Institute Talk: A Conversation with Senior Housing Design Authority Victor Regnier

Victor Regnier is, perhaps, the nation’s leading authority on the design and development of senior housing with service across the LTSS continuum. A joint professor at USC’s School of Architecture and Leonard Davis School of Gerontology, Regnier is the only person to achieve fellowship status in both the American Institute of Architects and the Gerontological Society of America.

As a designer and practicing architect, he has provided consulting advice on more than 400 building projects in 38 states and several foreign countries. As an academic, he has written 10 books or monographs and directed more than 20 research projects. Regnier’s latest book, Housing Design for an Increasingly Older Population, was published in September 2018.

Gerontology Institute Director Len Fishman recently talked with Regnier about  northern European models of senior housing with supportive services and their influence on housing for older adults in the United States. The following is an edited version of their conversation.


Len FishmanLen Fishman:
Your view of housing and services for older adults has been deeply influenced by models from Northern Europe, especially Denmark, Sweden, Finland and the Netherlands. How did this happen?

 

Victor Regnier: I had been working on a research project with the head of geriatric medicine at UCLA in the late ‘80s, early ‘90s. I wanted to examine new housing models and had an upcoming sabbatical. He said I should go to northern Europe. He had been impressed by their attitudes and perspective on creating non-institutional circumstances for older people, especially older frail people. I ended up going to five countries. I asked to see the most non-institutional or residential housing for the frailest individuals and visited 100 buildings.

LF: You were coming from a country where, at that point, there was no assisted living to speak of and the idea of housing with supportive services hadn’t emerged yet. What were your impressions? Continue reading

News Flash: UMass Boston Gerontology Makes Headlines in 2018

By Taryn Hojlo

UMass Boston’s gerontology faculty and students produced exciting new research findings and achieved remarkable public service achievements in 2018. The news media took notice.

Associate professor Beth Dugan and her Gerontology Institute colleagues published the 2018 edition of the Massachusetts Healthy Aging Data Report in December.The comprehensive report examined a vast array of health indicators on a community-by-community basis, creating an essential resource for policymakers and local leaders to better serve Massachusetts seniors. News coverage by WBUR in Boston looked at seven key takeaways from the report. The Boston Globe dove into the healthy aging data and produced a front-page story examining the impact of depression among elders. Dugan and her team ended the year at work on a similar report profiling the health status of seniors in New Hampshire. Continue reading

New Reports Explore Global Expansion of Foreign-Born LTSS Workforce

By Natasha S. Bryant

Foreign-born nurses and personal care assistants make up an increasingly significant percentage of workers in the field of long-term services and supports (LTSS) around the world, according to new research from the Global Ageing Network and the LeadingAge LTSS Center @UMass Boston.

These immigrant/migrant workers, who come primarily from developing countries, bring myriad benefits to the LTSS organizations that employ them and the care recipients they serve, according to findings from a 2018 study by the LTSS Center.

Three new reports explore those benefits, in addition to identifying challenges associated with hiring foreign-born LTSS workers, exploring strategies to address those challenges, and providing an overview of global migration patterns and policies. Continue reading

Institute Talk: A Conversation with Penny Shaw, Activist and Long-Time Nursing Home Resident

Len Fishman and Penny Shaw

Gerontology Institue Director Len Fishman and Penny Shaw in Braintree, Mass.

The word that might best describe Penny Shaw is “indefatigable.” A long-time activist for persons with disabilities, Shaw is a visible and vocal presence on national, state and community issues. She is known for her sharp opinions and blunt talk as an advocate. Shaw sits on more than a dozen committees, including an advisory panel to the state Executive Office of Elder Affairs. She is a prolific writer on disability issues whose work has appeared in a wide range of journals and other publications.

 Shaw has also been a nursing home resident for nearly 16 years. A teacher with a PhD in French literature, she became disabled in 2001 with Guillain-Barre Syndrome, a rare neuromuscular condition, and was not expected to live. After a year in a rehab hospital, Shaw was transferred to a nursing facility in Braintree, Mass., specializing in neurorehabilitation care, where she now lives. Gerontology Institute Director Len Fishman recently met with Shaw to talk about nursing homes from a resident’s perspective. The following is an edited transcript of their conversation.

LEN FISHMAN: You’ve been living in a nursing home for many years now. What was it like at the very beginning?

