Dramatic demographic and societal changes have moved a number of critical aging issues into focus in the 21st century. A significant number of Americans are expected to occupy a caregiving role for an older adult at some point in their life. This forecast is underscored not only by the tremendous number of boomers expected to reach age 65 over the next several decades, but also by uncertain future state and federal resources for older adults. Just reference the current debates on Medicare and Social Security.

To address the growing needs of older adults and caregivers, some surprising groups have joined hands. Public policy experts and politicians have worked closely with community health professionals and aging activists over the past few years to promote legislation on aging and caregiving. As a result, new programs and alliances have been formed. Yet, the needs are greater than the resources can support. What can be done? One increasingly viable option is the creation of an aging collaborative -- a community-based public-private partnership of aging and caregiving services.

Aging collaborative groups should represent a broad cross-section of nonprofit and for-profit organizations. Both groups provide services and programs to older adults and their families. Each representative group is a valued member -- providing a critical resource and unique perspective to the collaborative. The list of potential collaborative partners is inexhaustible.

The following examples highlight just a few of the many possible members.

1. Community-based nonprofits such as hospitals, health clinics and adult day health centers -- maintaining the health and well-being of older adults in the community.

2. Skilled nursing facilities -- providing essential end-of-life care, as well as transitional care for older adults en route from hospital to home.

3. Assisted living facilities -- offering important housing alternatives for older adults who require assistance or desire more socialization but are not yet at the level of a skilled nursing facility.

4. Supportive home services (for-profit and nonprofit) -- helping seniors and caregivers in the home, such as home health (skilled and unskilled), case management, emergency response, home modification, meals, financial and estate planning, respite, education/training, assistive devices and Internet programs. The makeup of any aging collaborative should reflect the unique characteristics of the community it represents.

The purpose of the aging collaborative is to share information, ideas and responsibility. Practically, the aging collaborative offers a win-win situation for both the public and private sectors. For-profits benefit from enhanced relationships with other for-profits, as well as nonprofit organizations -- increasing the possibility of referrals. In turn, for-profit members are encouraged by the collaborative to provide some of their services on a sliding scale or pro-bono basis. Nonprofits also benefit by gaining new ideas and partners -- essential for the many nonprofits dedicated to serving low-income as well as under-served older adults and their families.

Success of the aging collaborative means that the group, as a whole, acknowledges and embraces the belief that older adults (and when appropriate, their caregivers) have the right to choose services that best meet their needs. By promoting this philosophy, the aging collaborative effectively supports enhanced independence and quality of life for consumers. This concept, referred to as "consumer direction," is fast gaining attention in the delivery of home and community-based services. Consumer-directed care recognizes and supports the inherent benefits of giving consumers choice in the design and delivery of services.

Originally launched as a critical next step in the delivery of home- and community-based services for younger disabled adults during the 1970s, consumer-directed care has flourished since then. It has proven to be a powerful empowerment tool for a variety of populations, including older adults. This shared consumer-directed approach to the delivery of services, coupled with a commitment to shouldering community needs as a cohesive group, distinguishes the aging collaborative from the more classic networking organizations.

With an exploding numbers of older adults and caregivers just around the corner, creative solutions to aging and caregiving problems must be initiated and solved at the local level. The aging collaborative allows all stakeholders involved with the critical issues of aging and caregiving to be successful, and it brings resources and people together with meaning and purpose.

For more information on local caregiving resources, contact the Southern Caregiver Resource center, (858) 268-4432, or scrc@caregivercenter.org . For more information on aging collaboratives, please contact LifeCourse Care, (925) 254-0522, or mparrish@lifecoursecare.com.