difference

What’s the Difference between LifeStyle Solutions
and other long term care insurance policies?

  • LifeStyle Solutions (LSS) offers the opportunity for proactive assessments through the Coventry Service Program for free from the first day of the policy.
  • Wellness is at the heart of all that we do, based on our 7 dimension wellness model! We promote positive aging through a focus on collaborative planning and prevention.
  • LSS long term care insurance offers a Select class of insurance for individuals with conditions that make it difficult for them to obtain coverage.
  • Use of the Coventry Service Program does not affect the insurance policy or premium.

What is The Coventry Service Program?

kayaking

The Coventry Service Program Includes:

  • Free consultation and information about whatever is on the member’s mind. We often talk with our policyholders about:

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    Safety at Home to Age in Place

    Staying Physically Active

    Fall Prevention

    The Importance of Social connections

    Driving Safety

    Caregiving

    Resilience

    Maintaining Brain Power

    Making a Contribution/Sharing your Talents

    Livable or Age-Friendly Communities

    So give us a call soon!

  • A pro-active assessment for conditions that could threaten independence (CCTI’s) based on current research. That is paired with pro-active planning for aging well in place.

  • Periodic Check-in calls

  • Educational initiatives through Community of Members teleconferences, newsletters, and more.

  • Individual wellness plan with functional fitness test.

Why Do We Have Such A Focus On Wellness?

kayaking
  • Our approach is holistic and multi-dimensional because so many things can contribute to the quality of an older adult’s life.
  • We are committed to helping people “age how and where” they choose.
  • Research consistently documents the link between well-being and higher activity levels.
  • Social engagement, a sense of purpose and fall prevention all have protective benefits.

The seven dimensions of the Wellness Model

wellness model
  • The Physical Dimension – Maximizing your functional fitness and physical capacities

  • The Spiritual Dimension – Nourishing your soul and having a sense of meaning

  • The Vocational Dimension – The broad sense of work; having a sense of purpose and making a contribution with your skills & talents

  • The Environmental Dimension – Creating a physical environment that is manageable, safe and supports your aging in place

  • The Emotional Dimension – Being able to express and manage your feelings; coping with stress/challenges

  • The Social Dimension – Building & maintaining social networks, giving and getting support from friends & family

  • The Intellectual Dimension – Engaging your brain and stretching it with lifelong learning, experiences and activities

*The seven dimensions wellness model is based upon the work of Bill Hettler, MD, at the National Wellness Institute, and the International Council of Active Aging; and the wellness program was designed in collaboration with the John Hopkins University School of Medicine Division of Geriatrics.

the research says

  • People more fit and active died at half the rate than of those who were less fit and had a higher score on the Fried Frailty Index. 1

  • A recent 25 year study came to the conclusion “The effects of healthy lifestyle factors on the proportion of future life lived free of disability indicate that the disabled period can be compressed, given the right combination of these factors.” 2

  • The pilot CAPABLE Program (Community Aging In Place, Advancing Better Living for Elders) aimed to reduce the impact of disability among a sample of older adults by addressing both the individual functional capacity and home environment. For example, it provided access to assistive devices, home modifications and functional strengthening through a multi-disciplinary team to participants. After participating, 75% of the study members improved their performance of activities of daily living (ADL’s) and the number of ADL’s they struggled with dropped by half. Home hazards were reduced from an average of 3.3 to 1.4 hazards. The practical effect of these improvements in functioning and home safety can be life changing, in terms of enabling participants to stay in their homes with reduced risks and enhanced capacity. 3

1Rockwood, Kenneth, MD etal. "Changes in relative fitness and frailty across the adult lifespan: evident from the Canadian National Population Health Survey".  CMAJ. 2011 May, 17, 183(8); E487-E494. 2Jacob, Miniood, MD et al, “Can a Healthy Lifestyle Compress the Disabled Period in Older Adults?”. Journal of the American Geriatrics Society, Vol. 64. 2016, p.1952-1961. 3Szanton, Sarah, et.al. “Home-Based Care Program Reduces Disability and Promotes Aging in Place”, Health Affairs 35, No. 9 (2016): p.1558-1563.

