Multisector Plan for Aging: Collaborating to Improve Outcomes for New Jersey’s Older Adults

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Welcome to All Teach, All Listen, Beyond the ECHO, examining public health
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challenges through an interdisciplinary lens, amplifying diverse voices,
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encouraging critical thinking, and promoting collaborative civic action across the healthcare system.
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Each episode pairs professionals from different disciplines to model how cooperation,
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This podcast is powered by the Eagleton Institute of Politics as part of Democracy Week 2025.
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I'm your host, Sean Cuddihy. For our fifth episode of the season,
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we wanted to shift our focus to older adults in New Jersey.
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We are joined by Dr. Joshua Raymond and Dr. Cathy Rowe to discuss the work that
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is being done to improve the lives of older adults.
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Before we get started, I'll introduce our speakers a little bit more.
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Dr. Raymond is a professor of medicine at Robert Wood Johnson Medical School.
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He is board certified in family medicine, holds a certificate of added qualification
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in geriatric medicine, as well as
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a certificate of added qualification in palliative care and hospice care.
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He has been the medical director at the Manor Nursing Facility for the last
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10 years, medical director of Parker Somerset and faculty in Parker Division
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of Geriatrics within the Department of Family Medicine at Rutgers Robert Wood
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Johnson Medical School.
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Dr. Raymond is on the board of directors for New Jersey Advocates for Aging
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Well, and he is the former president of the New Jersey Long-Term Care Leaders Association.
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He is also a former president of the New Jersey Medical Directors Association.
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He was also chosen by the New Jersey Hospital Association to be on the Pulse
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Steering Committee for the creation of the New Jersey State Pulse Form.
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We are also joined by Dr. Rowe, who is the executive director of New Jersey
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Advocates for Aging Well, a non-profit focused on the needs and solutions for
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New Jersey's older residents.
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Dr. Rowe has extensive experience in healthcare and public health,
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working with underserved populations, chronic illness, and food insecurity before
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focusing on aging and establishing age-friendly communities.
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Dr. Rowe earned her DRPH in health policy and management from Columbia University,
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where she received a fellowship in public policy.
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Her bachelor's is in economics from Bates College. Thank you both for joining.
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So let's get started with some questions. Both of you are clearly passionate
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about health and quality of life for older adults based on your bios and getting to know you.
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How did you both get into this field?
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And give us a little bit of history of why you're so interested in this work.
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Dr. Raymond, we'll start with you.
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Sure. Thanks. Thanks, Sean. I come from a family medicine background.
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Before medical school, I did a master of public health and had some real keen
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interest and just in the environment and how public health really influences
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people's health and how they age.
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I went to medical school down in Philadelphia at Jefferson and did a fellowship
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at Rutgers Robert Wood Johnson Medical School.
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And during that time, really focused on people outside of the hospital,
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in the outpatient setting, as well as in nursing homes and the assisted living.
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And it really became evident that the environment and the quality of life was
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what was so important for people's health and really focus on the combination
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of environment and health for successful aging. Dr. Rowe, how about you?
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Sure. Well, I also have a background in public health. And, you know,
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in public health, aging is the goal.
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If everything else is working, that's our goal, to have long and healthy lives.
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And, you know, we've made so much progress over the last 50 to 75 years.
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When you think about it, we probably all know, we have family members or neighbors
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or know people who remember the time before vaccines, when they lined up at
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school and got their polio vaccine on a sugar cube.
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It's incredible how much progress we've made in the last 75 years that help us live longer.
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So I think that aging is really the success story in public health and all the
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progress that we've made.
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So as we see all this progress being made, I'm sure new challenges are emerging for older adults.
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Dr. Raymond, maybe you could kick us off with some of the unique challenges
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that are facing older adults.
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Sure. As we age, they're really a combination of medical issues,
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social issues, environmental issues that make it more challenging to remain in place in New Jersey.
