Green House Blog

A flexible, diverse vision for eldercare with Jennie Chin Hansen

This week’s podcast episode with Senior Director Susan Ryan featured Jennie Chin Hansen, who has served as the CEO of On Lok, president of AARP, and a stakeholder in California’s Master Plan on Aging.

A happy, peaceful abode

Much of the podcast focused on Chin Hansen’s time as director of On Lok.

On Lok, which loosely translates to “happy, peaceful abode” in English, started out as a community center providing social services to elders in San Francisco’s Chinatown in the 1970s. When Chin Hansen joined in 1980, the organization merged social services with medical services.

In 1984, On Lok received funding from the Robert Wood Johnson Foundation to see if this model – which had nailed the concept of serving the needs of elders without infringing on their autonomy or desire to live in their own homes – could be replicated elsewhere. As Chin Hansen admitted, at the time, the stereotype of On Lok was that it worked only because it served a largely Chinese, tight-knit population. They aimed to upend this conception, and they certainly did: There are currently 250 PACE models based on the On Lok blueprint in 31 states, serving incredibly diverse populations.

An ecosystem, not a transaction

Chin Hansen talks a little about the role of serendipity in paving her path throughout her career. I thought the process of On Lok’s development was a perfect example of what can happen when you choose to seek out opportunity in the face of uncertainty and chance. For example, the eventual merging of social with medical services happened because On Lok took a look around and realized that the needs of elders were not being met with the single-pronged approach that they had started with. Rather than throw in the towel, they chose to rebrand, resulting in an organic merge that has made On Lok the holistic, reliable care model it is today.

Another story Chin Hansen shared was when On Lok ran into a lack of funding when they wanted to build a nursing home. They were forced to build a community without walls, but this flexibility ended up being its strength, especially during COVID-19, when elders that were ill could still be in their homes, surrounded by loved ones.

Having leadership that embodies adaptability, resilience, and flexibility is perhaps what leads On Lok to be what Chin Hansen calls “an ecosystem, not a transaction.”

Chin Hansen’s vision for eldercare

Chin Hansen ends the podcast suggesting that medicine, for all the good it has done, may not be the ultimate solution to our health and wellbeing. We see this in eldercare all the time –when we prescribe anti-psychotics, limit favorite foods if they’re deemed “unhealthy”, time bathroom breaks, and resign elders to tiny clinical rooms in the name of health and safety.

Though this care is often well-intentioned, I resonated with Chin Hansen’s sentiment that it’s the most inexpensive expenditures that lead to wellbeing. In fact, as she further mentions, studies have suggested that clinical medicine accounts for only 15% of our health outcomes. While we still have a while to go in ensuring that all people have access to this 15%, On Lok and the leadership of Jennie Chin Hansen makes me optimistic that around the country, eldercare will start to look less like a pill and more like family, friendship and feelings of home.

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