Packaging supportive services with housing—a pressing issue for older adults The population of older adults is expected to explode in the coming years. Linking Housing and Services for Older Adults: Obstacles, Options, and Opportunities examines a crucial, complex, and often overlooked issue for policymakers and the public at large: older adults’ increasing needs for housing and supportive long-term care services. As baby boomers strive to help their parents make difficult decisions about their options, pressure mounts for policymakers to develop appropriate housing and services. This book brings together respected experts to discuss the answers to difficult questions about meeting the housing and support service needs of aging adults. Linking Housing and Services for Older Adults: Obstacles, Options, and Opportunities explores in-depth the tough issues pertaining to which populations are presently being served, what their needs are, and who is being left out. You’ll learn exactly what types of services are available, who is providing them, and how are they packaged. From residential care to assisted living to institutional care, this book addresses all facets of the complicated problems of providing availability to fulfill need. This important source presents insightful analysis of the total range of issues and the challenges to progress as well as offering specific recommendations to effectively offer housing and vital long-term care supportive services to older adults. Linking Housing and Services for Older Adults: Obstacles, Options, and Opportunities discusses in detail: the argument for increased development of supportive housing for older adults—and the barriers preventing it the issues related to providing a variety of housing and service options to the Medicaid population two case studies that illustrate how policies aimed at linking housing and services play out at the state and local level—and the need for strong leadership and the ability to develop key partnerships as vital aspects for success the interrelationship of factors regarding nursing home admission, the availability of subsidized housing, and Medicaid eligibility the need for care management to be holistic—including environmental care assessment, repair, and renovation management in addition to current long-term care settings creating affordable assisted living facilities for older persons receiving Medicaid services the successful components of the national Coming Home Program four case studies emphasizing different finance and regulatory approaches—providing lessons learned for developers, state agencies, and advocates of affordable assisted living This vital educational resource is also an essential reference for local, state, and national policymakers, housing officials, and long-term care providers.

As older adults and their families opt out of nursing homes, a range of home and community-based services (HCBS) have risen up to provide care. HCBS span platforms and approaches, from home health care to assisted living to community-based hospice to adult day services. These models are, for most, preferable to nursing homes and allow older adults to “age in place”—live longer in their own homes and communities. Home- and Community-Based Services for Older Adults examines the existing and emerging models of HCBS, including the history, theory, research, policy, and practices across care settings. Emphasizing the multidisciplinary and interprofessional practice approaches used to deliver care, this book is an essential learning tool for students interested in medicine, nursing, social work, allied health professions, case management, health care administration, and gerontology. As the population of older adults grows, the authors ask, how can we best meet the needs of older adults and their families in the most effective, cost-conscious way while honoring their care choices?

Accessible and affordable housing can enable community living, maximize independence, and promote health for vulnerable populations. However, the United States faces a shortage of affordable and accessible housing for low-income older adults and individuals living with disabilities. This shortage is expected to grow over the coming years given the population shifts leading to greater numbers of older adults and of individuals living with disabilities. Housing is a social determinant of health and has direct effects on health outcomes, but this relationship has not been thoroughly investigated. In December 2016, the National Academies of Sciences, Engineering, and Medicine convened a public workshop to better understand the importance of affordable and accessible housing for older adults and people with disabilities, the barriers to providing this housing, the design principles for making housing accessible for these individuals, and the features of programs and policies that successfully provide affordable and accessible housing that supports community living for older adults and people with disabilities. This publication summarizes the presentations and discussions from the workshop.

Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.

Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed. Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs.

As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.

There have always been homeless people in the United States, but their plight has only recently stirred widespread public reaction and concern. Part of this new recognition stems from the problem's prevalence: the number of homeless individuals, while hard to pin down exactly, is rising. In light of this, Congress asked the Institute of Medicine to find out whether existing health care programs were ignoring the homeless or delivering care to them inefficiently. This book is the report prepared by a committee of experts who examined these problems through visits to city slums and impoverished rural areas, and through an analysis of papers written by leading scholars in the field.