A Wise Prescription for Reform

Dr. Jason Karlawish has a deceptively direct prescription for transforming eldercare: make it a political priority and emphasize human connections.

Karlawish is the co-director of the University of Pennsylvania’s Penn Memory Center. During a recent episode of the “Elevate Eldercare” podcast, he told Green House senior director Susan Ryan that he believes transforming eldercare comes down to having the political will to change the way we think about and care for elders – and their caregivers.

A physician, researcher, author, academic, and ethicist, Karlawish isn’t just blowing smoke. He said it’s time for lawmakers to have the difficult yet necessary conversations to define and implement a national system that respects and supports elders regardless of their cognitive abilities.

Through his work at the Penn Memory Center, Karlawish practices what he preaches. The center offers a different model of care that assists patients with cognitive impairment and their families from a holistic and interdisciplinary perspective. Together, elders and caregivers meet – with physicians and social workers at the center – to assess needs and compose a treatment plan that encompasses vital social and psychological elements.

A shift in attitudes about aging and reframing the vital role of caregiving are critical first steps to reforming the current system. Ageism and its associated stigmas must be eliminated, he said. Normal aging is viewed as an undesirable change in abilities that diminish and marginalize elders, he said, as opposed to a natural part of life that can be managed while still honoring autonomy and independence. These negative labels devalue older people and cause isolation that increases suffering for everyone involved.  

Stigmas carry over to caregivers, too. The caregiver role also must be re-envisioned, broadened, and elevated, he said. Supporting the mind of another person is a big job that is misunderstood and under-valued. The physical and psychological challenges of caring for an elderly family member must be recognized and cherished.

Karlawish said our current eldercare system is disorganized and chaotic. Eventually, drugs will be developed that may delay cognitive decline but that won’t solve the larger issue, he said. Going forward, long-term care must offer safe, social, and engaging programs and treatments. A sound, comprehensive infrastructure must be built that includes technology but also considers other important issues such as transportation and finances so that people of all physical and cognitive abilities can live well and with dignity.

Karlawish called for a national long-term care continuum that compassionately and realistically considers elders’ inevitable medical and social needs. We need better nursing homes that feel more homelike, revere elders and deliver palliative care when needed. Combine strong social and medical supports with kindness, love, and the human touch and everyone benefits.

The Green House Project couldn’t agree more with Karlawish’s thoughtful assessment of what is needed to reform eldercare. Cultural and political events have brought the issue to a head. As demographics and attitudes change, the desperate need for reform can’t be ignored. Now is the time for strong political leadership and new viewpoints to emerge. Let’s not waste time bickering and avoiding the elephant in the room when there is so much at stake.  

Listen to the Elevate Eldercare podcast on Spotify, Apple, Stitcher, or via The Green House Project’s website, www.thegreenhouseproject.org/podcast.