PENNY SHAW: First of all, I was intubated for five years with a feeding tube. I arrived [at what is now called Braintree Manor Healthcare] on December the 26, 2002, but I was not decannulated until August 2006. So I was basically bed-bound. Continue reading

Listening to Consumers and Advocates Who Helped Shape a Health Plan

 By Erin McGaffigan

In 2013, Massachusetts developed the One Care Implementation Council so consumers could have an active role in a new health care program serving people with disabilities who are eligible for both Medicare and Medicaid.  I recently had the pleasure of sitting down with consumers, advocates and state employees to talk about their experience on the One Care Implementation Council, and these interviews did not disappoint. You can find the full report on the Council’s engagement process and lessons learned here. This case study was jointly produced by the Center for Consumer Engagement in Health Innovation and the LeadingAge LTSS Center @UMass Boston.

As I reflect on the interview experience, I realize how much one can learn just by listening. Without question, Massachusetts’ disability advocates have pushed aggressively for meaningful engagement in long-term services and supports (LTSS) program design for years, and this really influenced how advocates and state leaders approached One Care’s engagement strategy. This was not the advocates’ “first rodeo,” and they came ready with ideas for making the Council an active body. This meant ditching the term, “advisory” and replacing it with “implementation” to mirror advocates’ intention to be deeply involved and “part of the action.” State partners, who also have administered their fair share of engagement strategies, spelled out Council expectations, including its purpose and desired representation, through a formalized Request for Response process after meeting with community leaders so that unnecessary process challenges were avoided. Continue reading

How Income Affects Perceived Health of Older Americans

The LTSS Center’s preliminary study, conducted for the National Council on Aging, involves analysis of health and economic data from 2014 Health and Retirement Study.

Center researchers found that 43 percent of people aged 55 or older with incomes below 250 percent of the federal poverty level reported their health condition as “fair” or “poor.” Individuals in this income group were 3 times more likely to characterize their health as fair or poor than similarly aged people who were at least 400 percent above the poverty level. Continue reading

Evaluating a Contemplative Care Approach for Nursing Homes

The LeadingAge LTSS Center @UMass Boston has been engaged by the New York Zen Center for Contemplative Care (NYZCCC) to evaluate the impact of the center’s Contemplative Care approach on nursing home residents. The evaluation will also assess the impact of NYZCCC’s Resiliency Training on nursing home staff.

Both the Contemplative Care intervention and the Resiliency Training will take place at Isabella Geriatric Center  in New York City. Continue reading

How Consumer Perspective Helped Direct a New Health Care Program

Erin McGaffigan

Erin McGaffigan

The One Care Implementation Council was established in Massachusetts five years ago to engage consumers and their advocates in the design and oversight of a new health care program serving people with disabilities who are eligible for both Medicare and Medicaid.

So how did that work out?

The LeadingAge LTSS Center @UMass Boston, with the Center for Consumer Engagement in Health Innovation, recently released a new case study that examines the creation and development of the council in detail. Continue reading

Choosing a Nursing Home: Can Yelp Help?

By Pamela Nadash, Edward A. Miller, and Jennifer Gaudet Hefele

Leaving loved ones in the care of a nursing home raises a host of fears: that they might suffer abuse at the hands of uncaring staff; that they might be medicated into a stupor; that they will be ignored and neglected. The specter of being trapped in a bad nursing home haunts us all. To avoid bad nursing homes, we need information that enables us to make good choices.

Pamela Nadash

Recently, The Boston Globe revealed that the U.S. Department of Veterans Affairs (VA) had not released data it had tracked over several years on the quality of the 133 nursing homes run by the VA. (Vets also have access to roughly 2,500 community nursing homes that the VA contracts with and about 160 State Veterans Homes.) Information obtained by the Globe indicated nearly half of VA-run nursing homes received the lowest possible score for quality (although scores on overall quality, which includes other dimensions, match national figures). Clearly, this is a story about the quality of nursing homes. But it is really a story about the need for access to good information — presented in ways the average person can understand — about nursing homes more generally. Continue reading

Better Tools Needed to Evaluate Health Care Consumer Engagement Strategies

Consumer engagement has become a health care priority, but it is difficult to evaluate the effectiveness of strategies and organization-level plans developed to achieve that goal.

In a recent blog post for Community Catalyst’s Center for Consumer Engagement in Health Innovation, authors Marc Cohen, Erin McGaffigan and Danielle Skenadore argue that “consumer engagement” itself is a term of art and can mean many different things.

“While the concept appears to have many supporters, how [it] is defined and applied in practice is much less clear,” they wrote. “Moreover, evidence-based strategies for successfully engaging consumers that are linked to clearly articulated and specific outcomes are few and far between.” Continue reading