers and providers in the field of long-term services and supports (LTSS).
In addition, we established our digital presence on the Internet through our new LTSScenter.org website, laid the groundwork for a biennial survey of LeadingAge members that will begin next spring, and continued work on several ongoing, multi-year projects.
PUBLISHED RESEARCH FINDINGS
During the past 12 months, LTSS Center fellows have published their findings from 6 research studies:
Intergenerational Programming: In February, we joined with Generations United to publish findings from the first part of a 2-part research project focused on intergenerational programing in affordable senior housing communities. Researchers documented myriad benefits of housing-based intergenerational programs, including a greater understanding among young people of issues faced by older adults, and decreased isolation and/or increased connectedness among older adults.
Comprehensive Culture Change: LTSS Center researchers found that comprehensive adoption of person-centered care and the household model can enhance interactions between nursing home residents and their care partners, improve residents’ dining experience, and reduce residents’ depressive symptoms. A research snapshot detailing the study findings was released in June.
Consumer Engagement: The LTSS Center and the Center for Consumer Engagement in Health Innovation released a case study in June examining how Massachusetts engaged consumers in the design and oversight of a new health care program serving people with disabilities who are eligible for both Medicare and Medicaid.
End-of-Life Wishes: Our study of Medical Orders for Life-Sustaining Treatments (MOLST), published this summer in the journal Geriatric Nursing, showed that the basic process of collecting information about end-of-life wishes can have a dramatic impact on the quality of information collected.
Housing Plus Services and Medicare: In August, the LTSS Center and RTI International shared findings from their evaluation showing that Support and Services at Home (SASH), a housing plus services program in Vermont, slowed growth in total Medicare expenditures for some of its participants. The findings appeared in the journal Cityscape.
Foreign-Born Workers: Foreign-born nurses and personal care assistants, who come primarily from developing countries, bring myriad benefits to the LTSS organizations that employ them and the care recipients they serve, according to findings from a study released in August. Three reports explore those benefits, identify challenges associated with hiring foreign-born LTSS workers, explore strategies to address those challenges, and provide an overview of global migration patterns and policies.
NEW AND CONTINUING GRANTS
During 2018, the LTSS Center continued our important work to help implement HUD’s 3-year Supportive Services Demonstration, explore financing options for service programs in affordable senior housing communities, evaluate a housing plus services model at Hebrew SeniorLife, assess the financial challenges facing middle-income elders, and engage older consumers in applied research.
We also began work on 4 new projects:
Geriatric Substance Abuse: The Geriatric Substance Abuse Recovery Program (GSARP) provides substance abuse counseling to older adults who come to The New Jewish Home in New York for post-acute care after a hospital stay. A 2016 study showed that the 3-year-old GSARP is helping participants address their substance abuse issues. During a new 18-month study, LTSS Center researchers will explore whether GSARP might also improve rehabilitation outcomes for program participants, among other questions.
Universal Home Care Worker Professionals: This 1-year research project will culminate in a white paper exploring the training and policy infrastructure necessary to develop a new universal home care worker family of occupations in California. The new occupation category has been recommended by the California Future Health Workforce Commission as a way to address the increasing demand for home care workers.
Contemplative Care in Nursing Homes: The LTSS Center is evaluating the impact on nursing home residents of a Contemplative Care approach developed by the New York Zen Center for Contemplative Care (NYZCCC). The evaluation will also assess the impact of NYZCCC’s Resiliency Training on nursing home staff.
Implementation of Intergenerational Programming: The LTSS Center and Generations United began a new project to support the development and implementation of high-quality intergenerational programming in senior housing communities nationwide. The project is designed to foster a broader culture of intergenerational interaction and exchange that, over time, becomes normalized in the housing setting.
THOUGHT LEADERSHIP
A large part of the LTSS Center’s work involves participating in state and national discussions about pressing issues in the LTSS field. This year, LTSS Center researchers played a prominent role in many prestigious conferences, including the Gerontological Society of America Annual Scientific Meeting in November. In addition, we’ve added our voices to deliberations about a variety of important issues:
LTSS Financing: A January report by LTSS Center Co-Director Marc Cohen and his colleagues proposes a policy roadmap for LTSS financing that combines public catastrophic insurance with gap-filling, private LTSS insurance. The authors say the plan would enhance benefits for people with long-duration impairments, reduce unmet LTSS needs, and mitigate burdens facing family caregivers.
State of Aging Policy: Later in the year, LTSS Center Co-Directors Robyn Stone and Marc Cohen contributed articles to a special issue of the Journal of Aging and Social Policy exploring the state of aging policy and politics in the Trump era. Cohen’s article explored challenges, goals, and needed reforms in the area of LTSS financing. Stone addressed the housing challenges of low-income older adults and the role of public policy.
Research Education: In November, the LTSS Center helped to develop a special issue of LeadingAge magazine focusing on how good research can inform public policy, aid self-evaluation by providers, and give older adults a vehicle to communicate their needs.
Meeting the Need for Home-Based Care: The LTSS Center is serving as a thought leader on a new study addressing ways to meet the future home-based health and personal care needs of a growing and diverse population. Center fellows are offering guidance to Massachusetts General Hospital researchers who will produce a white paper summarizing efforts to improve home care and address the sector’s unique workforce challenges.