How does the service program work?

hollyphone
  • Through a National Program Office in Maine, our team of MSW Wellness Specialists builds relationships nationwide by phone.
  • Staff has deep and varied experience in aging.
  • After the policy purchase, each policyholder gets a welcome letter from Bill Neugroschel, CEO, and Phyllis Bailey, National Director, Coventry Service Program.

  • Wellness Specialists follow with a personal outreach call, inviting use of any Service Program component.
  • Work evolves based on what we learn from policyholders and research.

frequently asked questions

arbor

Q - What is in the Coventry Service Program?

A - It starts with outreach and check-in calls to our policyholders; may include an assessment for conditions that threaten independence, or creation of a personal wellness plan; but always offers consultation and information about resources that members may need. It just depends on what the member decides to use. Periodically, we may also offer Community of Members Conversations via teleconference, webinars, policyholder newsletters or e-bulletins.

Q - Why is the Service Program offered?

A - Research consistently documents that being pro-active about what contributes to personal well-being makes a difference in deferring disability and sustaining a high quality of life as people grow older. Our goal is to optimize both the functional ability and vitality of our members! Research outcomes shape our program.

Q - Does it cost extra?

A - No, the Service Program is free and built into our LSS and LSS Select insurance policies. Using the Service Program will not affect your policy or premium.

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More FAQ's

Q - Who delivers the Service Program?

A - Coventry created a centralized national service program team of seasoned professionals with experience spanning the spectrum of options for older adults. They collaborate with local, regional and national leaders to find the best information and options to assist members in making decisions about what will help them live well as they grow older. Policyholders always get a personalized response!

Q - How do I contact the Service Program?

A - After a LSS or LSS Select long term care insurance policy is purchased, the new policyholder will be contacted and given the toll free phone number for the Coventry Service Program. The Service Program will check-in annually as long as you are a policyholder, more often if you request it.

Q - Does the Service Program pay for suggested services?

A - No, the service program does not pay for suggested services that grow out of the wellness planning or consultation process. If, for example, an outcome of an assessment was a suggestion that a member consider installing a handrail on a staircase to improve safety, the member would be responsible for purchasing the materials and paying for the installation. However, the Service Program can help the member locate someone to do the work, and can provide tools to help the member make an informed decision about who to hire for the work.

Q - What is the "Wellness Model" at the heart of the Coventry Service Program?

A - The 7 dimension wellness model is consistent with both current research findings and Coventry's belief that well-being as people age is affected by much more than their physicial health. Key contributors to well-being also include the social, emotional, intellectual, vocational, spiritual, and environmental dimensions of an individual's life. All work with policyholders is rooted in this holistic approach.

Q - How do members get information about their LSS or LSS Select long term care insurance policy?

A - If a member wishes to talk with someone about their policy, billing for premiums or questions that they have; she/he can call the Coventry Insurance Customer Service phone line toll-free at 1-877-782-4663.

Our Team

Coventry Resources

Coventry CareLink Coventry Service Program United Security Assurance
Headquarters
Baltimore, MD
National Office
Freeport, ME
Souderton, PA
LSS Policy Administration Service to LSS
policyholders
LSS Marketing, Sales
& Underwriting

our founders

The Founders of Coventry CareLink came to the creation of the LifeStyle Solutions (LSS) long term care insurance product with:

• an attitude of servant leadership,
• a commitment to the creation of pro-active options for aging well, and
• experience spanning insurance, residential development and community based care.

From the beginning, it was their vision to make a positive difference in the lives of older adults in the United States, through the offering of a robust long term care insurance plan and the Coventry Service Program which is an integral part of it. Rooted in a multi-dimensional model of personal wellness, the Service Program was designed to help policyholders promote their own health and well-being in the hope of deferring disability; and to offer information about supports for aging well in their homes when needed.

A deep initial collaboration with Johns Hopkins University School of Medicine Division of Geriatrics resulted in the first Coventry long term care insurance product, which continues to be shaped by the best practices and innovations of the present. The LifeStyle Solutions long term care insurance plans are underwritten and issued by United Security Assurance Company of Pennsylvania, a licensed life and health insurance sister company to Coventry.