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The nuclear family maybe isn't as prevalent now as it once was,
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and things like transportation becomes very important for people's health,
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as well as access to food and access to social activities.
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Yeah. And I think that globally, ageism is the biggest challenge overall.
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You know, we've eliminated so many other isms from our vocabulary and what we do.
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But for some reason, we still hold on to these outdated ideas and stereotypes.
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We don't lump any other group together like we do with older adults.
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So we're, you know, we're talking about people, let's say, from 60 to 80, 90, 95.
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We can't assume that they're all the same and have the common needs and the
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common health status at any time.
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So we really need to, you know, let go of these stereotypes and stop trying
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to treat all older people the same as if, you know, they have the same needs and desires.
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But in New Jersey, specifically, affordability is one of our biggest challenges.
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And like Dr. Raymond said, it's It's not just the health care,
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it's transportation, it's the housing.
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And I think one of the things that New Jersey does really well is we have really
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great support systems for people that qualify for programs by certain income
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eligibility, and that is wonderful.
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And most people don't qualify, but they still need help.
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So we need to expand and look at more than, you know, this is your cutoff line
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or a one size fit all, and start looking at how do we really meet the needs
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of a wider range of needs for a wider range of people.
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I think a lot of people might be asking, why now? Why is it so important for
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us to be addressing these challenges when there's so many other things that
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we can be looking at in the world of health care and public health?
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Dr. Raymond, any thoughts?
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Well, great question. As the demographics of our state changes,
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right, and there's going to be more people over the age of 60 than there are in school.
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So preparing transportation, access to health care, access to food becomes more
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and more relevant and important because so many people in our state will be
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needing these services.
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Yeah. And I think a lot of what applies for older adults applies for people at all ages.
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Like for transportation, nobody really plans for when they're not going to be
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able to drive or not be comfortable driving.
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But we also have younger people who just aren't getting their licenses like they used to.
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So we could look at how do we separate older people and their needs and get
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them. Or we can look at how do we change our transportation so that it works
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for everybody, including older adults.
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When people ask, you know, what they should do for aging, I say they should
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have a plan and a backup plan.
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And then probably even a third plan because we don't know what's going to happen.
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One of our board members, Carl Archer, is an elder care lawyer.
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And he said people make plans for retirement, but not for growing older.
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So, you know, when we don't, if we succumb to ageism and the othering of older
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adults, we're really discriminating against our future selves.
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So, you know, let's split the conversation a little bit. And,
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you know, hopefully everybody is expecting to live into their 60s, 70s, 80s.
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So start thinking about what do you want for yourself and not just what you
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think, you know, your older relatives or neighbors might want now.
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Dr. Ray, you brought up a lot of great points about how a lot of different professionals
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need to be involved in improving outcomes for older adults. What's really the
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importance of healthcare providers, Dr.
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Raymond, working with other industries to improve outcomes for older adults?
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You know, Sean, besides other industries, other disciplines,
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really, as a geriatrician, I work with physical therapists, with occupational
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therapists, with dieticians, and this is part of the healthcare team that optimizes
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an individual's quality of life.
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But besides that, thinking outside of the hospital and outside of healthcare
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settings, other resources are very important. For example, food delivery.
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And it's interesting to see how seniors in New Jersey are adapting with DoorDash
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or with Amazon having goods delivered to their home.
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So it really, it's important to think creatively about resources to keep people
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in their home and optimize their quality of life.
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Yeah, I would say that exactly. And we have to rethink longevity.
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And it's not just about needs.
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Like, you know, with food, it's not just people that can't afford food.
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It's maybe you don't drive. Maybe you can't, for whatever reason, can't get out.
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So we have to rethink longevity and what we can do to enable people to age in place, right?
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There's no way that we can or should build retirement communities for everybody.
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That's not realistic, and that's not what everybody wants.
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And one of the things that I think often gets overlooked is the role of the
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older consumer, because the fact is actually that older adults have more disposable
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income and they tend to spend locally.
