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Best Practices for Public Health
A PUBLIC HEALTH STRATEGY
FOR LIVING, AGING, AND
DYING IN SOLIDARITY
DESIGNING ELDER-CENTERED AND PALLIATIVE
SYSTEMS OF CARE, ENVIRONMENTS, SERVICES,
AND SUPPORTS
Mary Beth Quaranta Morrissey, Melissa Lang, and
Barney Newman
an informa business
ISBN 978-1-4987-6134-5
www.routledge.com
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Routledge titles are available as eBook editions in a range of digital formats
A PUBLIC HEALTH STRATEGY FOR LIVING, AGING, AND DYING IN SOLIDARITY
Mary Beth Quaranta Morrissey, Melissa Lang, and Barney Newman
A Public Health Strategy for Living,
Aging, and Dying in Solidarity
With more people living longer lives, there is increased importance in the
health care industry on improving services and supports for older persons.
This comprehensive book gives an expert overview of the topics and chal-
lenges, along with imperative ethical and legal frameworks.
A Public Health Strategy for Living, Aging, and Dying in Solidarity also
details existing programs and benefits in relation to a realistic portrayal of
population needs. Other important issues are covered such as long-term care,
palliative care and hospice, other vulnerable populations, elder abuse, public–
private collaboration, evidence-based policy making, and much more.
Mary Beth Quaranta Morrissey is a Fellow at Fordham University’s Global
Healthcare Innovation Management Center and a health care attorney and
aging and health researcher.
Melissa Lang is the Chief Executive Officer at Gilda’s Club Westchester.
Barney Newman is Medical Director Emeritus for the WESTMED Medical
Group, where he also served as the Chief Medical Officer.
Best Practices for Public Health
https:www.crcpress.com/Best-Practices-for-Public-Health/book-series/BPPH
Edited by Herman Koren, Indiana State University, USA
This series of books offers students, academics and practitioners invaluable
practical guides. It adopts a global perspective and aims to drive practical
action in an increasingly globalized world.
Best Practices for Environmental Health
Environmental Pollution, Protection, Quality and Sustainability
Herman Koren
A Public Health Strategy for Living, Aging, and Dying in Solidarity
Designing Elder-Centered and Palliative Systems of Care, Environments,
Services, and Supports
Mary Beth Quaranta Morrissey, Melissa Lang, Barney Newman
A Public Health Strategy for
Living, Aging, and Dying
in Solidarity
Designing elder-centered
and palliative systems of care,
environments, services, and supports
Mary Beth Quaranta Morrissey,
Melissa Lang, and Barney Newman
London and New York
First published 2019
by Routledge
711 Third Avenue, New York, NY 10017
and by Routledge
2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
Routledge is an imprint of the Taylor & Francis Group, an informa
business
© 2019 Taylor & Francis
The right of Mary Beth Quaranta Morrissey, Melissa Lang,
and Barney Newman to be identified as authors of this work has
been asserted by them in accordance with sections 77 and 78 of the
Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or repro-
duced or utilised in any form or by any electronic, mechanical, or
other means, now known or hereafter invented, including photocopy-
ing and recording, or in any information storage or retrieval system,
without permission in writing from the publishers.
Trademark notice: Product or corporate names may be trademarks or
registered trademarks, and are used only for identification and expla-
nation without intent to infringe.
Library of Congress Cataloging‑in‑Publication Data
Names: Morrissey, Mary Beth Quaranta, author. | Lang,
Melissa (Melissa Mary), author. | Newman, Barney,
author.
Title: A public health strategy for living, aging, and dying
in solidarity : designing elder-centered and palliative
systems of care, environments, services, and supports /
Mary Beth Morrissey, Melissa Lang, Barney Newman.
Description: Abingdon, Oxon ; New York, NY : Routledge,
2018. | Includes bibliographical references and index.
