IPA Bulletin: VOLUME 36, NO. 1 • MARCH 2019
Mary Sano, IPA President
I have had an opportunity to visit our affiliates and other colleagues around the globe and through these visits, I am reminded of the importance of the work to serve our members who serve the mental health and wellness needs of patients. In December, I had the honor to be invited to Naples to the XIV Brain Aging Conference sponsored by the Associazione Ilatialine Geriatrica. This meeting entitled “Psychogeriatrics: Between neurobiology, clinic, relationship. A medicine for our time” showcased the best of our knowledge about caring for aging populations. The meeting’s Chair, Dr. Vincenzo Canonico opened the meeting and the President of the Association, Dr. Marco Trabucci presided over the first day’s sessions. We heard from Paola Barbarino, CEO of Alzheimer’s Disease International (ADI) who reminded the audience of the global nature and magnitude of the epidemic of Alzheimer’s disease. Dr. Diego De Leo spoke on loneliness in the elderly, a topic which has received global attention. Some have suggested social isolation, a growing problem that contributes to loneliness, pointing out that mobility and economic limitations cause this isolation.
This trip was followed by an invitation to join the Alzheimer Association in their satellite meeting in Bengaluru where I was impressed to hear the sophistication of our Indian colleagues in identifying cognitive loss and dementia. One highlight of the meeting was to hear about the social networks in place to serve individuals who live in remote areas of the country. Public health service delivered via nurses and other community workers shares the burden of identifying and managing diseases.
Finally, I was invited to a meeting organized by Drs. Ilan Gonen and William Reichman, the president-elect of IPA. Entitled “Long Term Care: Aging in Place”, this event brought together disruptive thinkers from aging advocacy, aging residency and healthcare, health technology and health economics to provide transformative ideas on best practices of aging health and living opportunities. The session opened with a keynote by Dr. Nir Barzilai who described the science of aging and potential to define an indication in which interventions might interrupt both the aging process and the diseases which accompany aging. With that potential, the meeting faced the challenges of living longer and living better. The meeting provided us with economic challenges to longer life, reminding us that wrap-around services to provide for both health and living would be required.
One challenge is that currently institutions and governments compartmentalize services and the monies that pay for them. For example, housing and health care budgets are separate entities but housing can provide better compliance with health management. The audience was challenged to think about broader systems in which payors could cross current barriers which currently delineate between health services and social services, despite the fact that one may not be helpful if the other is ignored. For example, transitioning to home after hospital might require home adaptation in the home setting that is not supported by current health services. Models of financing that permit support across these traditionally distinct sectors are needed to maximize the quality of life for an aging person.
Another challenge is addressing the need to remain connected, related and meaningfully engaged with others as we age. These are certainly the areas in which our IPA members have the commitment and expertise. IPA members across disciplines strive to ensure that older persons have the opportunity to experience mental health and wellness and this experience often identifies a need for socialization and supervision. These needs may be difficult to address in long term care setting, which may be remote from family and friends. Even models of “aging in place” may limit access to the range of services and opportunities that are needed to ensure that clients have the opportunity to experience the fullness of health, wellness and even satisfaction in the lives they lead.
Another theme of the Long Term Care meeting was the use of technologies across many aspects of healthy aging. In particular, many technologies exist to help overcome barriers of distance or immobility, that lead to isolation and that can exacerbate loneliness. Descriptions of prototypes for connecting people across distances and generations were provided, and case studies of technologies to enhance health care communication and social interaction were discussed. At the individual level, however, limited income and resources may hinder uptake. Also cognitive and physical challenges to learn and adopt technology may impede maximal use and stigma associated with these challenges may make it difficult for individuals to ask for assistance. On a global level, it was noted that developing countries with limited infrastructure may not be able to support the systems needed to ensure connectivity or the education to use such capacities. However, the potential is great and the work of overcoming these barriers was made transparent.
I hope IPA and its members will contribute to these topics, creating innovative solutions to identifying methods that advance aging mental health and wellness to be delivered over the “long term” in any setting, permitting aging persons to age in the best place for them.