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So let's look at them as consumers and also as older workers.
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We're involved with a program now to promote age-friendly employment in New Jersey.
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And like Dr. Raymond said before, we have more people over 60 than in the classroom.
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So what does that mean for the future of the workforce.
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Business and employers need to get on board and start thinking of that.
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How do we keep people working longer? How do we increase our flexibility?
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So, you know, we just need to rethink the whole thing outside of healthcare
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and outside of a needs-based system to what's the role of older people in our entire economy.
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There has been a lot of partnership outside of healthcare and public health
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and the state and government, including private businesses.
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Can you explain how private businesses are also working to improve outcomes for older adults?
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Yeah, I think that private businesses, well, one, they're realizing there's
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potential for private business with our aging population.
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So one of the really fun things that we just did, we had a community challenge
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grant through ARP last year, and we hosted a housing design competition.
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You know, in New Jersey, several municipalities are looking at accessory dwelling
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units or changing their building code to meet the missing middle.
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And we had some fantastic submissions, very creative, on housing units that
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are appealing not just for older residents, but for people of all ages.
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I've come to realize that what I would want in my last house to downsize is
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the same thing my 25-year-old son is looking for for his first house.
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You know, the first house and last house, really the same thing.
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So once again, it's, you know, this doesn't just apply for aging.
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What's good for older adults is really good for everybody.
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And I think that, you know, private business is starting to recognize that.
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Are you aware of anything going on right now that is kind of modeling how this should be happening?
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Sure. You know, Sean, that's a great question. And the Centers for Medicare
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and Medicaid Services, who pays for Medicare across the entire country,
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started an initiative for the age-friendly movement inside hospitals.
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And every hospital in the United States will now be graded on how they perform
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with the 4Ms, what matters, medication, mentation, and mobility.
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And it's great to see all of the resources being dedicated to optimizing individuals
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and coming up with a very individualized care plan when they're leaving the hospital.
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So it's really taking on in healthcare settings.
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And I think one of the important things that New Jersey has done is really expanded
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our age-friendly communities, starting from a few communities in northern Jersey
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that were funded by private philanthropy.
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The state has made a commitment to expand age-friendly communities,
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and they focus on eight domains that the World Health Organization has designated
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as important, including the built environment, public places,
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transportation, housing, social engagement.
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Again, things that really apply to everyone and make communities better for all residents.
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And one of the important things that's going on now, New Jersey has a Medicaid
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palliative care benefit that's going to go live on April 1st.
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And our partners at Goals of Care Coalition have done a tremendous job,
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along with the state legislature, to bring that to fruition.
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And that's going to give thousands and thousands of New Jersey residents with
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more expanded care options and choices.
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So we have, you know, really important changes being made on that front with
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our health care options.
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And we also have a growing effort to expand the direct care workforce.
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There's a shortage of direct care workers. There was a New Jersey before COVID. COVID made it worse.
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And with a growing aging population, there's going to be more need.
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So both the Essential Jobs, Essential Care Coalition and the Depart has been working in this area.
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And the Department of Human Services just released the direct care work for
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strategic plan, which can make a really big impact on the future needs as we go forward.
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So there is a lot going on in New Jersey that's preparing us.
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You know, Cathy, that's really important. These are legislation that's making this happen.
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So it's so important to be involved with this and really advocating for seniors in our state.
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That's the perfect segue to the next question. I know both of you are very involved
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with pushing for a multi-sector plan for aging.
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Can you explain what that is and how that exactly will improve the lives of older adults?
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I don't know if that makes more sense for Dr. Rowe to go first.
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Sure, I'll take that one first.
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So first, a multi-sector plan for aging or an MPA,
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it's a 10-year blueprint for restructuring state and local policies and convening
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a wide range of cross-sector stakeholders to collaboratively address the needs
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of older adult populations.