The Vision of Our Founders, Bob and Gail Haldeman

founders

Sadly, we lost our Founder and President, Mr. Bob Haldeman, in February of 2016 to his fight with cancer. He was a gentle visionary we miss sorely. Bob and Gail, his wife of 51 years, are the reason for the development of LifeStyle Solutions long term care insurance – this unique combination of insurance benefits to offer some financial security and a service program to help policyholders stay well and active at home, before a claim is ever made. “We know this is an unusual combination – that few other long term care insurance companies offer a pro-active program to help policy holders stay well and at home. But we believe this is essential to a vital older age”, Bob said. Gail continues her involvement as a Board member, and their long term colleague, Bill Neugroschel, continues at the helm of the company as CEO.

Bob’s Vision still inspires us: “We will make a positive difference in the lives of older adults in the United States, through our Program and Plan. We will achieve this goal by offering a plan for staying at home as long as possible, with secure living based on financial protection, enjoyment of good health and wellbeing, strong social and cultural interests, and sound advice when further care is necessary.”

How We Began

arbor

The Coventry Service Program grew out of Coventry CareLink’s 15+ years of experience developing, building and opening continuing care retirement communities which provided financial protection for long term care costs and a full continuum of services on-site. Many consumers Coventry encountered asked, “Is there a way to get the same financial protection and access to services supporting my independence at home instead of moving?”

Our LifeStyle Solutions Long Term Care Insurance Plans and the Coventry Service Program are an integrated response to that question, promoting overall well-being through a research based program of 1) assessments for conditions that can create threats to your independence (CCTI's); 2) consultation about resources needed to maximize independence at home; and 3) personalized wellness planning. It also offers, if needed, assistance to enable policyholders to make the best possible use of LTC insurance benefits if more intensive needs arise. All of this happens when our seasoned professional staff collaborates with policyholders to create customized responses to the challenges which may emerge as they age in the homes they love.

The LifeStyle Solutions long term care insurance plans are underwritten and issued by United Security Assurance Company of Pennsylvania, a licensed life and health insurance company, which is a sister company to Coventry CareLink.

Why the name Coventry?

During a bike tour of the British Isles, principals of the firm visited Coventry Cathedral, which was bombed into ruins during World War II and then rebuilt through the joint efforts of the former enemies, Germany and England, after the war. A bombed out shell of the original church connects with a modern edifice, and speaks to the power of reconciliation. The combined structure also speaks to the creation of alternatives, in this case to war and violence, which has since become a significant ministry of the cathedral.
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Why The Name Coventry

During a bike tour of the British Isles, principals of the firm visited Coventry Cathedral, which was bombed into ruins during World War II and then rebuilt through the joint efforts of the former enemies, Germany and England, after the war. A bombed out shell of the original church connects with a modern edifice, and speaks to the power of reconciliation. The combined structure also speaks to the creation of alternatives, in this case to war and violence, which has since become a significant ministry of the cathedral.

The story of Coventry Cathedral took on new meaning when discussed among staff of the company. In their view – Coventry as a company could parallel the reverence for the past while utilizing the innovations of the future.

Coventry could preserve long held values of dignity and choice for those it serves; yet lead in the development of progressive alternatives in life options for older adults.

Coventry could prize the life experience of our elders, yet utilize findings from emerging research to serve them better.

The Coventry name is consistent with remembering lessons learned from the Coventry Cathedral experience about reconciliation; as we work to reconcile the consistent desire of older adults to age well in their own homes, with practical pro-active options to make that a possibility.

Why Do We Have a Thistle in Our Logo?

thistle

A word about the logo.

Thistles are weeds that grow almost anywhere. They thrive in the most adverse conditions and succeed where other plants wither. We believe the thistle represents a tenacity of spirit central to Coventry’s work!

What Motivates Us

Bill Neugroschel, CEO -“I was drawn to the aging services field because of my admiration for my maternal grandmother, Rose, who lived as the in-house matriarch with my parents, brother and I when I was growing up. And I was drawn to Coventry by the innovative ideas of the company founder, Bob Haldeman, who saw the unique need for a long term care insurance product based on the philosophy of continuing care retirement communities.”

