Healthy Aging

Maine is home to the oldest population in the U.S. In the coming decades, understanding how factors outside the healthcare setting influence the mental and physical health of older adults will be one of the state’s major public health challenges.

Goal 1: Research Objective
Prioritize funding of research centers and individual projects focused on improving the mental and physical well-being of older adults and their caregivers.
Goal 2: Enterprise Objective
Encourage the creation of elder-appropriate technology solutions for older consumers, especially in the areas of AI, virtual and augmented reality, household technologies, and cybersecurity.
Goal 3: Workforce Objective
Prepare an age-capable workforce that can adequately identify and respond to the mental and physical health needs of older adults, especially in rural areas.
Goal 4: Climate Change Objective

Assess and mitigate the impact of climate change driven diseases of highest risk to the elderly.

In the long-term care sector (i.e., nursing homes and assisted living communities) person-centered care represents a parallel effort to maximize the quality of healthcare received by older adults in these settings through organizational culture change, empowering a care team, keeping the older adult and family at the center of decision making. All older adults, and certainly those in the oldest state in the nation, should have access to the health resources and support needed to feel safe, and achieve maximum health, longevity, and well-being. Age-friendly health systems aim to: follow an essential set of evidence- based practices; cause no harm; and provide structures that create a positive daily routine and lead to better health outcomes.

The health of older adults is not only influenced by access to quality care, but also by factors operating outside of the healthcare setting (Rural Health Gateway, 2019). These “social determinants of health,” including educational and employment opportunities, socioeconomic status, housing, transportation, food, social support, physical environment, and community infrastructure, are the most powerful predictors of older adult health outcomes and, ultimately, longevity perhaps especially because of the cumulative effects over the life span (Henning-Smith, 2021). Understanding the differential impacts of these social determinants of health, and enacting policies and programs that will most effectively and efficiently reduce these barriers to the ability of all older adults to thrive, especially in rural communities, is the challenge that lies ahead for the state.

Notable Maine Institutions & Organizations

Area Agencies on Aging — Southern Maine, Spectrum Generations, Aroostook, Eastern, and Seniors Plus
Center for Community Inclusion and Disability Studies, University of Maine
Center for Excellence in Aging and Health, University of New England
Center of Excellence in Collaborative Education, University of New England
Center on Aging, University of Maine
Dirigo-Maine Geriatrics Society
Harvard Pilgrim
LeadingAge Maine & New Hampshire
Maine Council on Aging
Maine Gerontological Society
MaineHealth
Margaret Chase Smith Policy Center, University of Maine
Muskie School — Cutler Institute, University of Southern Maine
Northern Light
Office on Aging and Disability Services, State of Maine
State of Maine Office of Aging and Disability Services

Current Activities

There are several concurrent initiatives across the state that seek to increase Maine’s efforts to ensure the provision of age-friendly and person-centered long-term care, and reduce the negative cumulative negative impacts on older adults of a range of social determinants of health factors.

These programs include:

AgingME, the HRSA-funded Geriatrics Workforce Enhancement Program (GWEP). A partnership of the University of Maine, the University of New England, and a large array of community health and human service partners, GWEP aims to create a more age-friendly health system by better preparing an age-capable workforce, transforming primary care practices, and engaging and empowering older adults.
The Age-Friendly movement in Maine remains ahead of the national curve in terms of activity across the state. During the past year the University of Maine Center on Aging provided technical assistance and coordination of age- friendly and lifelong communities in partnership with AARP national and the state chapter, and Americorps. The Maine Council on Aging is performing complementary efforts with additional lifelong communities across the state.

Suggested Future Research

The transportation needs and challenges that older adults and people with disabilities face in rural communities continue to be significant as they try to access healthcare, meet their daily needs, and avoid social isolation. The pandemic has increased the urgency of innovation in the offering of rural transportation services. Viable solutions must address not only enabling accessing specialized healthcare services that address urgent chronic care needs, but satisfy daily living, quality of life, and socialization needs as well. Furthermore, such efforts need to be equitable ensuring responsiveness to the needs of diverse older adults, people with disabilities and their caregivers, including those residing in marginalized communities. Existing resources to turn to include the National Aging and Disability Transportation Center, National Rural Transit Assistance Program, National Center for Mobility Management, National Center for Applied Transit Technology, Shared Use Mobility Center, USDA Transport Services Division, ITNAmerica, and The Federal Transit Administration.

Expanding the number of age-friendly communities, in a state that has already qualified as just one of ten in the U.S. that is age-friendly, is essential to continue to make them livable for older adults and others across the life span. This includes providing increased numbers of small cities and towns with the technical assistance and financial resources to address their built environments, including those facets of such settings that are more likely to be underdeveloped and of lesser quality than urban settings, including water quality, space for recreation and exercise, access to nutritious food, and availability of broadband internet and cellular connectivity, among other community infrastructure and physical environment features. Research is needed to tease out the preferred strategies and evidence-based best practices for advancing livability across the recognized domains of an age friendly community.

The scarcity of adequately trained health and mental health personnel is a long-standing problem and may be growing more serious given the fact that this workforce is aging more rapidly than most other employment sectors with large numbers expected to exit the workforce over the next ten years. The lack of direct care workers who provide daily direct support to older and disabled adults in their homes and long-term care settings is particularly acute in rural communities due to low compensation, inadequate training, limited career advancement, high turnover, and the unique barriers created by rural conditions. More emphasis on rural economic development, widespread broadband, employment programs for an aging rural workforce, and navigation assistance and workforce skills development programs are badly needed (Dorrer, 2021). Increased availability of respite and relief programs for elder caregivers is also warranted. Research continues to be needed to fully understand healthcare workforce needs in rural communities to be able to strategically target resources and identify the most efficacious workforce intervention strategies.
Older adults remain less likely to be digitally literate than other segments of the rural population. While not the sole solution to ensuring they have access to the information and products needed to live safer, healthier, and more engaged lives, technology can be an important supplement to more traditional modes of human exchange. Resources are needed to provide more training and create more user-friendly designed devices and apps. For individuals, especially older adults and others still adjusting to a high-tech, digital world, more readily available, elder-appropriate technology solutions for older consumers are needed, especially in the areas of artificial intelligence, virtual and augmented reality, the Internet of Things (IoT), and cybersecurity.
Social connectivity is more important than ever, given the significant increase in the number and proportion of older adults experiencing the harmful effects of social isolation and loneliness, both prior to and subsequent from the COVID-19 pandemic. Research-driven, evidence-based programs that both prevent and can reverse instances of social isolation and loneliness are badly needed, including those that provide opportunities for socialization, recreation, leisure, and the receipt of needed health and human services . In addition, research is still needed for identifying the risk and occurrence of social isolation and loneliness in communities.