Across the country, there are several examples of universities that have partnerships with senior housing communities. Take Newton, Mass.-based Lasell Village, located on the campus of Lasell College, or the University of Florida, which announced a partnership in 2014 with The Village in Gainesville, in Gainesville, Fla. The partnerships function in different ways and have different goals, but increasingly, universities are becoming more interested in senior living, and vice versa, for the mutual benefits that they can realize.
The University of California, San Diego is one of those universities. Through the launch of its Center for Healthy Aging in 2014 and now plans to build a senior living community on its La Jolla, Calif. campus, UC San Diego has big plans for its foray into senior housing.
We sat down with Dr. Dilip Jeste, M.D., senior associate dean for Healthy Aging and Senior Care at the University of California, San Diego, and head of the university’s Stein Institute for Research on Aging, and Center for Healthy Aging, to learn more about the university’s plans, what colleges want with senior living in the first place, and why the Center for Healthy Aging is launching an inaugural symposium this spring.
What is the interest of an institution like UC San Diego in the development of senior housing?
Academic healthcare centers like UC San Diego are taking note of the rapidly changing scenario of senior healthcare. The population of older adults is increasing, but the number of geriatric trained health care providers is not only stagnant, but in some cases (e.g., geriatric medicine and geriatric psychiatry) it is actually going down. The question is: how can we care for the growing number of older people who have greater healthcare needs when there are not enough clinicians to take care of them? We have to come up with new models.
These models will focus on rewarding prevention rather than reimbursing the systems for numerous services provided for treatment. An ounce of prevention is worth a pound of cure. Prevention of illnesses often involves changes in lifestyle to make it more health-friendly. Research shows that older adults who stay active – physically, cognitively, and socially – are less likely to develop a number of illnesses. Where can we change the lifestyle? In the senior living and in the community.
At UC San Diego, we are keenly aware that the senior housing and the community are becoming the primary sites for healthcare. Future hospitals and clinics will be mainly for highly specialized procedures and for emergencies. Most of the healthcare will be received at home.
Technology will be an important asset in the emerging healthcare systems. With telemedicine, a person can be examined at home. Thus, say a world expert in a specific type of cancer, who is thousands of miles away, can be connected to a patient’s home via Skype. Then there are biosensors – wearable devices that can collect information continuously on physical activity, heart rate, blood pressure, glucose levels, electrolytes, and so on. These data can then be transmitted in real-time to a remotely based expert who can make a diagnosis and recommend treatment.
Universities with academic health centers have a vital role to play in the evolving healthcare system. Universities are not just for science and publishing papers. We are here to help the community and enhance its well-being.
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What do you see the University as being able to offer to the industry?
A university such as UC San Diego, which combines expertise in healthcare with research know-how, can be immensely helpful to the senior living industry as well as technology industry. To give you an example, we conduct clinical trials of new medications, using randomized controlled design, choosing appropriate methodology, and importantly, selecting appropriate outcome measures for evaluation. That’s our area of expertise. Such studies may lead to FDA approval of the medications that are found effective, and then the Medicare and other insurers are likely to pay for the use of those medicines. I don’t see why the same strategy shouldn’t apply to use of specific technology in senior living. We should be able to test and determine which technology helps and which doesn’t.
Currently there are few evidence-based guidelines for using technology to improve healthcare, lifestyle, or well-being in senior living facilities. That’s where UC San Diego Center for Healthy Aging would come in – that is, to test technology where older adults live, and evaluate whether it significantly impacts their health and wellness. Importantly, we don’t have conflicts of interest as we are a non-profit institution, and are not seeking to market our products or build homes.
Tell us a bit about UC San Diego’s senior housing development plans.
UC San Diego is in very early stages of planning a university-affiliated senior housing facility on our campus. The construction is at least a couple of years away, but plans are under discussion. What is exciting is that geriatric healthcare specialists will work with technology experts as well as architects along with community representatives, to design this facility. It will be open not just to our emeriti faculty but also to the community at large. We will develop state-of-the-art facilities, designed scientifically. The technology and activities inside will be those that promote physical and cognitive health and social function.
I like the use the term “living lab.” We expect that many residents there will be interested in helping find out what works and what doesn’t – for example, if some specific type of diet or specific physical activities help normalize their blood sugar. Is completing a crossword puzzle better than playing a video game for retaining memory longer? Those questions need evidence-based answers. UC San Diego is a powerhouse in research and this will be a unique opportunity to do research with and for seniors.
However, a large part of the ongoing work of our Center for Healthy Aging involves collaborating with outside continuing care retirement communities in southern California and elsewhere. We want to help them test technology and assess its effects on real health in their residents.
What has UC San Diego learned about senior housing in the two years since launching the Center for Healthy Aging?
A lot. We have come to appreciate, ever more than before, the value of senior housing for healthy aging of the community. When we started our work, the original focus was on personalized medicine. Now it is clear to us that it needs to extend to the entire community. We believe that senior housing will play a critical role in facilitating health and lifestyle, preventative care, and better treatment.
Our Center for Healthy Aging encompasses various components of the UC San Diego campus, such as schools of medicine, engineering, pharmacy, and management. Importantly, it includes working with the industry, specifically senior housing and technology providers, and the community itself. We are now involved in the WHO Global Network of Age-friendly Cities and Communities Network Initiative. Thus, our work area has broadened considerably.
Senior housing is not just a shelter or an investment. It really is going to be the home for healthcare. What is needed is showing that certain types of changes in the senior housing or changes in healthcare practices or use of specific technology would enhance residents’ health in an objectively measurable manner. Therefore, our partnering with the senior housing industry is essential.
You’re having an upcoming symposium on the topic. What’s the purpose of this event?
We have scheduled the Inaugural Symposium for our Center for Healthy Aging on Thursday, May 26 on the UC San Diego campus. It is open to the community and is free, but registration is required. Through this symposium we are bringing together stakeholders from different groups with the goal of finding out how people can age successfully in their homes and in the community. The two main areas of focus are healthcare and senior housing. Technology is involved in both. We will hear from, among others, senior living management, a past president of the Society of Neuroscience for Architects, a technology expert, a geriatric health specialist, and a senior resident from San Diego.
We are excited by the opportunities provided by such new collaborative initiatives in an area of great importance to the society. We will be learning from the senior living experts and from the community residents, just as we provide them with our geriatric healthcare research expertise. Thus this becomes a mutually enlightening and rewarding project.
Interview by Elizabeth Ecker