Elaine Griffin, Vice President for Operations - "I am motivated to provide excellent customer service to both internal and external customers. It is my pleasure to motivate our Baltimore-based operations team daily and to help them keep the focus on our customers. I am proud to be a part of a Company that is committed to excellence and whose goal is to reach outcomes that benefit each party. It gets me up each day!"

Phyllis Bailey, National Director, Coventry Service Program - “Preserving dignity and an array of choices makes all the difference - I know that from caring for my parents and from the quality of life my grandfather experienced into his 90’s. I am committed to creating options so older adults can age how and where they chose."

Gordon Haldeman, Wellness Director - “This all started in a conversation with my Dad at a Raven’s football game where he invited me to come work on a project on how people can age well. I had the chance to watch that up close because my grandmother had always lived upstairs or one block away my whole childhood.”

Terri Robinson, Senior Director of Marketing, Communications & PR“I came to this company because I wanted to work in a small company – where if one succeeds, all succeed; and there is a direct connection between the people who buy and sell our products and services."

Matt Sussman, Senior Director of Business Development“I do what I do because I love to help people. I was the conservator for my grandmother who needed care, because no one else was available. She did not have long term care insurance - would never have qualified for it, and when the first bill came in, I was shocked at the cost of home care. Not having a plan made it really difficult.”

Contact Us

For questions about an existing LSS long term care insurance policy – please call the Coventry CareLink LifeStyle Solutions Customer Service Team toll-free at 1-877- 782-4663. For Billing, Credit Cards payments, Premium questions, or Refunds, etc., press 2 and follow the prompts.

For Claims, please press 4 and follow the prompts.

Or by e-mail Customer Service can be reached at carelink@coventrycarelink.com. The mailing address is Coventry CareLink, 1302 Concourse Drive, Suite 303, Linthicum, Maryland, 21090.


To utilize the free Coventry Service Program that is part of LifeStyle Solutions long term care insurance policies (for free consultation and information or a personalized assessment), policyholders can call the Service Program toll-free at 1-855- 865-4114. The mailing address for the Coventry Service Program is 174 South Freeport Road, Suite 2-C, Freeport, Maine 04032; and the e-mail address is serviceprogram@coventrycarelink.com.


If you are interested in finding a local broker for LifeStyle Solutions Long Term Care insurance, please call United Security Assurance toll-free at 1-800- 872-3044, extension 129. The address for United Security Assurance is PO Box 64477, Souderton, PA 18964. The e-mail address is marketing@usa-cal.com.

Newsletters

Books We've Enjoyed

Many books come our way, and here are a few that we have enjoyed!

In “Life Gets Better: The Unexpected Pleasures of Growing Older”, author Wendy Lustbader, (who has worked for several decades as a social worker specializing in aging issues), conducted first-hand research with older adults in all walks of life. She found overwhelmingly that they spoke of the mental and emotional richness they have drawn from aging; and rather than experiencing a decline from youth, aging people were happier, more courageous and more interested in being true to their inner selves than were young people she interviewed. A good counter-balance to the “fear of aging” stereotypes in the media.

“The Book of Joy: Lasting Happiness in a Changing World”, by His Holiness the Dalai Lama and Archbishop Desmond Tutu with Douglas Abrams. (2016). This book is a record of the unprecedented week that these two spiritual luminaries spent together to celebrate the Dalai Lama’s 80th birthday. The book offers a chance to listen in as they humbly explore how they have developed lives of peace, courage and joy despite experiencing severe challenges of loss, violence and oppression in their lifetimes.

“Being Mortal: Medicine and What Matters Most”, by Atul Gawande (2014) This book was an honest recognition by a medical doctor that the medical profession has not always considered the human and personal needs of the patient when wanting to use the doctor’s knowledge and skill to “cure” or at least alleviate the maladies that afflict us as patients, especially in the later years of life. It gave me hope that there are some who are recognizing the importance of giving patients all their options and the subsequent consequences of each. It is also a reminder to us as patients and/or potential patients that we are the ones who need to let doctors know what we want to be able to do in our life while living with whatever disease or condition we happen to have. Very readable and encouraging! (from Linda M., Wellness Specialist)

"The Third Chapter: Passion, Risk and Adventure in the 25 Years after 50", by Dr. Sara Lawrence-Lightfoot.
In this book, the author talks about revisiting paths not taken in earlier years, and about being open to new adventures rather than staying purely in your comfort zone as you grow older.

