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Program Promotes Aging in Place Model Community

By Lindsey Getz

The idea of “aging in place,” or the opportunity to stay at home as one grows older, has continued to gain traction. The AARP regularly surveys thousands of older adults and has found that consistently at least 80% report that they want to remain in their homes and communities rather than move to a retirement community or supportive housing environment. But there are barriers that prevent many from doing so. The need for programs to support this opportunity is critical. One such program has been developed in the Greater Mercer County region of New Jersey and is serving as an excellent model for other communities.

United We Age, a United Way program, was designed to keep people aged 60 and over in their homes so that they can age in place with dignity and have access to needed services and socialization activities, while maintaining their physical and mental health. Through this program, the United Way has partnered with a number of local organizations to provide necessary resources that help make these goals possible.

Avoiding the Cracks
Tara Maffei, MSW, vice president of community impact for United Way of Greater Mercer County says that United We Age was designed to target the needs of individuals in the community who might otherwise “fall through the cracks.” In other words, they earned too much to qualify for Medicaid or other governmental assistance but they haven’t made enough to pay for costly private care.

“We have safety nets in our society for individuals who don’t earn enough but we often don’t have supports in place for those that fall in between,” Maffei says. “There is a huge portion of individuals in our society that fit into this category.”

In the past, Maffei says, these older adults were often forced into options they didn’t desire. But with a program like United We Age, it gives these people other options.

“We don’t want those individuals to lose their homes or have to spend all of their remaining resources on finding the extra help they may need,” Maffei says. “A 60-year-old can reasonably expect that they may live another 20 years and they may want to leave their home to their children. We believe they should have the opportunity to do that. A program like this is designed for those individuals who need some help maintaining what they have worked their whole lives for. They are in need of resources in their home to be able to stay safe and healthy and ultimately age in place.”

Those services and supports provided include case management, education, home-delivered meals, home health aide, home safety, transportation, nursing support, and volunteer support.

“Supports like these allow individuals to stay in their home and remain safe and healthy,” says Linda Meisel, MSW, LCSW, executive director of Jewish Family & Children's Service of Greater Mercer County, the organization that handles the case management for the program. “The result is a huge improvement in the quality of life because it decreases isolation and also helps keep the individual more independent. This program ensures that basic needs such as nutrition, home health care, and even personal hygiene are attended to. All of that helps to keep people out of local institutions.”

That is a huge benefit not only to the individual but also to the community. “It’s far less expensive for the community to care for its people outside of a facility and in their own home,” Meisel points out. “It’s also beneficial that elders who live within their community continue to spend their money in the community. They use the pharmacy, the grocery store, and they continue to invest in their local community as they always have.”

Of course Meisel adds it is also financially beneficial to the individual. “Families have gone bankrupt paying for the cost of long-term care,” she says. “Many of these individuals have worked their whole lives and have put time and money into their local communities. Now it’s time for the community to support them. That’s what this program is all about.”

Staying Safe and Healthy
Safety is a critical component of this program. Maffei says that data have revealed that all it takes is one fall for an aging person to take a downhill slide into poor health. One of the goals of the program is to prevent home accidents like this. Often it only takes simple changes to make a home safer to live in—and to age in. That’s why part of the United We Age program includes a safety assessment with a fall-assessment component.

“Things we might look for include linoleum that is peeling back and posing a fall risk or furniture that is placed in a common walking area,” Maffei explains. “We not only fix potential fall risks but [also] install safety grab bars and make the home safer to live in.”

The program is also adopting in-home mental health services with the recognition that many older adults do experience conditions such as anxiety and depression that have a major impact on quality of life. Maffei says those conditions are only made worse when people are isolated from the community.

Nursing support is also available to help older adults understand and manage medical conditions; examples include medication management, transition from hospital to home, and of course, diet and nutrition. And door-to-door transportation within the Greater Mercer County area is offered not only for medical appointments but also for employment, social events, and other activities.

“Social activity is important for both mental and physical health,” Meisel says. “It’s important that elders stay active and engaged. I also like to point out that we tend to forget that once an individual goes to an institution, they typically can’t even decide when they’re having lunch anymore. Everything is set up and therefore decided for them. This program offers the opportunity for older adults to continue to make their own choices and to maintain their freedom.”

The Social Worker Role
The United We Age program is unique in that it’s a fee-for-service program. There are no grants. Instead, agencies are reimbursed on a fee-for-service basis. Through these partnerships, the services are available at a low cost—sometimes no cost—to qualifying individuals.

“Finding a funding partner is really the key to making this successful,” says Meisel. “The model of United We Age is easily replicable if the funding is available. In Greater Mercer County our United Way is very visionary. They recognized the problem within the community and figured out it would be a smart thing to fund. There’s a big return on investment by keeping people in the community—and keeping them spending in the community.”

In addition to funding, partnering with the right support organizations is also important. Maffei says that social workers are critical at all levels of a program like this. “You need social workers in the advocacy role to make sure that programs like this are created in the first place,” Maffei says. “One program alone cannot address everyone’s needs, so social workers need to make sure there are ample programs in place that cover everyone on the spectrum of aging. But social workers are also needed within the programs once they are in place.”

For United We Age, Maffei says the case management handled by Jewish Family & Children's Service of Greater Mercer County has been essential to the program’s success. “You need good, strong social workers to be case managers in a program like this,” she says. “The Jewish Family & Children's Service of Greater Mercer County does a great job with boots-on-the-ground management of not only dealing with clients but checking in on their safety and interacting with family members.”

Maffei says that social workers can make the ideal candidates for setting up and managing these types of aging programs in any community. “Social workers can see the bigger picture and that’s really important in a program like this,” she says. “We can look at the future and see the importance of good outcomes—and we can make sure that they come to fruition.”

— Lindsey Getz is a freelance writer based in Royersford, PA, and a frequent contributor to Social Work Today.