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Senior care: Are we prepared for the impending healthcare crisis?


The number of older adults with complex health needs is outpacing the number of healthcare providers with the knowledge and skills to care for them adequately. In 2011, the 78-million-strong Baby Boom generation starts to turn 65. In 2030, the number of older Americans will nearly double from 12% of the population to almost 20%. About 75% of adults older than age 65 have at least one chronic medical condition, and 20% of current Medicare beneficiaries have five or more chronic conditions. Older adults are more vulnerable to injury and acute illnesses and have a diminished ability to perform daily activities.
These trends all lead to increased use of health services. Predictions loom that the Hospital Insurance Trust Fund, which pays hospitals through Medicare Part A, could be exhausted by 2019. A recent report from the Institute of Medicine (IOM), “Retooling for an Aging America: Building the Health Care Workforce,” boldly states that the nation isn’t prepared to meet the social and healthcare needs of this population.

Key recommendations of the IOM study
The IOM study recommends sweeping reforms, with bold initiatives designed to:
• boost recruitment and retention of all types of geriatric specialists and caregivers
• increase the competence of all geriatric care providers, including family caregivers
• develop innovative, cost-effective models that expand worker’s duties and responsibilities
• devise new payment mechanisms and align financial incentives for providers and teams to deliver care to older adults more effectively
• teach older adults to manage their own health.

Is nursing ready?
For more than a decade, nursing leaders have been building nurses’ capacity not only to care for older adults but also to provide leadership in health-system change. The John A. Hartford Foundation has pledged $67 million toward the “Building Academic Geriatric Nursing
Capacity” program. The American Academy of Nursing (AAN) is playing a key role in this effort to develop geriatric nurse leaders and improve access, quality, and safety of care and to promote wellness among seniors.
Nine Hartford Centers of Geriatric Nursing Excellence, located at top universities across the country, have helped prepare more geriatric nurse researchers, educators, and clinicians, who are disseminating and implementing evidence-based geriatric practice. Scholars and fellows funded through these programs are located in 33 states and the District of Columbia. (For more information on this program, visit www.geriatricnursing.org.)

Helping seniors take charge of their health
While the next generation of older adults will be better educated than previous generations, little can compensate for age-related memory loss, visual and hearing impairment, musculoskeletal decline, and decreased mobility. But by learning how to manage their own health, seniors can help maintain active lifestyles and avoid the risks of obesity, depression, and anxiety.
The IOM report calls for increased specialty training in geriatrics for healthcare workers who treat seniors. The report notes the key role that older adults and their friends and family members can play. It advocates that programs be established to help these often unpaid caregivers learn the skills needed to provide care to loved ones and reduce the stress associated with being a caregiver.
To spotlight many of these important issues, The American System for Advancing Senior Health (ASASH) and the University of the Sciences in Philadelphia are hosting the Advancing Senior Health (ASH) Conference. In this pioneering, senior-specific medical/practitioner educational event, healthcare professionals from all disciplines and specialties will learn about innovative assessment and care techniques, collaborate on ways to maximize positive outcomes, and discover strategies for improving the accessibility, quality, and economics of care for our country’s booming senior population. The conference will be held in Philadelphia on October 1 and 2. (Visit www.ash-conference.com/index.html for more information.)
We urgently need to reform our healthcare models and retool the workforce to ensure a reliable system that will meet the Baby Boomers’ demands for years to come. We have a lot of work to do!

Pamela F. Cipriano, PhD, RN, FAAN, CNAA-BC

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