If you would like to recommend some books for inclusion here, send a note to: serviceprogram@coventrycarelink.com.


Life Lessons

When we talk with our policyholders, we periodically ask them “what are Life Lessons you have learned that you would like to share with other people?” Here are some of the insights offered in the last 12 months.

life lessons
“Don’t take yourself too seriously and be positive whenever you can. It’s important to live in the moment and forgive so you do not dwell on the past and can move forward. Look forward and leave everything negative behind you. Cherish your friendships because they are your lifeline. Always take care of your spiritual life because it's there for you at your lowest times, and take care of your physical body so it will function longer. In life remember to always do your best, always be truthful, and don't make assumptions.” P.A. Texas.

“Think before you act! Don’t let one moment of pleasure ruin your life forever. Don’t stand by while injustice is happening.” L.A. Texas

“Keep a good spiritual, emotional and physical balance in life. It is good to put others before yourself instead of “being all about yourself”. I wish my kids could find a better balance of priorities in their busy lives. I do not get “wrapped up” in technology and wish that the younger generation was not so “wrapped up” in technology as well”. R.B. Ohio

“Be good to others, don’t burn any bridges, value honesty and a work ethic, and care for each other.” G.B. Ohio

“Faith and Friends!” W.E. Indiana

“Don’t take anything for granted”. N.B. Ohio

“It is important to get good guidance in life. To get basic support early in life and to get mentoring that can make you aware of what’s ahead and help you prepare. You need someone to help guide you because life gets complicated.” J.B. Pennsylvania

“Don’t be afraid of following your dreams”. D.B. Maryland

“It is important to have a good sense of self, and to also let other people be who they want to be. It is also important to not compare yourself to other people. …And it was important to realize that although bad things may happen, I had to be able to move on and not let it devastate me or hold me back. It was also important to learn what makes me happy – to not apologize for it and not care so much about what others thought. I learned that I am a good person, and doing what was best for me is important too.” C.W. Texas.

“Be responsible for your own actions, don’t make excuses. Be a leader, set a good example, don’t lose your temper. Be fair, be a planner and save for the future.” M.F. Illinois “Choose your life’s work based on personal satisfaction and the ability to live out your dreams, rather than on the amount of money you earn.” L.F. Illinois

“Learning how to love and be loved is the essence of life. ….I try to live in the present and not in the past, and feel that learning to let go of anger and resentment has been very valuable. Everyone should live with gratitude and appreciation – respecting yourself is very important in learning to respect others. This all has helped me to connect with others and live without judgement.” J.F. Illinois

“Begin with a higher being to guide you. I have told my grandchildren not to let anything keep them from success, to feel satisfied and content in life.” K.G. Louisiana

“Treasure every day, and if there are things you want to do, then get up and do them!” G.H. Georgia “Young girls need to get a good education because you never know what will happen in life and when they will need to support themselves. And it’s important for them to make sure they are happy with whatever they do in life.” F.H. Texas

“Be the best you can be and think before you do things!” K.H. Illinois

“Be true to yourself. Show love and compassion for others. Give of yourself as much as you can. Think before you speak, don’t be hasty and avoid being selfish.” L.L. Louisiana

“Doing the right thing for the right reasons”. G.M. Texas

“It’s important for people to have hobbies and interests in their life to enjoy. It’s a valuable skill for people to know how to make things, which people do not always have anymore…” D.M. Texas

“1) Do what you like, 2) Let things go, and 3) Be around people you like.” E.M. Illinois

“Do the right thing. Enjoy life but prepare for the future. Save, because you are the only one you can depend on for certain.” C.N. Texas.

life lessons
“I feel that you should decide what you want and go get it….It doesn’t matter where you come from, it’s where you want to go that matters. When I was in school, the guidance counselor told me that my sister and I should just be dishwashers. But my business teacher gave me the encouragement that I could do more and be a secretary or CPA. I overcame a lot of discrimination and poverty even though I was told that I could not do much in life. I always lived by the saying that ‘every tub sits on its own bottom’, which I took to mean that I was responsible for my own life. I am proud of my sons and others that I helped get started in the accounting field, and of my own accomplishments in my profession.” M. O. Texas

