From reimagining to reality: replacing traditional care models with next generation services


Goodlife’s most valuable outcomes are the result of listening to and understanding our most vulnerable residents. We’ve learned they want, and require, something different than what providers have traditionally offered them. Here’s what we know for sure, especially now in the midst of COVID-19:

  1. It is impossible to prevent or contain cross contamination in congregate settings (like nursing homes, group homes, assisted living, clinics of all kinds, etc.). 
  2. People want to live as independently as possible, in typical homes, in safe neighborhoods. The alternatives (moving to congregate care facilities) are associated with the fear of decline and becoming increasingly dependent.
  3. They want to receive care and support from people they know and trust, in the safest and least intrusive way possible.
  4. They want to be independent, but not isolated or lonely. They crave enrichment, engagement, and connectivity.
  5. They typically want to only pay for what they need and, whenever possible, will do they can to care for themselves and lower costs.

New thinking for real change
We’ve known for some time now that traditional behavioral and health services are not a long-term answer. And unfortunately, bolting technologies onto antiquated service models will not change that reality. Time and time again, we’ve seen people and institutions “want” to preserve what they have (think Blockbuster Video) and change as little as possible to maintain current processes and investments in existing infrastructure. It just doesn’t work. 

To truly make change, we must think differently. Companies like Amazon, Instacart, Netflix, Uber, DoorDash, and Grubhub were created (or recreated from the ground up) using new business models that changed how the world works. Their founders did not merely take technologies or software and attach them to old service approaches. Instead, they provided us new ways to receive support that smartly use technologies. 

To create a new behavioral/health paradigm we must build a new service model guided by a new vision, mission, and goals that are not burdened by the way things work. This new vision must also deploy and deliver support very differently than ever before.

Needs and resources: A balancing act
Statistics and trends that justify needs (e.g., waiting lists, lack of access, shrinking financial resources, poor service outcomes, the disappearing workforce, and more) are all well known for those who require support to live independently. This includes people with behavioral or health challenges, those with a range of intellectual or developmental disabilities (I/DD), seniors, those with a traumatic brain injury, or many other populations–they all experience barriers to independence and they all need support. In fact, managed care is increasingly removing funding silos that are population-specific and simply funding support needs for multiple populations using highly similar sources and assessments.  

While we can justify each population’s trends and needs independently1, let’s simply concede that a) we have greater need than ever before; b) our resources are shrinking; and c) our traditional approaches to care won’t keep up with demand, keep people safe, or offer what they want. 

What is truly needed is a new paradigm of care. We need services that can deliver personalized and individualized care to homes and neighborhoods, exactly when and where needs arise, unobtrusively and as cost-effectively as possible, by familiar and trusted caregivers. What we don’t need is to invest in more congregate approaches, clinics, or other “places.” And we don’t need to bolt on an electric engine to a 1990 Ford. 

Lessons from the pandemic
Experiencing a pandemic in the last several weeks has put a spotlight on our care delivery systems: what works, what doesn’t, and what is needed. Doctors, nurses, behaviorists, social workers, care coordinators, and program administrators are struggling with the reality that the system is not set up to allow them to provide care in small settings. Our current support infrastructure is inadequate, disjointed, difficult to navigate, and impossible for people with needs to understand and use. We need a new way, a new infrastructure, and a new delivery system.  

Over the next several weeks I will explore these gaps with you and talk more about GoodLife’s new paradigm of care: neighborhood and in-home support that is redefining what’s possible for delivering safe, affordable, personalized care directly to our residents. 

Stay tuned for more from our President and CEO, Dr. Mike Strouse. In the meantime, we’d love to hear how your organization is adapting–or how we can help– in these uncertain times. 

1 For example, every 8 seconds another senior turns 65; 90% of baby-boomers say they want support to age-in-place; 50% of individuals with I/DD are served by a family member; 25% of these family caregivers are over 60 and will soon not be able to provide care–or even more, require care themselves; waiting lists to receive services in some states exceeds 8 years; and there are more.

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