LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1. Change in how society lives - different towns/states and less ability to care for family/isolation

2. Women in the workforce

3. People living longer, more complex health issues

4.

​

1. Desire to age at home

2.

3.

4.

1. Financial security/retirement savings/living on edge of poverty

2. Change in volunteer habits

3.

4.

1. Lessened/unstable funding

2. Supplemental benefits vs other sustainable structures

3. More people over 60 living alone/more dependence upon HCBS and communities

4. Assisted Living/transition communities

1. Diversification of issues that affect demographics (gender rights/roles/identity, broader race narrative)

2. Desire for services and products to be at our fingertips

3.

4.

​

​

​

​

​

​

​

What Drove the Changes?

​

1. Ability to move to different states, both members of partnership working smaller families/fewer adult children
2. Need income to sustain reasonable budget
3. Medical technology and research/treatment advancements

4.

​

1. Change in family structure, smaller families, not as large family networks, fierce independence/not wanting to be a burden

2.

3.

4.

1. Loss of or reduction in pensions, social security not meeting needs

2. Other volunteer commitments, change in lifestyles, second employment

3.

4.

1.

2. Managed care

3. Living apart, people not having children

4. More housing options available for people with resources

1. Changing laws, rights, values
2. Cultural and generational changes

3.

4.

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1.Older Americans Act

2.

3.

4.

​

1.

2.

3.

4.

1.Chipping away of economic security in older age

2.healthcare workforce changed

3. Early retirement became a trend

4. Improvements in care for memory loss and other healthcare needs for older adults

1. technological innovations have increased communication options and services for older adults. Technology has also created a big barrier for many older adults

2. Older adults are seen as a key marketing segment and new services/products are created (like senior living communities at universities)

3.

4.

1.

2.

3.

4.

​

​

​

​

​

​

​

What Drove the Changes?

​

1.Perception of older adults as poor. and understanding that families need help (services and financial support) in caring for older adults

2.

3.

4.

​

1.

2.

3.

4.

1. Pension plans disappeared

2. As more professions opened up to women, nursing and more traditional caregiving roles started to see impact. Relatedly, more immigrants started filling in those positions.

3. BEtter research and understanding of dementia and alzheimers

4.

1. Older adult population is growing, and are have money, and they still have time and money to spend

2.

3.

4.

1.

2.

3.

4.

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1. Institutions were teaching restraints

2. Stigma of certain diseases - county homes

3. Caregivers were not identified or defined

4. Started to see diagnosis and more education

​

1. OBRA, SNF’s
2. Structure to SNF

3.

4.

1. SAIL
2. Classes, exercise

3.

4.

1. Assisted Living increase in Minnesota

2.

3.

4.

1. Identification of Caregivers
2. Respite
3. Shift to HCBS services

4. Co-creating and collaboration

Basically started heavily institutionalized environment to more home and community based setting - more defined by the end user

​

​

​

​

​

​

What Drove the Changes?

​

1. Establishment on OAA, Medicare, Medical Assistance
2. Baby Boomers
3. Improvement in Science Breakthroughs

4.

​

1. Careers for RN, LPN and other health care

2.

3.

4.

1. Transform 2030

2.

3.

4.

1. Increase in reports of negative outcomes

2.

3.

4.

1. Communication and
2. SDOH
3. Technology
4. Empowerment

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1. Multi-generational living settings

2.

3.

4.

​

1. moving away from “institutions” to more community-focused settings

2.

3.

4.

1. HMOs introduced
2. growth of home care and community based services
3. providers specializing in geriatrics

4.

1. focus on dementia care
2. families are spread out, not in same geographic areas as their aging loved ones

3.

4.

1. Changing demographics - more baby boomers
2. workforce issues
3. limited access to affordable and accessible housing

4.

​

​

​

​

​

​

​

What Drove the Changes?

​

1.

2.

3.

4.

​

1.

2.

3.

4.

1. changes in healthcare delivery models - get people in and out

2.

3.

4.

1. technological advances
2. families not close in proximity
3. more restricted insurance coverage
4. economic and cultural disparities

1. ​

2.

3.

4.

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1. Deinstutionalization of aging servies

2. Family systems began to change- less intergenerational housing. families became more mobile

3.

4.

​

1.Mortium of Nursing Homes

2. Hmoung- immegration

3.

4. Continuum model of care

1. Life expenency and comorbid health issues impacting the aging process and the need for help

3. More acceptance of asking for help

4.

