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Introduction1
As the demographics of the United States shift toward a population that is made up of an increasing percentage of older adults and people with disabilities, the workforce that supports and enables these individuals is also shifting to meet the demands of this population. For many older adults and people with disabilities, their priorities include maximizing their independence, living in their own homes, and participating in their communities. In order to meet this population’s demands, the workforce is adapting by modifying its training, by determining how to coordinate among the range of different professionals who might play a role in supporting any one older adult or individual with disabilities, and by identifying the ways in which technology might be helpful.
To better understand how the increasing demand for supports and services will affect the nation’s workforce, the Health and Medicine Division and the Division of Behavioral and Social Sciences and Education of the National Academies of Sciences, Engineering, and Medicine (the National Academies), with support from a group of sponsors (see page ii for a list) convened a public workshop on June 27, 2016, in Washington, DC. The workshop was hosted by the National Academies’ Forum on
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1 The planning committee’s role was limited to planning the workshop, and the Proceedings of a Workshop was prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants, and have not been endorsed or verified by the National Academies of Sciences, Engineering, and Medicine, and they should not be construed as reflecting any group consensus.
Aging, Disability, and Independence2 (the forum), an ongoing, neutral convening activity with stakeholder members from the federal government, industry, academia, and nonprofit organizations. The forum meets to discuss how to support independence and community living3 for people with disabilities and older adults. The forum is particularly interested in four focal areas that are key to supporting community living and enabling individuals to maximize their independence: home and community settings, services and supports, workforce, and financing. The forum also explores how technology, policy, research, and quality can affect these four focal areas (see Figure 1-1).
This workshop, planned by an ad hoc committee (see Box 1-1 for the committee’s statement of task), aimed to identify how the health care
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2 See www.nationalacademies.org/ADIForum (accessed July 22, 2016).
3 For the purposes of this Proceedings of a Workshop, “community living” refers to living at home, as opposed to living in a residential facility, unless stated otherwise in the text.
workforce can be strengthened to support both community living and community participation for adults with disabilities and older adults. It was organized to meet the following five objectives:
- Discuss the state of knowledge in the field: Identify qualities that may be needed in the workforce providing services and supports to enable older adults and people with disabilities to live in the community and participate in activities of their choosing. Explore models and potential best practices.
- Explore strategies to increase and measure the quality of the workforce as well as better understand the needs, barriers, and opportunities for coordination across the workforce.
- Review technologies that have the potential to strengthen the workforce and enable community living and participation while also maintaining person-centeredness.
- Highlight data and research needs to support policy changes that could strengthen the workforce and community infrastructure.
- Consider strategies for disseminating effective methods to aging and disability stakeholders.
Under the National Academies guidelines, workshops are designed as convening activities and do not result in any formal findings, conclusions, or recommendations. Furthermore, the Proceedings of a Workshop reflect what transpired at the workshop and do not present any consensus views of either the planning committee or the workshop participants. The purpose of these proceedings is to capture important points raised by the individual speakers and workshop participants. Speaker presentation slides are also available.4
After two context-setting keynote presentations, the workshop featured three panels of presentations designed to meet the above objectives. Each panel consisted of three or four presentations followed by a short question- and-answer session and a 15-minute facilitated discussion among small groups of workshop participants that aimed to address one of two questions related to the immediately preceding panel presentations. A rapporteur at each table then presented the results of those discussions to the workshop audience at large.
OPENING REMARKS
Workshop planning committee co-chairs Terry Fulmer of The John A. Hartford Foundation and Fernando Torres-Gil of the University of California, Los Angeles, welcomed the workshop participants. Torres-Gil began the workshop by noting that one of the priorities for the forum is to better understand how the nation can prepare for the inevitable future in which an increasing percentage of Americans are older and have disabilities. This trend will continue regardless of the nation’s political climate, said Torres-Gil. “Thus,” he said, “the issues of workforce and its many manifestations and how it relates to a community-based system [are] critical as we begin to prepare for hopefully some opportunities in the years to come to expand a long-term care support system.”
ORGANIZATION OF THE PROCEEDINGS
The workshop (see Appendix A for the agenda) was organized by an independent planning committee in accordance with the procedures of the National Academies. This publication describes the presentations and the discussions that occurred throughout the workshop. Citations included in this proceedings are from the workshop presentations and discussion, with the exception of those that are provided in clarifying footnotes. Generally, each speaker’s presentation is reported
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4 See http://nationalacademies.org/hmd/Activities/Aging/AgingDisabilityForum/2016JUN-27.aspx (accessed July 22, 2016).
in a section attributed to that individual. In some cases, a speaker’s responses given during discussion sessions were incorporated into the section describing that speaker’s presentation. In addition, presentations and discussions may be organized in a different order from that in which they occurred during the workshop in order to create a better flow of information for readers of this Proceedings of a Workshop. Chapter 2 recaps two keynote presentations that provided a backdrop for the rest of the workshop’s discussions. Chapter 3 examines how workforce training, education, and development can enable community participation, and Chapter 4 considers various perspectives on coordination across the spectrum of caregivers, providers, services, and supports. Chapter 5 discusses efforts to harness the potential of technology to enable community living and participation while also optimizing person-centered services. Chapter 6 details workshop participants’ comments discussed during facilitated table discussions on strengthening the workforce. Chapter 7 provides a brief summary of the workshop’s key points and closing remarks.
In accordance with the policies of the National Academies, the workshop did not attempt to establish any conclusions or recommendations about needs and future directions, focusing instead on issues identified by the individual speakers and workshop participants. In addition, the organizing committee’s role was limited to planning the workshop. This Proceedings of a Workshop has been prepared by workshop rapporteurs Joe Alper and Sarah Domnitz as a factual summary of what occurred at the workshop.
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