Saturday, February 14, 2009

Part I: Senior Healthcare | Helping our elders live independently for longer in their home environment

With the US elderly population potentially doubling by 2030 from 36 million to 72 million; an estimated 45% drop in formal or professional caregivers over the next 30 years; and a national health expenditure projected to rise from $2T in 2005 to an estimated $4.1T by 2016, it's clearly become a necessity to think innovatively around services for our growing senior citizen population. Currently, 78% of all at-home, long-term care is provided by informal caregiving networks i.e. friends and family members. As seniors push to live independently for longer in their home environment, the effort on the part of these caregivers creates enormous responsibility and even burden, which in the end may not be sustainable. With a growing senior population living longer, the strain on dwindling financial and caregiving channels, we may find ourselves at a breaking point very soon.

Right now, there's considerable effort going into rethinking how services could and should be provided. We're starting to consider new distribution models for federal dollars as well as some intriguing ideas around co-operative services between seniors' social and local networks. Below is a summmary of a case study sponsored by Harvard's Kennedy School: Ash Institute for Democratic Governance and Innovation. The study looks at a new distribution of federal dollars in China.

The government created "Purchasing Services for Senior Citizens at Home," to ameliorate the difficulties of older persons living alone. Rather than involving itself in the details of providing services to the elderly, the government supported creation of this program to manage daily operations. It secured cooperation with local civil organizations and subsidized them for performing functions that were previously carried out by government. It has been successful since inception as it is grounded in extensive social participation.

Services are now "purchased" by either individuals or enterprises. Many elderly do not pay at all; the services are "purchased" for them. The word "purchase" is used uniquely, as purchasing is often entirely subsidized by the government. Any qualified senior can receive one hour of services at government expense. Seniors who do not meet the requirements for services can still participate as many services are offered by volunteers. Those who can afford to purchase services may choose to buy additional services on their own. Additionally, an emergency telephone number "81890" is available for older people who live alone.

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