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They're designed to create more of a coordinated system of high-quality care
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and support services that promote healthy aging,
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independent living, and engagement, while they also address the issues that
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are related to health care, to housing, transportation, and other social determinants of health.
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So every state develops its own multi-sectional plan on aging based on its unique
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characters, its history, their resources.
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What to me is one of the best, most promising things about this,
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this is not a political issue because aging is not political.
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It's red state, blue state. We're all aging.
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But looking at and preparing in advance for how are we going to work with our
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shifting demographics?
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How do we get ahead of this? How do we prepare for, you know,
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the day when we're already on the cusp, when our retirees outnumber our students?
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Let's look at it now. And New Jersey has been involved with a learning cohort
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from Center for Healthcare Strategies, with learning from other states,
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getting technical assistance on how we could do it.
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And we also have a campaign called Lifelong Strong New Jersey campaign,
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which is actively calling for the new administration to adopt a multi-sector
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plan. And I think that it's, I think we're right on the edge of that.
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I think it's very possible and plausible because the new administration is so
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focused on affordability, which is really, you know, at the heart of our aging challenges.
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Can people afford to age well in New Jersey?
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So it's aligning very well. And we really hope that in the next few months,
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we have a commitment for New Jersey to move forward with a multi-sector plan.
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So with a better understanding of what a multi-sector plan for aging is and
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the possibility of that happening soon,
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what is something that individuals in various professions, in healthcare,
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in public health, what can they do right now to advocate for a multi-sector
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plan on aging or for just improved conditions for older adults?
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You know, Sean, I'll take that one first. At Rutgers Robert Wood Johnson Medical
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School and Parker Health Group, we are promoting education for seniors in the medical school.
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And it's in all comers. Besides medical students really advocating for education
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for a physical therapist, for nurse practitioners, for pharmacists,
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for nurses' aides, and really open learners' eyes about opportunities,
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taking care of seniors, and really the benefit that they can provide.
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For these individuals and really the satisfaction that is given by providing
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that care to a needing population.
00:17:25.307 --> 00:17:30.627
Well, first, go to the Lifelong Strong website, which is lifelongstrongnj.org,
00:17:30.827 --> 00:17:35.107
where we've got resources and links for national efforts and what other states
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are doing where people can learn more.
00:17:36.927 --> 00:17:41.407
And then next, people should really understand the demographic shift that we're
00:17:41.407 --> 00:17:44.567
talking about and what that entails, what it will require.
00:17:45.067 --> 00:17:49.127
But I think the most important is to take a look at your clients,
00:17:49.167 --> 00:17:53.427
your community, both professionally and personally, and take a look at what
00:17:53.427 --> 00:17:56.367
people need and want to age in New Jersey.
00:17:56.787 --> 00:18:00.107
And like, what do you need to age well in New Jersey?
00:18:00.287 --> 00:18:02.967
What do you want to see in place for your grandparents, your parents,
00:18:03.127 --> 00:18:05.267
or yourself in 20, 30, 40 years?
00:18:05.627 --> 00:18:09.407
Right now, we've got 1.6 million residents over the age of 60.
00:18:09.527 --> 00:18:15.687
So that's 1.6 million reasons to start looking at this and move forward with a multi-sector plan.
00:18:16.247 --> 00:18:20.967
And, you know, this is, we all want to be there. We all want to have long and
00:18:20.967 --> 00:18:23.627
healthy lives. So let's start working on this now.
00:18:24.107 --> 00:18:28.367
So we are approaching the end of the recording. But before I get into the last
00:18:28.367 --> 00:18:31.427
question, is there anything else that either of you wanted to talk about that
00:18:31.427 --> 00:18:34.187
maybe we didn't discuss in the written questions?
00:18:35.131 --> 00:18:39.591
But maybe what I could say instead is it's more important to be training a younger
00:18:39.591 --> 00:18:46.051
population for the awareness of caring for seniors and the opportunities that
00:18:46.051 --> 00:18:52.171
are there and really promoting the next generation of caregivers to care for
00:18:52.171 --> 00:18:54.571
those individuals in New Jersey.
