What the Future Holds

Denmark gave us the vision of a humane system, intentionally designed to increase the functional independence of seniors living at home in their advanced years. The Federal Administration on Aging provided a programmatic lens through which to adapt highly relevant evidence-based approaches. Our challenge now is to design and implement a comprehensive system that is population-based, is composed of high traction, innovative services, and that is sustainable in light of impending changes in the policy and payment arenas.

Richard M. Krieg, Ph.D. President & CEO The Horizon Foundation

The good news about our health care system in America is that more and more of us are living longer, with the potential for a greater number of happy, productive years than were enjoyed by previous generations. The disturbing news is that, on a national level, we are just beginning to understand the implications of this medical revolution—especially the challenge of meeting the needs of older adults who are living with chronic diseases such as arthritis, asthma or diabetes. And we are only beginning to devise strategies, programs and systems that will allow this older population to take maximum advantage of their “ extra” years.

The Foundation has committed significant resources, both human and financial, to the development and refinement of Howard County’s Aging-In-Place Initiative. With our dedicated network of partners from both the public and private sector, we have been able to achieve significant momentum.

Growing local awareness of the social and economic challenges posed by an increasingly elderly population, the creation of a strong, sustainable and committed public-private partnership, the enhancement of community-wide and Office on Aging planning capabilities, the ability to maintain an active “on the ground” service delivery system, vast improvement in continuity of care, the implementation of innovative new program elements and the generation of additional resources from federal, state and local sources are some of these achievements.

Our work focuses intensely on Howard County and its residents, as it should. But we are also aware that what we do in this county—the relationships we create, the systems we build and the public awareness that generates support for meeting the needs of older residents—has important implications for the United States as a whole.

We are blessed in our communities to have an extraordinarily capable Area Agency on Aging (AAA). The Howard County Office on Aging has been the central driver and program hub for the entire initiative. Its stewardship of the process has yielded all that has been accomplished, and all that is to come. The Foundation believes that AAA oversight is critical to future model replicability in other geographic locales.

We are pleased to be able to draw on successful, evidence- based programs, such as the self-management workshops for chronic disease, that have been piloted elsewhere and to have a role in testing their potential viability as national strategies. And we hope that the pioneering work that Howard County has undertaken can also serve as a model for other cities and counties that are grappling with similar challenges.

As we proceed to embed aging-in-place strategies in our communities, the Foundation and its partners are mindful of the acute need to improve public policy development around the needs of the burgeoning senior population. Unless this occurs, the good works of localities will be fundamentally hampered in the years ahead.

However, building on the base created over several years, in Howard County we are now on a path that should contribute to resolving the formidable service delivery problems associated with a rapidly aging population.