Mobilize for aging in community: It’s the right thing to do

Thoughts from Lizbeth Heyer, 2Life Vice President and acting CEO

In the December issue of Elevate, we explore the advantages of, and barriers to, integrating affordable supportive housing, health care, and home care for older adults — a significant component of our aging in community philosophy. At 2Life, we’ve seen firsthand how this integrated approach, together with engaging social and cultural programs, is life-affirming and dramatically extends the time people can age in community.  

Data from the U.S. Department of Housing and Urban Development underscores the benefits. On average, older adults live in 2Life communities nine years longer than seniors in less supportive affordable housing communities nationwide. This is especially compelling because, typically, more than 30% of 2Life residents are nursing home-eligible based on their care needs, yet fewer than 2% who leave us each year move to a nursing home. 2Life’s health and wellness programs are proven to delay and prevent physical and emotional decline. And, when possible, 2Life’s resident services coordinators (RSCs) make sure residents receive home care in their apartments. 

So, if integrating affordable housing, health care, and home care is so beneficial, why isn’t aging in community the standard? Why is this integration so hard to achieve?

A lack of affordable housing subsidies is no doubt a key contributor, but the more comprehensive answer lies within our misaligned, siloed, and underfunded systems of health insurance and housing and home care subsidies. To access the care and support they need, older adults must be either Medicaid-eligible or able to pay for housing, health care, and home care services themselves — a very costly prospect. 

Yet many older adults in Massachusetts fall into a significant financial void, with incomes that are slightly too high for Medicaid yet far below what’s needed to age well. It’s alarming — but not surprising — that Massachusetts ranks first in the nation for economic insecurity among retired residents, who have a median income of less than $32,000 versus the estimated $60,000 required to cover basic needs.

This economic abyss may explain why Massachusetts has the second-highest nursing home placement rate in the country. When older adults run low on funds, the current system forces most into nursing homes in order to access government assistance. This unwelcome and highly avoidable way to age is also an inefficient use of public resources. Consider this: A year in a nursing home is greater than five times more costly than living in a supportive community with integrated services.   

How can we change this picture? 

At 2Life, we’re addressing the problem with a multi-dimensional strategy. First is policy advocacy. We’re actively working with legislators and policymakers at local, state, and federal levels to heighten awareness of the misalignments and structural shortcomings of existing housing, health care, and home care programs. Showcasing best practice, we provide key insights into what we know works. We also recommend policy and funding innovations to support integration.

Second is innovation. 2Life is working outside the lines to pioneer a host of site-based solutions designed to leverage the benefits of integration. 

• Our partnership with Element Care, the highly innovative health care provider, will bring a new PACE (Program of All-inclusive Care for the Elderly) program and quality preventive care to several 2Life locations, starting with our newly expanded Brighton campus. This exciting pilot program will address a critical need for more convenient and comprehensive site-based care access. At the same time, we are exploring ways for Element Care to offer PACE provider services to those who live with us but are not Medicaid-eligible, extending convenient, affordable, and person-centered care to all regardless of income.
• We are working with UnitedHealthcare, a Senior Care Options provider, on a coordinated care management program in which 2Life’s RSCs help residents navigate the complex health care system and ensure they receive needed care at home to prevent hospitalizations and avoid unnecessary trips to the emergency department.
• We are partnering with several Area Senior Access Points and home care agencies to develop innovative contract consolidation strategies to make home care more coordinated, accessible, and affordable for 2Life residents.

Third is mobilization and coalition building. Building a groundswell of support to advance the cause, we continually seek out partners and peer organizations across the nation that share our commitment to aging in community. And, as it turns out, our best allies are 2Life residents. By supporting residents in visiting their city and town halls, Beacon Hill, and Capitol Hill, we’re elevating the most powerful voices to tell the story of why aging in community is both life-changing and smart policy. 

As with any complex societal issue, there is no simple solution. Making progress is hard work. It requires partnership, coalition-building, mobilization, and advocacy to drive needed policy changes. But at 2Life, our commitment — that every older adult should have the opportunity to live a life of connection and purpose in a dynamic, supportive environment — is unwavering. 

Thank you for your continued interest in and support of 2Life Communities. If you’re inspired to act, contact Emily Levine and learn how to join in our mission.