One fact that no one disputes about health care in Rhode Island is that the state’s population is aging. This demographic shift has put new emphasis on long-term care service providers.
Recently, the trade association for Rhode Island’s nonprofit, long-term care service providers changed its name to LeadingAge RI, indicative of the realignment now underway in the delivery of services and changing needs of clients.
Providence Business News asked LeadingAge RI Director James P. Nyberg to talk about the changes being brought about by medical advances, demographic shifts as well as cost considerations and decreases in state and federal budgets.
PBN: What kinds of new models of care and support will LeadingAge RI be advocating and developing for Rhode Island’s aging population?
NYBERG: Our diverse members from nonprofit nursing homes, assisted living residences and senior housing providers, as well as adult day centers, bring a unique perspective to the tasks of developing, evaluating and advocating new models of care and support. We support efforts to rebalance our long-term care system by promoting home- and community-based services, while also recognizing there will always be a need for quality nursing home care.
Adult day care needs to be considered a central component of long-term care. Most people are not aware of the wide range of medical care, social services, family support, and other resources that are available at these centers, so we are working to promote adult day care as a primary resource for older Rhode Islanders.
We also need to expand assisted living as an alternative to nursing home care, especially for individuals on Medicaid.
Another new concept involves housing with services, in which people who live in senior housing can easily access services to help them remain safely in place. It basically encourages a more structured approach to helping people live independently longer.
We are awaiting regulations for a new model called supportive care residences, which would house up to five individuals in a neighborhood setting and provide home care and other services. It is geared towards people who need some care and supervision but do not need to be in a nursing home.
There will always be a need for quality nursing home care, and we’ve been advocating for new household-style models of care, which redesign the living environment of nursing homes to create small households of eight to 12 people, including private rooms and a communal area.
These concepts are dramatically altering the long-term care landscape in Rhode Island.
Beyond Cash Donations: How New Forms of Giving Are Transforming Not-for-Profit Accounting
Evolving Funding Landscape for Not-for-Profits Not-for-profit organizations are being asked to do more with less,…
Learn More
PBN: An ongoing concern is how to cut down on the number of readmissions to hospitals – one of five patients are readmitted to the same hospital within 30 days of discharge. Many of these readmissions are elderly patients coming from nursing homes and assisted care facilities. Will LeadingAge RI promote innovative approaches to cut down on readmissions?
NYBERG: Reducing hospital readmissions is an important issue. Our long-term care providers are actively involved with Quality Partners and other local groups to advance that cause. Better communication and formal processes to ensure that appropriate information is included in discharges is critical, whether to a nursing home or a community-based setting; the more the long-term care providers know about the person’s condition and required follow-up care, the better able they will be to help prevent a return to the hospital.
In addition, there is some evidence that [experienced] nursing home staffing is a factor in lower hospital readmission rates, which is an important consideration when we look at the Medicaid reimbursement system for homes.
PBN: LeadingAge RI recently changed its name, reflecting the name change of its national parent organization, from American Association of Homes & Services for the Aging. How do you feel the name change will enhance your voice here in Rhode Island?
NYBERG: The new name enhances our distinctive voice as a membership organization of nonprofit providers across the long-term care spectrum. There are a lot of challenges confronting our long-term care system, especially in an era of scarce public resources. So we need to be innovative and forward thinking, and recognize that new models of care and delivery are necessary. Our mission-driven members have been caring for older individuals for decades or more; they will continue to lead the way in responding to the challenges – and opportunities – of the age boom. LeadingAge RI is a better reflection of who we are and what we do. It is also easier to remember and recite than RIAFSA.
PBN: How is LeadingAge RI participating in initiatives to support health IT in Rhode Island?
NYBERG: It is very important for long-term care to have a seat at the table as Rhode Island expands adoption of health IT. Older, disabled, and chronically ill individuals who long-term care providers serve often have a multitude of health issues, multiple care providers, and they move frequently from one setting to another. This population stands to benefit a great deal from the greater accuracy and accessibility of information through health IT efforts.
Many of our nursing homes are already adopting electronic medical records, a great opportunity to improve communications across care settings, reduce medical errors and improve the quality of care. The Rhode Island Quality Institute is a national leader in this area, and we have worked with them on various efforts, including serving on the currentcare Advisory Committee. [Our ability] to get all Rhode Island nursing homes involved in currentcare would be a national achievement.
PBN: There have been a number of new developments regarding the treatment and diagnosis of Alzheimer’s disease. What role, if any, do you see LeadingAge RI playing in raising awareness about these new treatments and diagnoses options?
NYBERG: Members of LeadingAge RI incorporate the latest information about Alzheimer’s and dementia into their care for their residents, whether it be new activities and programs to promote brain health, behavioral approaches to manage their conditions, and other forms of therapy to maximize their physical and mental health.
They will bring in an expert speaker who can discuss new developments related to Alzheimer’s disease, and also provide practical advice for caregivers struggling to care for individuals with dementia. LeadingAge RI also sponsors numerous educational seminars for our members to ensure they receive the latest information and advice. Our upcoming annual conference, for example, has a session on managing agitation in dementia residents, including how to do so without over reliance on medications.
