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One Step at a Time

One Step at a Time

Moving often means something new and exciting is next, but this is one case where in my opinion, the journey is not better than the destination.  As I pack for an upcoming move, I must confess that I find the whole process overwhelming.  I underestimate how long it will take, how much stuff we have, and how many “keep it or pack it” decisions there will be. So naturally, my first step was to procrastinate.  I’d walk into a room, empty box in hand, trying to decide where to begin and think, “Maybe I’ll read just one more chapter of my book and come back later…”

But you can only do that for so long. Eventually, a deadline looms and you need to get serious and get moving. Once knocked into action by cold, hard reality, though, I’ve found that momentum builds quickly.  It starts to feel good to assess what we have and what we truly need, to clear out the accumulated clutter, to find new homes for things we no longer need, to pack up treasured things, and to see progress.  And then there is anticipating the joy to come in the unpacking and setting up anew – perhaps even adding a few new items, to fill gaps or fit in better with our new space and our lives now.

What does this have to do with MeHAF’s work?  The parallels struck me earlier this week as I spoke with Eileen Griffin and Elizabeth Gattine of University of Southern Maine’s Muskie School of Public Service, authors of a newly released report, Charting a Pathway Forward: Redesigning and Realigning Supports and Services for Maine’s Older Adults. The paper compiles important data and historical context about Maine’s current and future demographics, Long Term Services and Supports needs, and the systems that provide and pay for these services.  The picture it paints lets us know that the time to get serious is here – we’ve avoided this task long enough!

The challenges are complex, no doubt.  Our systems and programs were created and patched together over time to meet evolving needs.  Some of their design has been driven by funding and other priorities, rather than designed to optimally meet identified needs. As a result, integration and coordination is not always what it should be, and some critically important types of support remain without consistent or reliable funding mechanisms. This can lead to wasted resources, duplicated effort, and important gaps.

For example, there are often relatively low-cost services that make or break an older person’s ability to return and remain home successfully after a hospitalization.  These might include things like home-delivered meals, bathroom grab bars, or rides to appointments or the grocery store. In some areas, some of the time, many essential supportive services are available.  But that is not the case always or everywhere. They may depend on community volunteers and programs, funded by grants or donations that need to be routinely replenished.  They may be subject to a waiting list because demand is too great.  Program eligibility determination may be needed before services can start. Or perhaps there is simply no one tasked with the coordination that efficiently connects people with services in a timely way. If a critical piece of the puzzle is absent or delayed, the person may land back in the hospital unexpectedly – a costly outcome that can often be avoided, but only if we find ways to strengthen and better resource community-level service systems and ensure their consistent availability when and where needed.

Like walking into a room full of things to sort and pack, our instinct when we look at the complex web of providers and payment streams involved can be to postpone thinking about it for another day.  It can feel too complicated to tackle, and there is the concern that tinkering with only parts of the system may not help solve fundamental problems.  

But these systems affect us all, and they are critically important to our ability to live the lives we hope for as we age.  We can collectively begin building momentum to improve them.  We each age every day – and that’s a good thing!  It means that we bring our individual and collective experiences and the lessons we’ve learned tackling other big challenges to bear on finding innovative solutions to support our state, our communities, and our institutions to adapt today’s systems to the changing needs of tomorrow’s society.  It begins by learning more about what is, what’s working and what’s not, and where the possibilities lie. 

USM’s paper does a great job of providing that overview and suggesting opportunities for change to begin the conversation.  Raising our own level of knowledge about the issues and the opportunities is only the first step of many – but like packing the first box, the next one will be easier...

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