Seeking Proactive, Equitable Care for Elders

Editor’s note: The John A. Hartford Foundation, the Administration for Community Living (ACL) and The SCAN Foundation fund the Aging and Disability Business Institute, led by USAging. As partners in the Institute, ASA and USAging are collaborating on a series of webinars and articles in Generations Now profiling diverse organizational leaders who are working in cross-sector collaborations.

Edem Hado may be a senior strategic policy advisor at the AARP Public Policy Institute in Washington, DC, but her work and focus in her career is really driven by a passion to help older adults, which stems from her relationship with her Ghanaian grandfather. She moved to the United States when she was 9, but prior to that grew up with her grandfather, calling their relationship “incredible. He was the one who taught me how to properly iron clothes (with starch) and how to fly a kite, and I learned to love all the timeless musicians like ABBA and Whitney Houston from him,” said Hado.

Immersed in his daily life, Hado found it to be a meaningful and fulfilled life, so when she began thinking about a career in aging, she hoped to work on ensuring other older adults could live such a joyful and purposeful life as well.

“That really fuels my purpose, I really believe that older adults should be able to age in good health with dignity and on their own terms,” she said.

“Especially in my Ghanaian culture, older adults are very much revered. They’re treated with dignity, so it was difficult to see that contrast when I first moved to the U.S. in terms of how they can be regarded here as expendable, and all the challenges many struggle with such as ageism and other forms of discrimination.”

After earning an undergrad degree from Brown, Hado spent four years in the homecare delivery space, working with startups focused on streamlining the care older adults receive as well as better integrating paid workers as part of the care team. “My work on the ground gave me firsthand experience and exposure to the challenges that older adults face, as well as their families and direct care workers, such as their issues financing care, plus the mental and physical toll of caregiving on family members,” Hado said.

Considering how devalued she felt the caregiving role was for direct care workers, the lack of empowerment and potential for greater career opportunities made her realize that policy would be the best channel for the greatest impact. Hado received a Master’s in Public Health from the Harvard T.H. Chan School of Public Health, which set her on the path toward her current position at AARP.

Career Chasing Equitable Care

She has been at AARP for four years, looking at solutions for expanding home- and community-based services (HCBS), to work toward a world in which most older adults could age in their own homes, as is their wish.

At AARP she envisions ways to strengthen support for family caregivers, as the bulk of supports for older adults come from family and close friends. “So how do we support family caregivers in that role and how do we ensure paid workers are also supported knowing they are pivotal members of the care team?” she asked.

Hado spends her days conceptualizing and managing policy research aimed at advancing equity in aging services, providing high-level guidance to internal stakeholders on the policy work she has done and promoting evidence-based policy recommendations via AARP’s publications, forums and speaking engagements.

We need to make sure that the people who we’re crafting the policy solutions for have a say in those solutions.

Right now, she’s working with AARP state offices in Georgia and New York, looking at ways to address racial/ethnic and LQBTQ+ inequities in HCBS through community-based research, and with provider organizations, assessing the older adult journey through the HCBS systems, where the gaps in care exist and how to address them through policy or pilots or other on-the-ground solutions.

“I’m really passionate about elevating voices that are not often included in the conversation, making sure that the people who we’re crafting the policy solutions for have a say in those solutions,” she said.

AARP is also intentional in making certain that not only are the older adults centered in the work, but that they know what will be done with the information they have provided the team, so they don’t feel abandoned once the project is completed. “That’s why a lot of our work has been in collaboration with community organizations, those the residents trust, so they trust us to make sure our solutions are sustainable and so they recognize that [said solution] was co-created with them,” she added.

Hado is an ASA RISE Fellow, too, which she said has given her more clarity and conviction regarding ways to advance equity in the aging space, plus she’s connecting with others with whom she might collaborate.

“Oftentimes you’ll see that we’re siloed in the aging sector, but all of our work ties together and we can benefit more from reaching out and talking to each other more,” said Hado.

If she were to envision the perfect world for older adults, one that was more attune to her native Ghana’s way of treating older adults, she hopes that long-term care in this country might become more proactive and responsive to the diverse needs and preferences of older adults and their families, in a way that would center their voices in all aspects of care, guaranteeing the “older adult experience” is exactly what they want.

“I’m a big proponent of identifying ways to be more preventive in the aging space instead of being so reactive. We saw through COVID that there are so many cracks in the long-term care system, so how do we patch up those gaps, or perhaps some parts of the system require us to dismantle it all together and rebuild it in a way that’s transformative and impactful for older adults and their families. Plus, it needs to be a tailored system that can pivot when needed, say if an emergency arises,” added Hado.

She doesn’t claim to have all the answers as to how we might reach this point as a society, but she does know it is imperative that we avoid taking a fragmented approach to tackling the challenges surrounding care and caregiving of older adults. What’s needed instead is an integrated, cross-sector approach that’s also equitable, of course.

Edem Hado will be presenting at On Aging March 29, from 10:15 a.m.–11:45 a.m. no Advancing Equity in LTSS through Research, Policy and Practice.