Identifers: LCCN 2018005541| ISBN 9781498761345
(hardback) | ISBN 9781315367606 (ebook)
Subjects: | MESH: Health Services for the Aged--
organization & administration | Palliative Care | Long-
Term Care | Patient-Centered Care | United States
Classifcation: LCC RC952.5 | NLM WT 31 | DDC
618.97029--dc23
LC record available at https://lccn.loc.gov/2018005541
ISBN: 978-1-4987-6134-5 (hbk)
ISBN: 978-1-315-36760-6 (ebk)
To Lawrence O. Gostin and his Dad, Joseph Gostin
http://taylorandfrancis.com
Contents
Introduction xi
PART ONE
The crisis of suffering for older Americans
1 S ocial ecology of aging: Critical theoretical perspectives in aging
and public health policy for the twenty-first century 3
I Introduction 3
II Framing the social problem of elder suffering:
Social ecological and environmental contexts 4
III Social ecology of aging and its ecosystems:
Interaction of macro- and microsystems 5
IV Elder-centered care framework 30
V Public health and global public health strategies
for aging comfortably and palliatively 31
VI Conclusion 34
References 35
2 P hilosophic science theory: Toward a phenomenology
of a maternal cosmos in light of suffering 43
I Introduction 43
II Phenomenology: Schutz’s philosophic science
theory—Theory of the cultural sciences 44
III Social ecology of suffering: The maternal as possibility
for older persons’ agency, resilience, and generativity 51
IV Implications of theorizing for older adults’ agency,
resilience, and generativity: The example of dementia 60
V Conclusion 67
References 67
Bibliography 71
viii Contents
PART TWO
Paradigm shifts in delivery systems and financing
3 Moving from fragmentation to integrated, community-based services 75
I Introduction: Long-term services and supports 75
II Medicare and Medicaid 76
III Newer legislation and initiatives 79
IV Economic and social arguments for aging in place 82
V Hospice as a model 84
VI Conclusion 85
References 85
4 Development of elder-centered systems of care 89
I Introduction: Importance of delivery systems 89
II System dimensions and integration 90
III Conclusion 100
References 101
5 E volution of financing models and impact on quality and services
for older adults 103
I Introduction: Financing, reimbursement, and cost-saving models 103
II Insurance financing and coverage 103
III Reimbursement models 106
IV Cost-saving models 112
V Conclusion 114
References 114
PART THREE
Challenges in policy implementation: Examples from the field
6 L andscape for new models of care: Designing best practices
and environments 121
I Introduction 121
II Challenges in environment 122
III Programs and best practices 125
IV Conclusion 132
References 133
Bibliography 134
7 T he palliative turn in elder-centered care: A public health strategy
for interdisciplinary palliative and end-of-life care 135
I Introduction 135
II Health and human rights framework: The right to health 136
III International palliative care frameworks and recommendations 137
Contents ix
IV Palliative care and hospice movements in the United States 143
VII Futile treatment: How is it defined? 148
VIII Case study: Nursing home resident with dementia 149
IX Recommendations: The four-pronged approach of
the public health strategy for palliative care 155
X Conclusion 159
Acknowledgment 159
References 159
Bibliography 163
8 A more humanistic approach to relational decision making:
Practical ethics and ethics committees 165
I Introduction 165
II Case study: New York policy implementation—
Health care decision making, surrogacy, ethics
committees, and interprofessional education 166
III Ethics committees and ethics committee education 180
IV Conclusion 188
Acknowledgment 189
References 190
PART FOUR
Setting the stage for transforming elder care
9 P olicy recommendations for more compassionate elder care:
Systems reform, social justice, and sustainable social solidarity 195
I Introduction 195
II Portrait of growing old in America 196
III Systems reform, social justice, and sustainable social solidarity 198
IV Conclusion 205
References 207
Bibliography 208
Appendix A: Caregiving resources 209
Appendix B: Ecology of policy: Description of public policy
making proces 213
Appendix C: Psychosocial support 219
Appendix D: Resources and program examples for older adults 223
Appendix E: Elder abuse, maltreatment, and neglect resources 227
Appendix F: Finger Lakes Geriatric Education Center—Geriatrics
Workforce Enhancement Program 229
Appendix G: Photographs of Eduardo 235
Index 241
