Baby boomers may not have specialists needed at age 65
When 78 million baby boomers reach age 65 in 2011 they will depend upon a health care workforce that is too small and unprepared to meet their needs, according to a new report from the Institute of Medicine.
The report, Retooling for an Aging America: Building the Health Care Workforce, identifies a number of bold initiatives that should begin immediately to train all health care providers in the basics of geriatric care and to train families how to care for aging friends or family members.
Several reports show an overall shortage of health care workers in all fields, but the situation is worse in geriatric care because it attracts fewer specialists than other disciplines and experiences high turnover rates among direct-care workers nurse aides, home health aides, and personal care aides. For example, there are just over 7,100 physicians certified in geriatrics in the United States today one per every 2,500 older Americans. Turnover among nurse aides averages 71% annually, and up to 90% of home health aides leave their jobs within the first two years.
Older adults as a group are healthier and live longer today than previous generations, the report notes. Even so, individuals over 65 tend to have more complex conditions and health care needs than younger patients. The average 75-year-old American has three chronic conditions, such as diabetes or hypertension, and uses four or more prescription medications, the committee found. Dementia, osteoporosis, sensory impairment, and other age-related conditions present health care providers with challenges they do not often encounter when tending to younger patients.
While the number of older patients is rapidly increasing, the number of certified geriatric specialists is declining. Medicare, Medicaid, and other health plans need to pay more for the services of geriatric specialists and direct-care workers to attract more health professionals to geriatric careers and to stanch turnover among care aides, many of whom earn wages below the poverty level.
Although a comprehensive examination of Medicare was not the focus of this study, the committee noted several ways that the program hinders the provision of quality care to older adults, including Medicare's low reimbursement rates, its focus on treating short-term health problems rather than managing chronic conditions or age-related syndromes, and its lack of coverage for preventive services or for health care providers' time spent collaborating with a patient's other providers.
Copies of Retooling for an Aging America: Building the Health Care Workforce are available from the National Academies Press at 202-334-3313 or 800-624-6242 or on the Internet at http://www.nap.edu. Additional information on the report can be found at http://www.iom.edu/agingAmerica.
When 78 million baby boomers reach age 65 in 2011 they will depend upon a health care workforce that is too small and unprepared to meet their needs, according to a new report from the Institute of Medicine.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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