1.Funding of HCBS began

2. Case Loads are larger

3. Somalia immegration

4. Nature of senior servies as an industry small to business ( home to company to larger industry) Profiit growth mindset.

Vertical business models.

1.Recognition of Social Determenites of health

2. Non-profit survival and the need to look and act like a profit org.

3.Staying home to long

4. Middle market is being edgeout

​

​

​

​

​

​

​

What Drove the Changes?

​

1. lower birthrate- affordiablity of housing.
2. Bummer generation emerged

3.

4.

​

1.Capitolism

2.

3.

4.

1.

2.

3.

4.

1. Bummers are aging
2. growing aging populations

3.

4.

1. Private pay is emerging as the preferred payment model and creating disparities in certain groups
2. To age well you must have money
3. Community resources are beginning to emerge to assist certain populations

4.

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1. Urbanization; Changes to rural life and economy

2. Had to travel far outside the reservation for care; now have clinic and other more local health services. Still need to travel distance though.

3.

4.

​

1.Predominance of nursing facilities alone

2.

3.

4.

1.Community-based services expand.

2. Nursing homes evolving toward more services; housing campuses with multiple levels of care

3.

4.

1. Movement toward mega-health systems

2.

3.

4.

1. Recognition of impact of social determinants of health; medical field starting to realize how these (and related HCBS) affect health care utilization

2.Technology changes in care delivery system

3. Greater Twin Cities United Way eliminates aging as a funding priority.

4. Growing diversity in older population, but culturally appropriate services have not kept up

​

​

​

​

​

​

​

What Drove the Changes?

​

1.

2.

3.

4.

​

1.

2.

3.

4.

1.Recognition of need for non-residential care

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

We stayed in one column rather than looking at each decade specifically

​

1. planning for future less intentional 50 years ago

2.communication much more intentional now

3.Finding resources very difficult - Development of new resources much better now

4. Building residential facilities - did not consider unique needs of residents - What do the services and space offer residents is considered more greatly now -now planning for 50 to 110 - less so 50 years ago - less focus on mitigating smells, adequate lighting, pleasing congregate spaces, adequate privacy

5. (Resevation)Travel to medical facilities was long - outlying clinics are more accessible- now, slowly improving, improved cultural understanding of each other

-Housing slowly improving but still an issue on the

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

​

​

​

​

​

​

​

What Drove the Changes?

​

1.

2.

3.

4.

​

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1. different view of ageism

2. Medicare and Medicaid just started

3. Older Americans Act

4.Used Senile instead of dementia

​

1. Care centers were retirement homes not skilled nursing
2. Gray Panthers
3. Adult Day started
4. Hospice on the horizon

1.Changed terms to dementia

2. Acknowledgement of demographics

3. Project 2030 came out in 1997

4.Either in home or in NH

5. Senior housing first buildings

6. Managed care-dual eligible programs

1. Health equity work started
2. Targeted focus for distribution of Older Americans Act funds-- “mainstream” doing better in service to diverse communities
3. FInancing reform discussions--

4.LTC task force investment--grants, HCBS development work, service gap filling

5. Focus on volunteerism and civic engagement--senior volunteer programs

1. Expansion of assisted living
2. Expansion of choices/options for seniors
3. greater focus on ageism

4.

​

​

​

​

​

​

​

What Drove the Changes?

​

1. People didn’t think Medicare/Medicaid would be as expensive because lifespan was shorter

2.

3.

4.

​

1. NF became a choice replacing family care
2. Rights of aging were in discussions in colleges--in response to seniors losing choices
3. Caregivers needed a break

4.

1.

2.

3.Board on Aging first strategic plan--hit the demographics

4. women entering the workforce--alternative housing development started.

5. Independent seniors chose alternative housing--fierce independence

1.Numbers are drivers--impact of financing for LTC on Medicaid

2.

3.

4.

1.

2.

3.

4.

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1. Family structure/ living situation changed

2. Boarding houses

3. Medicare/ Medicaid

4. Front porch/ social structure

​

1. Women moved into the workforce

2. Nursing facilities

3. Older Americans Act

4.

1.

2. Assisted Living

3. Medicaid Waivers

4. Commuter/ attached garage

1.

2. Communities of care

3.

4.

1. More training required

2. Technology/ remote services

3. Provider Risk sharing

4.

​

​

​

​

​

​

​

What Drove the Changes?

​

1. Defined pension

2. Most retired at 65 or younger

3.

