Crossing Silos….. Deliberately #1

by Louis on March 25, 2013

Policy folks, operators and advocates often lament silos as barriers to aging in place, good medical care and  other current issues. I agree, but I see very little effort that crosses silos. If silos are the problem, why not set strategies that cross silos deliberately? I hear about models and programs in caregiving, transportation, home modifications, technology senior centers and others.   Of course, providers acknowledge that no program exists as an island but I have not seen anyone take the ‘portfolio’ to break the silos. Is it sacred ground? Can we focus on breaking down silos? Will that get the job done? We can’t know if we don’t try.

Analogous action occurs in the business world all the time. Companies are horizontal…concentrating on their core, but see efficiencies by increasing control of related sectors so they take steps to be more vertical. Or, just as often, they see distractions and inefficiencies of their verticality and slough off divisions to improve operations. Oil companies are a good example.WoodSilo2 There are many segments involved in getting gas to the pump or the generating plant. Oil futures and exploration, extracting, shipping, refining, shipping again and retail. We often hear one of the big (or small) companies is reforming their parts to make things better. They buy a new division or sell one…all in the effort to get the mix of relationships right. Google does it. They build some parts in house, buy some and partner for others. Critics recognize how rarely acquisitions result in the predicted synergies. Daimler bought Chrysler and sloughed it off a few years later at a huge loss. Now Fiat is taking their chance with Chrysler.  Think Time-Warner and AOL. This month Time Warner ‘spun off’ Time, Inc into a separate company. Humana is at the cutting edge of in home care strategies..they have acquired some pieces including Senior Bridge but developed HumanaCares in-house.

Aging in Place 2.0…the organized  systematic future of Home and Community Bases Service needs this sort of businesslike thinking. Words like horizontal and vertical are not o.t We are stuck myopically in silos. We need n in the HCBS discussion. We need at least this sot of innovation to move deliberately to integration and collaboration in the future.

{ 3 comments… read them below or add one }

Aaron D. Murphy March 26, 2013 at 3:15 pm

Louis – Thank you as always for your insights and professional advocacy! Great points about the need to “cross over”, as we have also suggested in recent blog posts based on our valuable time spent with you at “Aging In America” #Aia13 in Chicago a couple weeks ago. Keep up the great work, and I look forward to the next opportunity to collaborate and/or share the stage with you to present – it was a blast!


Rachel Adelson March 27, 2013 at 9:50 am

Good thinking. This is always the challenge in human service — getting from established structures that may have worked in the past, or that work for the people who created the structures, to something that works for the people instead of the structures. It’s like person-centered care in the case of dementia: seems so obvious, but we have to take down a wide range of barriers to implement on a broad scale. Maybe the scale of the demographics will force the issue and address housing, transportation, health care, income support, social connectedness, purposeful activity and on and on …. as a whole instead of bits and pieces. For anything to be successful, they all have to mesh like gears.


shoshan ahacham April 3, 2013 at 1:11 am

Dear Louis Tenenbaum

No Doubt that Silo is truly a structured barrier for implementing effective Aging in Place Service Platform. (See Harvard research about it dated 2002)
Crossing Silos…Deliberately #1 is the right way to go!
The key challenge is how to make it happen.
Baring in mind that there are at least 10 stakeholders industries related to the Global Industry emerging market.
So, is it a realistic vision or just a dream?

To my humble view there is a way to make it happen.

The first step is to realise that elderly people are not one size. You have to focus on each individual customer, aged 70 and over.
The second step to understand and adresses the Needs and Wants of each individual who wish to stay at hom in the community connected to freinds & family

The third step is to deliver a personal complementary basket services ‘at affordable cosr ‘to enable each customer to live in dignity meaning full life ,

The Fourth step is to build bind and bond, a personalized sustainable holistic complementary service platform to addresses the Independent Living challenge

This is what Homage for Life is all about
If you wish to ave more details pls contact me..
All the best
Shoshan Shacham
Homage for Life
Ramat Hasharon


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