“Surround yourself with good people and good friends who support you.” J.P. Texas

“Try to keep things in perspective, stay in the present as much as possible and practice moderation.” R. R. Colorado

“Don’t worry about what you cannot change. Love life and be happy. Know when to speak and when not to speak.” C.R. Texas

“Find a joy in every day and live it. And know that there is good in every day. Be thankful for all that you have.” J.R. Illinois

“Realize how valuable you are in youself, you do not need a man to be worthwhile. Value yourself and take care of yourself. Be aware of others, and think of ways to help others.” D.R. Ohio.

“I try to practice doing unto others as I would want done to me – these positive values give me a clear conscience so I know that I can sleep well at night.” E.S. Texas

“I have tried to pass on the importance of a good education and doing the best at whatever you are doing.” J.T. Georgia.

“Life is there outside the door – and you must embrace it!” B.V. Texas

“It’s important to develop and maintain close relationships with your grandchildren: to be present in their lives, to participate in their activities and to let them know that you cherish and love them. Hopefully you will inspire and influence them the way that your grandmothers did you”. J.C. Ohio.

“Having my faith, being kind and loving to each other, and having a love of nature”. C.C. Pennsylvania.

“Probably honesty is one thing I have tried to share with my children as much as I can”. K.E. Texas

“I have learned the value of patience in relationships. I had to teach myself this and I have come to see the importance of taking time to improve relationships. Think twice, measure twice and cut once in terms of relationships”. J.B. Ohio

Research Updates

Click on the links below for information about emerging research!

woman on computer
  • Here is an abstract for the research article on compressing the disabled period in older adults through a healthy lifestyle.

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    Compressing the Disabled Period

    Journal of the American Geriatrics Society. 2016 Oct; 64 (10): pages1952-1961.

    Can a Healthy Lifestyle Compress the Disabled Period in Older Adults?

    Authors: Jacob ME1,2,3, Yee LM4, Diehr PH4,5, Arnold AM4, Thielke SM6,7, Chaves PH8, Gobbo LD9, Hirsch C10, Siscovick D11, Newman AB12.

    Abstract

    OBJECTIVES:

    To determine whether lifestyle factors, measured late in life, could compress the disabled period toward the end of life.

    DESIGN:

    Community-based cohort study of older adults followed from 1989 to 2015.

    SETTING:

    Four U.S. communities.

    PARTICIPANTS:

    Community-living men and women aged 65 and older (N = 5,248, mean age 72.7 ± 5.5, 57% female, 15.2% minority) who were not wheelchair dependent and were able to give informed consent at baseline.

    MEASUREMENTS:

    Multiple lifestyle factors, including smoking, alcohol consumption, physical activity, diet, body mass index (BMI), social networks, and social support, were measured at baseline. Activities of daily living (ADLs) were assessed at baseline and throughout follow-up. Years of life (YoL) was defined as years until death. Years of able life (YAL) was defined as years without any ADL difficulty. YAL/YoL%, the proportion of life lived able, was used to indicate the relative compression or expansion of the disabled period.

    RESULTS:

    The average duration of disabled years was 4.5 (out of 15.4 mean YoL) for women and 2.9 (out of 12.4 mean YoL) for men. In a multivariable model, obesity was associated with 7.3 percentage points (95% confidence interval (CI) = 5.4-9.2) lower YAL/YoL% than normal weight. Scores in the lowest quintile of the Alternate Healthy Eating Index were associated with a 3.7% (95% CI = 1.6-5.9) lower YAL/YoL% than scores in the highest quintile. Every 25 blocks walked in a week was associated with 0.5 percentage points (95% CI = 0.3-0.8) higher YAL/YoL%.

    CONCLUSION:The effects of healthy lifestyle factors on the proportion of future life lived free of disability indicate that the disabled period can be compressed, given the right combination of these factors.

    © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  • This research abstract summarizes the initial findings regarding the CAPABLE program, which offers home modification in addition to other supports.