4.

​

1. IRA/ defined contribution

2. Rx and med/ tech improves QOL

3.

4.

1.Social Security retirement

2.

3.

4.

1. LTC insurance

2. Volunteers

3.

4.

1. Great recession/ housing values

2. Older adults in min wage jobs

3. Boomers remain in the workforce

4.

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1. Rising issues with resource for LBGDQ

2. Patterns of Family Care - women in the workforce

3. Language we use to describe ourselves - especially with older adults

4.Technology counties to make large impacts

​

​

1. Manufacturing to digital industry
2. Aging demographics and culture changing how we are taking care of our elders
3. Retirement expectations
4. Worldveiws have shifted internationally

1. Change in support services
2. More challenges in outstate areas in receiving resources

3.First language translations

4. Maintaining Medicare/Social Security

1. Women’s rights
2. Rights to Die

3.

4.

1.

2.

3.

4.

​

​

​

​

​

​

​

What Drove the Changes?

​

1.Equity

2.Technology

3. The way we connect socially

4. Cost have increase on many different levels

​

1. political issues
2. Public health has expanded
3. Restructure of Healthcare/and payment methods
4. focus on “Community” health

1. Data Privacy
2. Medicare/

Medicaid support

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1. Older Americans Act Medicare (60s)

2. Gerontology as a concept

3. Movement to care for older adults in home to nursing homes

4.

​

1.Passage of MN Vulnerable Adult Act

2. Rise and change to Hospice

3.

4.

1. 2030 Report Released
2. Caregiving as an entity
3. ​

4.

1. Gerontology as a certificate/board
2. Costs of services

3.

4.

1.Changing in the differences and variations in who older adults are

2. Workforce Shortage

3. Technology gap and changes

4.

​

​

​

​

​

​

​

What Drove the Changes?

​

1. More women in the full time workforce
2. Movement in how care is received and delivered

3.

4.

​

1. ​

2.

3.

4.

1. Realization of number of Boomers
2. Retirement changing age moving

3.

4.

1. Healthcare costs rising

2.

3.

4.

1. Recognition of different needs and different ages; concept of ageism

2. Change in volunteering

3. Polarization in communities

4.Retirement changing age moving

​

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1. Cost of aging/receiving care in aging

2. Need of and cultural diversity of caregiving workforce

3.

4.

​

1.

2.

3.

4.

1.

2.

3.

4.

1. Nonwhite cultures don’t enter caregiving facilities/roles as often as white culture.

2.

3.

4.

1. Moving into virtual world has disenfranchised elders

2. Mental health concerns for elders is in line with general mental health crisis

3. Elders want to be active and contribute but sometimes don’t know where/how

4.

​

​

​

​

​

​

​

What Drove the Changes?

​

1. People are living longer and need to plan for a longer lifespan of care

2. We are a healthy state but also have some of the largest disparities

3.

4.

​

1.

2.

3.

4.

1.

2.

3.

4.

1. We need to explore and understand the influence and impact of disparities

2.

3.

4.

1.

2.

3.

4.

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1. Improvements in Healthcare - Resulting in longer life

2.The concept of idle aging is no longer

3.People have more options to choose how they age/but harder to sustain these services

4. Government has historically not supported underserved BIPOC communities - and are slowly realizing this but fumbling in the space - Redlining banned in loans to minorities 80 years ago but effects still showing up 50 years ago of institutional descrimination.

​

1.Tax reforms in property tax and others.

2. AIDS

3.HMO Movement got started

4.Nursing Home and LTC improvements

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

​

​

​

​

​

​

​

What Drove the Changes?

​

1.Cardiovascular preventative medicine and Oncology preventative medicine as well as technology. Also changes in medicare and adding funding for said care. Funding available for research

2. The economic decline - after each drop people stay in the workforce longer. Senior Corp Volunteer Corps formed - Prior to safety net, people worked until they gave out. The rise of Unions also provided a safety net

3. The continuing concentration of wealth in US and across the planet - we don’t have money coming in through tax income to support many of the things some of us think it is important to maintain. Social media has really affected how people educate themselves - 24 hours news.

4. Polarization - allowing public health issues to become polarized. (also prompted by social media).

​

1.Prior to tax reform many communities had funding to do the programming they needed. After economic downturn services didn’t resume.

2. Big social push around education and dispelling myths -lots of funding in research for a cure.

3. Nursing Home Reform Act 1987?

4.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1

2.

