Moving Toward a Global Age-Friendly Ecosystem.

The designation of "age friendly" has clearly engaged the attention of scholars and leading experts in the field of aging. A search of PubMed references citing the term produced 15 results in the 5-year period from 2006 to 2011; that number increased to 572 in the period from 2015 to 2019. The work, notably led by the World Health Organization with the initiation of age-friendly cities and age-friendly communities, has now sparked a movement for the creation of age-friendly health systems and age-friendly public health systems. Now more than ever, in an era of pandemics, it seems wise to create an ecosystem where each of the age-friendly initiatives can create synergies and additional momentum as the population continues to age. Work of a global nature is especially important given the array of international programs and scientific groups focused on improving the lives of older adults along with their care and support system and our interconnectedness as a world community. In this article, we review the historical evolution of age-friendly programs and describe a vision for an age-friendly ecosystem that can encompass the lived environment, social determinants of health, the healthcare system, and our prevention-focused public health system.

A National Strategy For Palliative Care.

In 2014 the World Health Organization called for palliative care to be integrated as an essential element of the health care continuum. Yet in 2017 US palliative care services are found largely in hospitals, and hospice care, which is delivered primarily in the home, is limited to people who are dying soon. The majority of Americans with a serious illness are not dying; are living at home, in assisted living facilities, or in nursing homes; and have limited access to palliative care. Most health care providers lack knowledge about and skills in pain and symptom management, communication, and care coordination, and both the public and health professionals are only vaguely aware of the benefits of palliative care and how and when to access it. The lack of policy supports for palliative care contributes to preventable suffering and low-value care. In this article we outline the need for a national palliative care strategy to ensure reliable access to high-quality palliative care for Americans with serious medical illnesses. We review approaches employed by other countries, list the participants needed to develop and implement an actionable strategy, and identify analogous US national health initiatives to inform a process for implementing the strategy.

Funding Research in Emergency Department Shared Decision Making: A Summary of the 2016 Academic Emergency Medicine Consensus Conference Panel Discussion.

As part of the 2016 Academic Emergency Medicine Consensus Conference, "Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda," a panel of representatives from the Office of Emergency Care Research, the Patient-Centered Outcomes Research Institute, the American Heart Association, the John A. Hartford Foundation, and the Emergency Care Coordination Center were assembled to discuss funding opportunities for future research in this field. This article summarizes their discussion of funding priorities and examples of successfully funded projects related to shared decision making in emergency medicine.

Helping nursing homes prepare for disasters.

Responding to the deaths and suffering of older adults in long-term care facilities following Hurricanes Katrina, Rita, and Wilma, the John A. Hartford Foundation funded an initiative called Hurricane and Disaster Preparedness for Long-Term Care Facilities. Long-term care providers are now acknowledged as health care providers by most federal and state emergency response centers. This paper describes the planning, research, and dissemination efforts of the Hartford grantees. It also provides insights into successful disaster grant making, noting foundations' unique flexibility, strategic and long-term view, and ability to be a neutral convener of stakeholders that can help grantees work toward achieving major policy change.

Portrayal of nursing to incoming students: results of a national survey of geriatric and pediatric web images on baccalaureate nursing program web sites.

In the face of a rapidly aging America and given that older adults are the population that avail health care services the most, there is a clear mandate to stimulate nursing student interest in care of older adults. The purpose of this study was to determine if web sites of baccalaureate nursing (BSN) programs stimulate interest in care of older adults by quantifying and comparing images of older adults and children on baccalaureate nursing program web sites and examining the characteristics of these images. The reality that nurses primarily care for older adults is not reflected in images on BSN program web sites. This creates both a skewed perception of the nursing profession and a lost opportunity to stimulate interest in geriatric nursing.

Gerontological nursing content in baccalaureate nursing programs: comparison of findings from 1997 and 2003.

In 2003, the John A. Hartford Foundation Institute for Geriatric Nursing (Hartford Institute), in collaboration with the American Association of Colleges of Nursing, conducted a survey of baccalaureate schools of nursing in the United States to compare gerontological content to baseline data collected by the Hartford Institute in 1997. Since last surveyed in 1997, baccalaureate nursing programs have been the recipients of substantial new resources and initiatives focused on gerontological curriculum enhancement. While these initiatives are ongoing, and some are in an early stage of development, resurveying baccalaureate programs was seen as a means of taking a midcourse "pulse" as to the effectiveness of these efforts. Data suggest that there has been a fundamental shift in baccalaureate curriculum toward incorporation of a greater amount of gerontological content, integration of gerontological content in a greater number of nursing courses, and more diversity of clinical sites used for gerontological clinical experiences. As baccalaureate programs increasingly address the need to enhance gerontological nursing curricula, there continues to be an obligation to address the growing shortage of faculty with qualifications in gerontological nursing.