95% of Older Adults Want to Age in Place—Here’s How to Support Them

Aging gracefully, age is just a number, and young at heart are among the many adages associated with growing older and perhaps ring truer than ever. After all, baby boomers say 60 is the new 40, with two-thirds reporting they feel younger than they are.

Next to millennials, baby boomers make up an estimated 73 million people and are the second largest age group in the United States. By the year 2030, all baby boomers will be at least age 65.

People are also living longer and a majority (95%) say they want to live their later years in their current home rather than move to an assisted living facility.

“Older adults have a desire to maintain their quality of life, sense of control, and independence, all the while being surrounded by family, friends, and a familiar environment,” according to Ankur Bharija, MD, Geriatrician and Medical Director, Post Acute Care at CareCentrix.

As more care shifts to the home, providing whole-person care and supporting them every step of the way is the path to a better quality of life and member satisfaction for Medicare beneficiaries, but anticipating what they may need is the first step.

The Unique Needs of Older Adults

If you care for an aging parent or loved one, you know they have a diverse set of needs.

These needs are best described by the Institute for Healthcare Improvement (IHI’s) 4M Framework of an Age-Friendly Health System which includes:

• What matters: knowing and aligning care with members’ goals and care preferences
• Medication: using age-friendly medications that do not interfere with the other areas of the framework
• Mentation: preventing, identifying, treating, and managing brain health such as dementia and depression
• Mobility: ensuring individuals move safely every day?

While some older adults can successfully age in place and remain independent, for many, that’s simply not the case. Not only do most older adults have chronic conditions—78% have at least one—but they can also have vision and hearing loss, sleep problems, bone and muscle loss, respiratory issues, chronic pain, and an overall decline in physical and mental function.

Many have to test their blood glucose and take multiple medications every day. They may also have challenges with activities of daily living (ADLs), be at risk for falls and accidents, and have trouble with household tasks and driving.

Loneliness and social isolation are also a challenge, with?nearly one-fourth of older adults who are considered socially isolated. Social isolation is associated with:

• 50% increased risk of dementia
• 29% increased risk of heart disease
• 32% increased risk of stroke

Among those with heart failure, loneliness is linked to a 68% increased risk of hospitalizations and a 57% increased risk of ED visits.

“When we think about older adults’ needs, we need to think about what brings meaning to their life, and what their support system looks like, which is a critical piece to aging in place,” Bharija said.

After a Hospital Stay, New Needs Come to Light

Aging members want to return home as soon as possible from the hospital, but they may be reluctant or unaware that they need to adjust to a new normal. Not only can a hospitalization amplify existing needs, but it can also cause new needs to surface.

“After a hospital stay, regardless of the reason, there may be an impact to brain health and cognition, especially in the elderly population,” according to Bharija. “Unfortunately, PCPs and specialists don’t always have the time to assess them, which creates a gap in care.”

Older adults may assume their doctors are communicating and coordinating care, yet that isn’t usually the case. Plus, as people age, their social circles become smaller and doctors may not know if they have a spouse or friend to drive them to doctor’s appointments.

“I find this aging population feels that they’re a burden to others if they ask for help, so they don't,” said Staci?Dahl, Manager Clinical Program Development Pharmacist, Walgreens. “This is a care gap that can be easily addressed but is often missed.”??

Aging members may also find themselves ill-equipped to care for wounds, coordinate durable medical equipment (DME), or get around their homes while they recover.

They are also likely to face difficulties with changes to their existing medications or taking new medications—and making sense of it all. Low health literacy further complicates matters and may impact their ability to understand prescription drug coverage and identify services that are available to help with co-pay assistance and access.

Empowering the Home to Support Aging in Place

As members are discharged from the hospital, care teams can leverage predictive analytics to help match the right support for clinical and social needs, close care gaps, and help ensure a smooth transition home.

“The more payors are aware of what their aging members need and where the care gaps are, the more targeted their strategies can be,” according to Bharija. “That’s the value of care at home, and access to multidisciplinary care teams will play an important role in helping members age in place.”

Pharmacists also have an important role in supporting aging members in the home since they are uniquely positioned to build trusted relationships with their customers.

“Pharmacists have a responsibility to identify barriers to adherence, provide education, and help aging members navigate the options and resources available to them,” said Dorothy Loy, Senior Director of Pharmacy Services, Walgreens.?

For example, they can help ensure members are taking their medications as prescribed. Through medication reviews, pharmacists can send a report to the providers, who can educate the member at the next visit to improve adherence.

Retail pharmacies can also support members with services like auto-refill, medication synchronization (a service that makes it easier for members to pick up all their prescriptions at the same time), delivery, 24/7 pharmacist chat, multilingual support, easy-to-open bottle caps, and large fonts on labels, to name a few.

“Demand for aging in place is rising, so expect to see more services in the home like remote patient monitoring (RPM), home infusion therapy, palliative care, and SNF-at-home to continue to be made available,” Bharija said.

CareCentrix and Walgreens: Working Together to Care for Older Adults

CareCentrix and Walgreens are committed to working together to develop solutions that create a more coordinated healthcare ecosystem that supports aging members in the most convenient way.

Through CareCentrix’s solutions and HomeFirst Analytics, we focus on identifying members’ needs, delivering the right care at the right time, and driving improved clinical, social, and financial outcomes.

Walgreens’ holistic and multi-channel approach, at-home diagnostic screening kits, and a wide breadth of medication adherence programs drive quality outcomes, support multiple Star ratings, and reduce costs.

“The synergy between CareCentrix and Walgreens allows us to support transitions of care, close care gaps, and improve medication adherence—but we’re only just beginning,” Loy said. “CareCentrix’s data insights will continue to allow Walgreens to better service aging members and provide whole-person, personalized care at home and in their community.”

ICYMI: Read our past Connected to Care articles to learn how CareCentrix and Walgreens are bringing more access to care in the home and community for your members.