It's a Coming Tsunami. Which Funders Are Confronting an Aging America?

Recent grants from the John A. Hartford Foundation are one of the few bright spots in philanthropic support for seniors, which remains small, even as the U.S. elderly population grows rapidly.

The number of Americans over 65 has ballooned to 49.2 million this year, up from 35 million in 2000. That number is expected to double to about 88 million by 2050. Not only that, but older Americans tend to be sicker and have less access to care than the elderly in other high-income countries, according to a recent study backed by the Commonwealth Fund.

Despite that, care for the elderly remains a low priority for most funders. The Hartford Foundation, the Archstone Foundation in Long Beach and the Gary and Mary West Foundation in San Diego, are among the few funders to focus exclusively on care for the elderly, said John Feather, the CEO of Grantmakers in Aging. The AARP Foundation, as you might imagine, is another outfit that focuses its giving on the elderly. Much of its work has focused on affordable housing in an effort to keep poverty rates low among older people.

Many of the funders that work on aging focus on giving locally, Feather pointed out. That is true of John Gogian Family Foundation and the Eisner Foundation, two foundations that support the elderly in Los Angeles, where the funders are based.

These trends are reflected in the overall philanthropic support for aging, which accounts for 2 percent of total philanthropic giving in the U.S., Feather said. That number has remained constant, even as the number of older people has increased.

“I think at one point, a lot of us in the field really felt that—the expression used to be, ‘Demography is destiny,’—people would wake up and see that the baby boomers were coming. Never happened,” Feather said.

As for the foundations that do engage in aging work, a recent set of grants from the Hartford Foundation gives us a sense of where the money goes. The foundation pledged $833,000 to three organizations to share evidence and tools to improve outcomes for the elderly and support policies that strengthen the eldercare workforce.

A little over half of the money, $496,000, is going to Project Hope, a global healthcare and humanitarian organization, to continue its work with the policy journal Health Affairs. The partnership puts out best practices in elder care and advocates to put aging and health care policies at the center of the national healthcare debate.

Tides Center, a charity and nonprofit accelerator focused on social justice, will get $200,000 in support of its Eldercare Workforce Alliance. The alliance is a coalition of 31 national organizations. The grant will go to education and outreach to push state and federal policies that strengthen the workforce caring for the elderly and protect laws already on the books that protect the elderly.

The remaining $137,000 goes to the Institute for Healthcare Improvement to support the Hartford Foundation’s partnership with Commonwealth Fund, Peterson Center on Healthcare, the Robert Wood Johnson Foundation and SCAN. The five foundations are working together to improve health outcomes for adults with complex health and social needs.

The field of complex care typically focuses on treating people with expensive, chronic conditions. People who fall into these categories often have multiple, intertwining medical and social needs. As a result, while these patients comprise 5 percent of the people using the healthcare system, they account for 50 percent of the cost. The field doesn’t focus exclusively on the elderly—in fact, the funder collaborative came up recently in our coverage of RWJF’s work on trauma—but overlaps in places with elderly care.

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The gift to the Institute of Healthcare Improvement, which will incorporate aging into a larger body of work, is part of a pattern for grantmakers and organizations looking to draw attention and funds to aging issues, Feather said.

Nonprofits looking for funding in this space are fighting an uphill battle. Ageism is a big part of that, Feather says. “Americans don’t like to think of themselves as aging,” he said. Feather says that applies to trustees that direct funding, many of whom are older, too.

Feather describes the general sentiment around charitable giving as, “Children are an investment; older people are an expense.”

“While few people would say it as bluntly as that, we see it all the time,” he said. “It’s not that older people’s programs are bad, it’s just that, you know, there’s not return on that investment like there is if you do early childhood development programs for kids.”

To work around this, Grantmakers in Aging, the funder affinity group Feather leads, approaches foundations about considering the elderly in projects and fields they’re already working in, rather than asking them to start an aging funding stream from scratch.

“If you work in housing, or if you work in health, or you work in transportation, you inevitably work with older people,” Feather said. “Just find out more about their needs and pay more attention to it in the overall scope of what you do.”

For example, when working in a community, one thing organizers can do is a walkability survey that takes into account whether sidewalks are accessible for someone with balance issues, Feather said. Taking the needs of older people into account makes a community better for everyone.

The approach has found some success, Feather said. But the stakes are high.

“The largest generation of older people in America is here,” Feather said. “It’s not coming; it’s here.” That demographic shift and the threat of a thinning social safety net puts a lot of pressure on funders in the field to take a Band-Aid approach rather than spend funds to look upstream.

When government funding is cut for a program like Meals on Wheels, which came under threat earlier this year, funders are faced with the choice of shoring up a program that literally keeps people alive or investing in ideas that could lead to better care down the line, Feather said.

“There’s absolutely no way that philanthropy can replace the governmental role in providing a safety net,” especially now that private funders are stretched further than ever, he said. “Everyone is looking to philanthropy to pick up the slack, but there is no slack left in the system.”

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