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    Capable Program

    Published in Health Affairs, September 2016. vol. 35 no. 9. pages 1558-1563.

    Home-Based Care Program Reduces Disability And Promotes Aging In Place

    +Author Affiliations

    1. 1Sarah L. Szanton (sszanto1@jhu.edu) is an associate professor of nursing and of health policy and management at Johns Hopkins University, in Baltimore, Maryland.
    2. 2Bruce Leff is an associate professor of medicine and nursing at Johns Hopkins University. 3. 3Jennifer L. Wolff is an associate professor of health policy and management at Johns Hopkins University.
    4. 4Laken Roberts is PhD student in nursing at Johns Hopkins University.
    5. 5Laura N. Gitlin is a professor of nursing and medicine at Johns Hopkins University.

    Abstract

    The Community Aging in Place, Advancing Better Living for Elders (CAPABLE) program, funded by the Center for Medicare and Medicaid Innovation, aims to reduce the impact of disability among low-income older adults by addressing individual capacities and the home environment. The program, described in this innovation profile, uses an interprofessional team (an occupational therapist, a registered nurse, and a handyman) to help participants achieve goals they set. For example, it provides assistive devices and makes home repairs and modifications that enable participants to navigate their homes more easily and safely. In the period 2012–15, a demonstration project enrolled 281 adults ages sixty-five and older who were dually eligible for Medicare and Medicaid and who had difficulty performing activities of daily living (ADLs). After completing the five-month program, 75 percent of participants had improved their performance of ADLs. Participants had difficulty with an average of 3.9 out of 8.0 ADLs at baseline, compared to 2.0 after five months. Symptoms of depression and the ability to perform instrumental ADLs such as shopping and managing medications also improved. Health systems are testing CAPABLE on a larger scale. The program has the potential to improve older adults’ ability to age in place.

  • This research abstract provides an overview of a key study about relationships between frailty and an individual’s relative fitness.

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    On Frailty

    Published in the Canadian Medical Association Journal. 2011 May 17; 183(8): E487–E494.

    Changes in relative fitness and frailty across the adult lifespan: evidence from the Canadian National Population Health Survey

    Authors: Kenneth Rockwood, MD, Xiaowei Song, PhD, and Arnold Mitnitski, PhD

    Background:

    The prevalence of frailty increases with age in older adults, but frailty is largely unreported for younger adults, where its associated risk is less clear. Furthermore, less is known about how frailty changes over time among younger adults. We estimated the prevalence and outcomes of frailty, in relation to accumulation of deficits, across the adult lifespan.

    Methods

    We analyzed data for community-dwelling respondents (age 15–102 years at baseline) to the longitudinal component of the National Population Health Survey, with seven two-year cycles, beginning 1994–1995. The outcomes were death, use of health services and change in health status, measured in terms of a Frailty Index constructed from 42 self-reported health variables.

    Results

    The sample consisted of 14 713 respondents (54.2% women). Vital status was known for more than 99% of the respondents. The prevalence of frailty increased with age, from 2.0% (95% confidence interval [CI] 1.7%–2.4%) among those younger than 30 years to 22.4% (95% CI 19.0%–25.8%) for those older than age 65, including 43.7% (95% CI 37.1%–50.8%) for those 85 and older. At all ages, the 160-month mortality rate was lower among relatively fit people than among those who were frail (e.g., 2% v. 16% at age 40; 42% v. 83% at age 75 or older). These relatively fit people tended to remain relatively fit over time. Relative to all other groups, a greater proportion of the most frail people used health services at baseline (28.3%, 95% CI 21.5%–35.5%) and at each follow-up cycle (26.7%, 95% CI 15.4%–28.0%).

    Interpretation

    Deficits accumulated with age across the adult spectrum. At all ages, a higher Frailty Index was associated with higher mortality and greater use of health care services. At younger ages, recovery to the relatively fittest state was common, but the chance of complete recovery declined with age.

Tools That Help

Some helpful links and tips. More coming!

Click here for a helpful checklist from AARP on making your home fit for aging comfortably in place.

If you want to suggest other tools you found useful, please send them to: serviceprogram@coventrycarelink.com.