With an estimated 20% of America's population to be 65 and older by 2030, Michigan State University researchers warn that current health care providers are unprepared to handle the increase in eldercare demands.
Clare Luz, gerontologist, and Kevin Foley, a geriatrician, in MSU’s Department of Family and Community Medicine in the College of Osteopathic Medicine, say meeting the demand requires recruiting more medical students into geriatric specialties, training more direct care workers and improving the culture that defines aging.
“We have 10 more years until 2030 when the oldest members of Generation X will turn age 65 and join over 70 million other aging adults in America whose health care needs will demand far more from our existing health systems,” Luz said. “We don’t have a big enough or qualified enough health care workforce to deal with this. The shortage is critical.”
Their research updates the 2008 Institute of Medicine report “Retooling for an Aging America,” which made 13 recommendations needed to be completed by 2030 to prepare health care providers for the demands of a rapidly aging population. The research, published online October 23 and to appear in a June special edition of The Gerontologist, was conducted at the request of the Eldercare Workforce Alliance.
“Our results were eye-opening; we aren’t making much progress,” Foley said. “The aging population is growing, and we aren’t prepared to deal with older adults’ needs.”
To date, only one of the recommendations has been completed: the establishment and authorization for continuous federal funding of the Geriatric Academic Career Award that provides support for aspiring geriatrics clinician educators. Unmet recommendations focus on increasing training in care of older adults within different specialties such as nursing, social work, pharmacy and direct care.
The IoM report said only half of graduating internal medicine and family medicine residency graduates felt confident enough to treat elders. A dozen years later, Foley said, there are only 6,800 geriatricians in the U.S. and only three residency programs in the nation that require training in geriatrics for graduation. Such training to optimize patient care and wellbeing, moreover, is often underemphasized in many hospitals.
The shortage extends across all specialties, among them, direct care workers who support daily activities critical for maintaining quality of life for aging clients.
“Home health care agencies can’t find, train and maintain enough workers,” Luz said. “In Michigan alone, we need 36,000 more direct care workers than we currently have.”
Another challenge is cultural. “We live in an ageist society,” Luz said. “We don’t place a lot of value on older adults or respect the people who care for them.
Even with changes in attitudes towards aging and more trained medical professionals and skilled direct care workers, Luz and Foley say support for the IoM recommendations needs to come from the federal level.
“When the 2008 report was published, there was early interest and enthusiasm to begin the work but a lack of continuous leadership and oversight slowed the momentum for fulfilling all of the recommendations once the original committee disbanded,” Foley said. “The Institute of Medicine report is an important blueprint and we need to keep working on the goals that remain unfinished.”
With every year that passes, the number of baby boomers needing eldercare increases and the problem becomes more magnified. “We need to be more aggressive now to address these issues and the IoM report should have been a wakeup call.”