Reimagining Care for Older Adults

Long-Term Care

Aging successfully, safely, and happily requires a range of support services and types of accommodation. Unfortunately, too many older Americans spend many of their later years in institutions that are not best suited to their desires and social connections. To a significant extent, this is because regulations, payment systems and outdated models of care make a different array of options difficult to provide.

Convergence engaged in a national dialogue on reimagining care for older adults. The yearlong  Convergence Dialogue on Reimagining Care for Older Adults worked to assess the perspectives, values, and vision of key and diverse stakeholders, develop areas of agreement, and create an implementation and dissemination plan for public support of consensus-based recommendations to reimagine the care of older adults in nursing homes and the range of settings they call home.

Care for Older Adults

Reimagining Care for Older Adults Final Report

Recommendations Report Released

At the conclusion of the year-long Dialogue, the Convergence Dialogue on Reimagining Care for Older Adults released a report offering participants’ consensus recommendations to improve care for older adults. They recommend changes to America’s systems of care to meet the unique needs and realities of older adults today and in the future.

The report focuses on three major areas for improvement:

  • Care Settings: Create a constellation of care settings with adaptable and viable business models, so that preferred options are available as people age.
  • Caregivers: Ensure there are enough qualified direct and family caregivers to provide needed care and support.
  • Funding: Adequately fund the system of care, with payment systems and other features that are aligned with the reality of aging.

Convergence and the Dialogue participants are now in the Action Phase of the project, moving forward in the unlikely alliances that formed during the Dialogue to achieve real change on these issues. Impacts include sharing the report with leaders in government, academia, aging, long-term care, and communities to raise awareness about what can be done so that, wherever older adults call home, they may live with dignity, choice, and self-determination.

The shared vision of the Convergence Dialogue on Reimagining Care for Older Adults is to improve supports and services for older adults so that, wherever they call home, they may live with dignity, choice, and self-determination.
Read the Vision.

Care for Older Adults

Reimagining Care for Older Adults Issue Framing Paper

The project applies Convergence’s unique dialogue-to-action methodology to explore visions of the future and follows a December 2020 Convergence Center report funded by The John A. Hartford Foundation exploring options and opportunities for change. The SCAN Foundation co-funds this project.

To guide the Convergence Dialogue and other conversations on the future of long-term care, our Issue Framing Paper outlined the discussions aimed at reaching an agreement on restructuring long-term care for older adults.

Read the Convergence Dialogue on Reimagining Care for Older Adults Issue Framing Paper here.


Measuring Bereavement and Building Caregiver Resilience Paper
Bereavement is a poorly understood macro force impacting caregivers, the nation’s workforce, and care for older adults. This paper highlights ground-breaking research into bereavement exposure, bereavement measurement, and strategies for building resilience.

Read the “COVID-19 Pandemic Highlights Heightened Bereavement Exposure of People Living or Working in Nursing Homes” paper here.

Improving the CMS Rating System for Nursing Homes
The Centers for Medicare and Medicaid Services (CMS) rating system aims to help consumers learn about the quality of nursing homes. However, the system doesn’t offer insight into real experiences from nursing home residents and instead focuses on safety metrics and incomplete information about critical staffing issues. This paper reimagines the rating system to capture and reflect the quality of life and the lived experience of older adults and adults with disabilities in our nation’s nursing homes.What do you think?

Read “Improving the CMS Rating System for Nursing Homes” here.

Strategies for Housing Based Support
Many older adults choose to live independently as long possible. However, greater collaboration between agencies and organizations that provide housing and services is needed as many older adults lack the support they need to remain living on their own. Dialogue participants identified areas where collaboration is possible and suggest strategies that involve federal programs and policies that could reach systems and providers who serve older and disabled adults.What do you think?

Read “Strategies for Housing Based Support” here.

Rethinking Care for Older Adults

Building on Convergence’s Long-Term Care Financing Collaborative dialogue in 2016, we brought together almost 50 experts on aging and caregiving for older adults in three meetings in 2020 to brainstorm on the practice, policy, and business model changes needed to transform the system of care and the range of institutions. The conversations generated ideas for expanding opportunities for home and community-based care, advancing alternative business models in the institutional sector, and transforming the caregiving workforce. In December 2020, Convergence published a report, “Rethinking Care for Older Adults,” summarizing the series of conversations.

Read the Rethinking Care for Older Adults report here.

Many of the ideas in the Report would require legislation or changes in business practice, but others could be advanced at least in part by administrative or regulatory actions at the federal, state, or local level. To further develop some of these latter ideas, Convergence again invited experts from the original conversations, and some other experts, to flesh out their ideas for administrative actions consistent with the broad themes of the original conversations.

The result is the “Supplement to Rethinking Care for Older Adults: A Menu of Ideas for Administrative Actions.” Like the ideas in the original report, the proposals in this collection do not represent a consensus and they are not endorsed by nor represent the views of Convergence. Each proposal represents solely the views of the author. Convergence’s purpose in publishing this collection is to spur productive conversation about the future of care for older adults.

Read the Supplement to Rethinking Care for Older Adults collection here.

This collection and the December report were made possible by the generous support of The John A. Hartford Foundation and The SCAN Foundation.

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