00:18:55.431 --> 00:19:00.031
And I think that I'm very hopeful. I think we're so close to adopting an MPA.
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I think it aligns with the new administration's goals on affordability.
00:19:03.351 --> 00:19:09.911
And I think that, I mean, personally, by the time if the current governor has
00:19:09.911 --> 00:19:12.571
a second term, I will be retiring then.
00:19:12.851 --> 00:19:17.211
So I really think that we'll have things in place so that I can retire well and enjoy New Jersey.
00:19:18.211 --> 00:19:21.731
Nice, Dr. Rowe. That's one thing to be hopeful about. Dr. Raymond,
00:19:21.891 --> 00:19:25.031
is there something that you're hopeful about as we approach spring this year?
00:19:25.911 --> 00:19:29.151
I'm really looking forward to the rollout of the aging-friendly initiatives
00:19:29.151 --> 00:19:35.051
in hospitals and also the outpatient Medicaid palliative care benefit and seeing
00:19:35.051 --> 00:19:38.131
how that affects the care of seniors in New Jersey.
00:19:38.651 --> 00:19:43.131
And if people want to, you know, learn more about what's going on with aging
00:19:43.131 --> 00:19:46.411
in New Jersey, because we have so many great efforts underway.
00:19:46.731 --> 00:19:50.891
The New Jersey Advocates for Aging Well Conference is May 8th in Princeton,
00:19:51.071 --> 00:19:55.651
New Jersey. Details will be on our website at njaaw.org.
00:19:55.931 --> 00:19:59.631
That was a wonderful conversation. We certainly covered a lot.
00:19:59.831 --> 00:20:03.111
We discussed how the population of older adults in New Jersey is continuing
00:20:03.111 --> 00:20:07.371
to grow and how important environment play a role in aging well.
00:20:07.591 --> 00:20:12.311
We discussed that ageism, lack of transportation, and the affordability crisis
00:20:12.311 --> 00:20:15.731
are a problem not just for older adults, but really the entire population,
00:20:15.731 --> 00:20:17.591
and working to address these needs.
00:20:18.801 --> 00:20:22.941
Everyone in New Jersey. We discussed the need for interdisciplinary work from
00:20:22.941 --> 00:20:26.661
healthcare providers, public health professionals, private industry,
00:20:26.681 --> 00:20:31.241
and government to really work together to create better outcomes for all.
00:20:31.461 --> 00:20:34.981
We discussed what a multi-sector plan for aging is and how that could benefit
00:20:34.981 --> 00:20:36.281
older adults in New Jersey.
00:20:36.701 --> 00:20:40.861
And we discussed some things to be hopeful about as we look to the future.
00:20:41.341 --> 00:20:45.721
We have some wonderful resources that will be listed in a resource We're stocking
00:20:45.721 --> 00:20:47.481
it within the description of this episode.
00:20:48.301 --> 00:20:52.181
If you want to dive deeper into this and other critical public health topics,
00:20:52.261 --> 00:20:54.201
make sure you join us on one of our Echo Series.
00:20:54.641 --> 00:20:57.701
We just wrapped up our Getting Older in New Jersey Echo Series.
00:20:57.941 --> 00:21:00.761
If you're interested in learning about that, you can visit our website.
00:21:01.741 --> 00:21:05.161
Keep up with New Jersey Advocates for Aging Well by visiting their website,
00:21:06.841 --> 00:21:12.081
njaaw.org, where you can view events, services, resources, and news related to older adults.
00:21:12.661 --> 00:21:16.461
As I mentioned a full list of resources and items discussed today can be found
00:21:16.461 --> 00:21:20.061
in the document within the description of this episode Thank you again to our
00:21:20.061 --> 00:21:21.801
amazing guests and thank you for listening.