Caring for an Aging America: Meeting the health care needs of older adults

AN AGING AMERICA: What is meant by the terms “an aging America,” “Silver Tsunami,” and “Graying of America”?
The combination of the aging of the Baby Boom population, an increase in life expectancy, and a decrease in the relative number of younger persons, will mean that older adults—those over 65—make up a much larger percentage of the U.S. population than ever before.   In fact, approximately 10,000 Baby Boomers turn 65 every day.  By 2030, older adults will make up 20% of the American population—a big jump from today’s 13%.

WHO WILL CARE?: Why is  training in caring for older adults so important?  
Older adults often have different health care and long-term service and support needs than children and younger adults, and diseases and treatments can affect them differently. Older adults require care that considers these differences, as well as the multiple chronic health problems many older adults experience. An estimated 90 percent of adults over 65 have one or more chronic condition, such as diabetes, heart disease, arthritis, depression, and
hypertension. Just as children should be treated by health providers who are trained in pediatrics, older adults should receive care from professionals trained to care for them.

WORKFORCE VACANCIES: Why do not enough professionals specialize in caring for older adults?  
Many factors contribute to people not entering into the fields of geriatrics (the study of older adults’ health) and gerontology (the study of aging). One of the most cited reasons is that Medicare, which provides health insurance coverage for most older adults, sometimes offers payment rates which are lower than private insurance, so those who specialize in caring for older adults often earn less than their colleagues in other disciplines. Because older adults have multiple chronic conditions, and their care can be complicated, health providers spend more time with these patients and need to coordinate with other team members, including family caregivers. This extra time and coordination in not adequately compensated for within the current system.  Additionally, the supply of family caregivers, who provide the majority of long-term services and supports in this country, is unlikely to keep pace with future caregiving demand. In 2010, the caregiver support ratio was more than 7 potential caregivers for every person over 80 years old.  The ratio is projected to decline to 4 to 1 by 2030.

IT TAKES A TEAM: What is an interdisciplinary care team?
Older adults, and especially frail elders, often have complex needs that require coordinated care.  Providing coordinated care requires an interdisciplinary team tailored to the individual’s needs. The team may include: physicians, nurses, social workers, psychiatrists, psychologists, medical directors, pharmacists, dentists, physical therapists, medical directors, direct-care workers, and others as well as consumers (or patients) and their family caregivers.

Is team care more expensive?
Actually, studies have shown that geriatric team care can result in higher quality care that doesn’t cost any more than other approaches. In fact, there are strong arguments that coordinated care from a well-trained team can lead to a cost savings due to reduced re-hospitalizations, medication errors, and common complications such as injuries from falls.

TRAINING FOR ALL: Aren’t all health care providers trained to care for older adults?
Training requirements differ across the nation and across professions.  However, most health care providers currently provide at least some care to older adults, and within 20 years, it will be nearly impossible for them to NOT provide care to older adults. Many health professions have developed recommendations for minimum recommended eldercare competencies; however, those recommendations are not always followed.  Institutions and training programs must adopt them to ensure that all older adults receive quality care. Also, currently, there are no minimum federal training requirements for personal and home care aides. As a result, in many states, no training at all is required for this workforce.

PERSON- AND FAMILY- CENTERED CARE: I want to stay in my home for as long as possible.  Would a well-trained eldercare workforce help me do that?
People should be able to receive quality care to help them live independently in their homes and communities. An interdisciplinary team is the key to successful home care. Direct-care workers, and more specifically home care workers (home health aides and personal care aides), and family caregivers play a critical role in home care. Support for their work and training are essential to providing quality care.

TAKE ACTION: What can be done?
Visit http://eldercareworkforce.rallycongress.com today!  Tell your members of Congress to support programs that strengthen the eldercare workforce and improve quality of care to older adults:

• Currently, the Title VII Geriatrics Health Professions and Title VIII Geriatrics Nursing programs, funded through the Public Health Service Act, help to train eldercare practitioners and support faculty to conduct training.  These programs offer critically important training for the healthcare workforce overall to improve the quality of care for America’s elders.  In order to ensure that everyone knows how to care for older adults, we must increase the number of faculty and trainers able to provide that training.
• Additionally, programs under the Older Americans Act, such as meals on wheels and family caregiver respite, support individuals and their family caregivers.  These essential programs must receive adequate funding to meet the challenge of an increasing numbers of older adults.
• The quality of jobs for direct-care workers must also be improved, in terms of training, wages, and advancement opportunities, in order to attract and retain the millions of workers needed to provide care to an aging America. In 2014, the Obama administration is required to make recommendations to Congress for minimum training standards for home care workers.
• Visit www.eldercareworkforce.org to find out more about these issues and to sign-up to receive our monthly newsletter.