Advanced Old Age in America: What Can We Count On?

Grantmakers In Health, Altarum Institute, Grantmakers In Aging, and National Coalition on Health Care cosponsored a roundtable discussion on health care reform and elderly Americans living with frailty in their last years. In particular, the roundtable focused on the need to consider the distinct priorities and preferences of the old and frail, as well as those of family members and caregivers, as the nation considers a number of different strategies and policy changes to strengthen and streamline health care.

The roundtable addressed a number of questions, including:

• How serious are the shortcomings in services and the expected growth in costs as the population ages? How much time do we have to make arrangements for the coming increase in numbers?
• What should we promise to individuals living with frailty in old age and their families? How does this differ from the current trajectory?
• Half of those who live past 85 years old will have cognitive failure. What health care, social supports, and financial arrangements would serve people touched by this challenging situation?
• Which of the current reforms and trials offer prospects of moving us toward a workable set of solutions—that is, more appropriate and desirable services, at lower cost? Are there additional strategies that should be tested and developed?
• What role might local coalitions, commissions, and communities have?