Chapter 8: Forging the Will


All these good ideas and evidence of potential improvements are without force unless the citizenry demands reforms and refuses to accept partial solutions that jeopardize achieving the full potential. Citizens facing frailty in old age, which is all of us who don’t die while younger, have to become upset enough to raise our voices, demand improvement, enable political leaders to take on the issues, and insist upon learning how to make it all work, all across the country. This is a tall order, since we are still in a phase of inattention and failure to notice the shared experience of widespread suffering and frustration, along with inept services and inflated costs. Probably, family caregivers (present, past, and future) will need to rise up and demand attention to the plight of the frail elders they support and the family that is, was, or will be trying to cope. In addition, those responsible for public finance will be forced to take notice as the numbers rise and the costs escalate. But powerful forces are invested in the status quo, including simple familiarity and habit as well as financial interests and professional authority. Proving we can do better for our elders, our society, and ourselves, will be a triumph. The way to prove that is to launch pilot MediCaring Communities now, with resources we already have but can use more wisely. Showing it is possible is the answer to those who will say it can’t be done. With a few proven successes, spreading the promise of reliable and efficient care to all will be less of a struggle.

This movement will require strong advocacy groups. Currently, multiple skilled and insightful advocacy groups have formed around eldercare issues: Consumer Voice, OWL, WISER, Justice in Aging, Alzheimers Association, Caring Across Generations, National Alliance for Caregiving, National Council on Aging, AARP, and Caregiver Action Network, to name a few. The issues are of broad concern and perhaps groups concerned about the well-being of children and public services generally would weigh in, since otherwise health care for elders will continue to consume larger shares of public funds, making other investments more difficult. Citizens probably need to have sustained organizations in order to carry the day. When motivated citizens with well-considered agendas activate advocacy organizations to develop convergent demands, then reform takes shape.

This chapter responds to the following questions:

8.1 How can Americans become more aware of the challenges of frailty in the last phase of life and become familiar with the connections to public policy and historic service delivery arrangements?

8.2 What organizations and interests are likely to support or oppose the endeavor and what strategies might forge a consensus to proceed?

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