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Summit Focuses on Boomers, Health Care System

(The Business Monthly) -- Horizon Foundation President Richard Krieg knows all too well about the "crazy patchwork" that is the health care delivery system for older adults.

Krieg, who heads a $94 million philanthropy dedicated to improving health and wellness, has met the system head-on as he attempts to deal with his elderly parents' health conditions.

At the recent Maryland Summit on Health and Aging, Krieg described "a system made up of silos of care that is biased towards institutional, rather than home or community, services.

"There are few geriatric specialists in any discipline," he said, "in a system [that is] keyed to being sick rather than staying well. Payment follows the place, not the person, leading to a situation where acute illnes, not chronic care, is the primary focus."

Navigating the System
The summit, sponsored by The Horizon Foundation and Howard County government, attracted 300 attendees, including the directors of Departments of Aging from more than half of the counties in Maryland, Congressman John Sarbanes, Howard County Health Officer Peter Beilenson, former State Senator Paula Hollinger, Delegates Elizabeth Liz Bobo and Guy Guzzone, Howard County Council members Calvin Ball and Mary Kay Sigaty, and Howard County Executive Ken Ulman.

In his introductory remarks, Krieg said the purpose of the summit was to consider baby boomers' impact on health care delivery and quality of life.

In the last eight years, he added, he and his wife, a physician, "have had to learn, the hard way, about the crazy patchwork making up the health care delivery system for older adults. There have been good days and very bad ones. And it hasn't been easy."

The Kriegs aren't alone in their struggle to navigate the health care delivery system on behalf of aging parents. Based on Howard County's population of young retirees and older seniors, it's projected that almost 35% of the county's population will be seniors by 2030. The growth of the county's senior population is the fastest in the state.

"The bright side," Krieg said, is that "the boomer generation has been characterized by a struggle to open up new opportunities and possibilities for everyone. Shaped by the experience of the 1960s, they've tended to challenge barriers. They've stretched the limits in a number of areas, including reinventing and challenging timeworn institutions."

Many of the speakers at the summit are boomers themselves and are already challenging those timeworn ways of doing things. Here are some of the highlights of the event:

- Turning to technology. In her presentation, Sara Czaja of the University of Miami's Miller School of Medicine discussed an "Aware Home" developed by Georgia Tech. The home recognizes such emergencies as an accident, fire or stove left on; provides medical monitoring and rehabilitation and memory support; tracks daily and long-term trends; and improves connections with family and friends.

- Seeing seniors as community assets. Discussing Maryland's Baby Boomer Initiative Act, which was passed last spring, Laura Wilson said aging boomers can be "a source of social capital to address community needs." The director of the University of Maryland's Center on Aging also said that 60% of baby boomers expect to "seek meaningful paid or unpaid positions" well past the age of 50.

- Recognizing health care challenges. Linda Fried, director of The Johns Hopkins Center on Aging & Health, warned that the public health system is not ready for the growing population of seniors. "Twenty percent of older adults in the community are isolated without access to care," she said, and "links to clinical care are ineffective and undesigned."

- Rethinking public policy. William Benson, president of the Benson Consulting Group, emphasized prevention of illness in his presentation. Among his suggestions are promoting healthy living among the older population, engaging elders in meaningful and vital action, and making sure communities are "elder friendly" or "elder ready" and livable for all.

John Rother, AARP's policy and strategy director, also attended the summit to discuss the organization's Divided We Fail campaign, which calls for access to affordable health care for all Americans.

"Our institutions are not prepared for the challenges represented by the boomers," Krieg said in his opening remarks. "In reality, aging is a gradual, transitional process and it's different for everyone. Yet our society, our institutions and our health care system tend to create boxes based on categories that serve the needs of the system, rather than the older individual.

"In America, aging is characterized by abrupt transitions based on artificial definitions such as chronological age, level of care and degree of acuity," he said. "One of the themes of this summit is how we can create an environment where older adults have more flexibility in their life choices and more control over their lives, including health care. The cost of inaction will have two aspects: lost opportunity and a growing crisis for our health and long term care system.

Knocking for Opportunities
"Older adults represent America's only increasing natural resource," Krieg said. "Surveys have shown that as the boomer generation nears or enters retirement, it is looking for opportunities to contribute to their communities as workers, volunteers or hybrids of the two. But the same surveys show that boomers seeking this kind of purposeful work cannot find it.

"If Howard County and Maryland can provide these opportunities, it could tap into an enormous rebirth of community empowerment. If those opportunities are not created, we will be wasting an enormous reservoir of experience," he said.