3.

4.

​

1. Decrease of the impact of broader community

2. Geographic disbursement of friends and relatives

3.

4.

1. Dwindling housing options

2.

3.

4.

1.Less equitable and affordable options

2.Growing gap between haves and have nots

3. Lifestyle impacts (diet, sedentary)

4.Working caregiver challenges--employer and laws that support

5. Impact of technology

1.Isolation

2.Solo older adults, people who are aging

3.Growth in chronic conditions--living longer but in poorer health

4. Workforce demographic changes and workers demand for recognition, value, pay

5. Health disparities

6. Impact of trauma on health outcomes and life expectancy and life quality

​

​

​

​

​

​

​

What Drove the Changes?

​

1.

2.

3.

4.

​

1.

2.

3.

4.

1.

2.

3.

4.

1.More women in the workforce

2.

3.

4.

1. Conversations about social justice

2. demographic changes--demand for change

3.Fluidity of age definition

4.

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1.

2.

3.

4.

​

1.

2.

3.

4.

1. Increasing life span

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

​

​

​

​

​

​

​

What Drove the Changes?

​

1.

2.

3.

4.

​

1.

2.

3.

4.

1. Medical advances - not everyone has access

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1.

2.

3.

4.

​

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

​

​

​

​

​

​

​

What Drove the Changes?

​

1.

2.

3.

4.

​

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1. Creation of the MBA (1956)

2.

3.

4.

​

1. Vulnerable Adult Act (1980)

2.Women moving into the workforce

3.

4.

1.HWS development and changes

2.

3.

4.

1.Senior Linkage Line

2. Person Centered Care

3.

4.

1.

2.

3.

4.

​

​

​

​

​

​

​

What Drove the Changes?

​

1. Representation for the aging services.

2.

3.

4.

​

1. Defined abuse,neglect, maltreatment
2. Gender Role shift

3.

4.

1. Consumers

2.

3.

4.

1. Need for access to information for MN.

2. Olmstead 1999

3.

4.

1.

2.

3.

4.

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1. 2. Policy changes that are either driven by interest groups: industry and consumers

2. In Mn its been collaborative effort

(AARP has been around for along time)

3.

4.

​

1.

1.Over Medicalisation of aging-over diagnose,

2.We dont die Well.

​

2.

3.

4.

1. Support for caregivers
2. Challenge that we have not changed

​

• Proliferation of HCBS-we put a lot of people in the community without a structure to support
• No system

1. Language is changing -in a way people are invested in it
2. Asset based-
3. ​

4.

​

​

​

​

​

​

​

What Drove the Changes?

​

1.

2.

3.

4.

​

​

2.

3.

4.

1.Industry and Consumers there is medical help available

2.

3.

4.

1. There is a shift in the concept of Assisted living for communities of color

2.

3.

4.

1. A bigger movement towards resepect
2. More respect to mental health
3. Individuals still struggle with individual ageism
4. Emphasis on healthy aging

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1.

2.

3.

4.

​

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

​

​

​

​

​

​

​

What Drove the Changes?

​

1.

2.

3.

4.

​

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1.

2.

3.

4.

​

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

​

​

​

​

​

​

​

What Drove the Changes?

​

1.

2.

3.

4.

​

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1.

2.

3.

4.

​

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

​

​

​

​

​

​

​

What Drove the Changes?

​

1.

2.

3.

4.

​

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

LOOKING TO THE PAST

​

50 Years Ago

40 Years Ago

30 Years Ago

20 Years Ago

10 Years Ago

What Were MAJOR Changes in the Field Over Time?

​

1.

2.

3.

4.

​

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

​

​

​

​

​

​

​

What Drove the Changes?

​

1.

2.

3.

4.

​

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

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What Were MAJOR Changes in the Field Over Time?

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1. We stayed in one column, sorry!

2.Cost of aging - things are becoming so much more expensive - the income gap and the ability to even afford to get sick or get old

3. Demographic shift - the demographics have changed significantly

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Workforce shortage - overall shortage - the care providers are sometimes different cultures, this is wonderful, but it takes some "getting used to" and some cultural awareness

5.Increasing awareness of health disparities - we're overall a healthy state and rated always as one of the top communities, but we see some of the largest disparities in the nation and so we need to understand - it can be true that some people are living well and that other people have a lack of access and barriers to accessing services.

6. Disparities in mental health care, we're lumping aging as a mental health crisis and equally not being dealt with

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