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Covering advances in research, practice and policy nationwide

MAY–JUNE 2020 volume xli number 3

the bimonthly newspaper of the American Society on Aging t i t l f t i i t i

In nursing homes, the “best care possible” is linked to the “best life possible”

In this issue

Medication adherence education does work page 4

AARP THOUGHT LEADERSHIP Improving the global health and wealth spans for an aging populace page 5 AGINGWHILE . . . Challenges—and opportunities—for women as they age page 6 IN FOCUS The nursing home reboot: it’s long overdue pages 7–11 New Learning Collaborative puts CBOs in the know about partnering page 15

What does it mean to live the best life possible? In this time where efficiency rules the day, some might believe that liv- ing a best life is too complex and therefore unattainable—especially for those living in long-term-care settings. But in reality, living one’s best life boils down to simple things that most of us who don’t live in these settings take for granted. The best life possible means recognizing that older adults are the experts on their own lives. In simplest terms, a best life possible means recognizing that adults living in nursing homes are the experts on their own lives. They have spent decades per- fecting every aspect of meeting their own needs; they know what works for them and what doesn’t, and they deserve to CMS annually updates the clinical quality measures approved for its pro- grams. Effective Jan. 1, 2020, CMS ap- proved including malnutrition clinical quality measures in two Qualified Clini- cal Data Registries, the Premier Clinician Performance Registry and the U.S. Wound Registry (see Table 1 on page 12). CMS’ value-based programs reward healthcare providers with incentive pay- ments for the quality of care they deliver to Medicare beneficiaries. These pro- grams are part of CMS’ larger quality strategy to reform how healthcare is de- livered and paid for in the United States. One example of a CMS value-based program is the Merit-based Incentive Payment System (MIPS), which is used by physicians and outpatient healthcare pro- viderswho do not report through a health- care system or a large group quality management program. Starting in 2020, outpatient providers reporting through MIPS can choose to report on the CMS- approved malnutrition clinical quality measures; a focus on malnutrition could help to improve patient quality of care be- cause, as documented in a recent U.S. Government Accountability Office report, “barriers to older adults’ meeting nutri- The CMS QualityManagement Program—andWhy It Matters

By Ann Wyatt and Tena Alonzo T hose of us who have worked in the field of aging have long been con- cerned with how to provide the best care possible for individuals who are frail, ill and in need of help. This concern remains, but our understanding of how to achieve such care continues to evolve, startingwith parsingwhat is meant by the “best care possible.” The most progressive among us came ear- liest to the notion that the best care pos- sible is inextricably linked to the best life possible, and that this standard is person- al, specific and differs for everyone: we cannot provide the best care for someone if we do not figure out all that we can about what constitutes a person’s best life, from their perspective. The Best Care Possible, the Best Life Possible CMS takes a significant step forward to help end elder malnutrition By Bob Blancato C urrently, up to one in two older adults is malnourished or at risk for malnutrition. Yet, malnutri- tion is not systematically screened for, as- sessed, diagnosed or treated in the U.S. healthcare system. As 2019 ended and the World Health Organization’s Decade of Healthy Aging began (learnmoreat ), a significant achievement was reached that is worthy of recognition and atten- tion. For the first time, the Centers for Medicare & Medicaid Services (CMS) ap- proved multiple malnutrition-specific clinical quality measures for a CMS quali- ty management program. Clinical qualitymeasures are tools that help to measure and track the quality of healthcare services provided by health- care professionals and institutions. Evalu- ating and reporting quality measures help to ensure America’s healthcare system is delivering effective, safe, efficient, pa- tient-centered, equitable and timely care.

maintain a sense of their expertise no matter how frail or ill they may become. Nowhere is the link between quality of care and quality of life more apparent than in nursing homes, where people live for weeks, months and years with increas- ing frailty, and where choices about what matters most can easily be overwhelmed by organizational priorities. Changing the culture of long-term care to accommodate each person’s life exper- tise has been in process for years and is the basis of the person-centered movement. However, the challenge of fully embracing person-centered care lies in the struggle to change howorganizations get things done. To acknowledge and accommodate each

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The 2020 ASA Award winner: a staunch mentor, teacher and caregiver advocate T he 2020 ASA Award goes to Louis Colbert, who has spent four decades serving older adults in roles at area agencies on aging. The ASA Award is pre- sented to an individual who has made out- standing contributions to aging-related research, administration or advocacy. Louis Colbert is an extrovert with an infectious laugh, a matching sense of hu- mor and genuine warmth. But underlying that engaging exterior lies a serious well of concern for older adults and an immense desire to help not just elders, but also pro- fessionals in the field of aging. As a child, Colbert watched his parents care for his grandparents and older neighbors, and it wasn’t until he was midway through high school that he realized not everyone lived The caregiver support group ‘has been such a revelation and a joy.’

Louis Colbert

with a grandparent. “I have so many won- derful, positive memories, and it’s all con- nected tomy interest in this work,” he says. A Start in Senior Services Colbert held his first field placement in 1976 at an area agency on aging (AAA) in his hometown of Media, Penn., while earning his Masters in Social Work from Temple University. He says he was lucky to be mentored by his young bosses, and there he developed an abiding love for working directly with older adults. His first job out of graduate school was as a group services coordinator with the

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