Graying of America: How the elder boom could impact health care

Would you want to live to be 100? Whenever Thomas A. Cavalieri, DO, poses this question to senior citizen groups, usually only a few people raise their hands, but nearly every hand goes up when he changes the question to living to be 100 while maintaining a good quality of life.

“Advances in medicine mean this goal is becoming increasingly achievable for many Americans,” says Dr. Cavalieri, a geriatrician and dean of the Rowan University School of Osteopathic Medicine (RowanSOM) in Stratford, New Jersey. “At the same time, with the projected growth of the elderly population, we’re going to need more physicians with specialized training to care for seniors.”

U.S. Census projections indicate that by 2050, the population of adults age 65 and older will nearly double to almost 83 million, up from about 43 million in 2012.

Dr. Cavalieri and geriatrician James Lin, DO, say the elder boom will likely lead to increases in in-home care and preventive health care and create a much greater demand for physicians trained to care for the elderly.

Expanding training

The geriatric workforce already has a shortage of doctors, nurses and caregivers. Carrying a heavy debt burden upon graduation often prompts new physicians to pursue careers in more lucrative specialties.

But all physicians, not just those who specialize in geriatrics, will need to have some training on handling the unique challenges of treating older patients, Dr. Cavalieri says, noting that there currently is not enough adequate training to prepare primary care physicians to treat the elderly. Specialists, too, need extra training, Dr. Lin says.

“Psychiatrists need to undergo special training for treating dementia patients,” says Dr. Lin, who is also the director of the Lake Erie College of Osteopathic Medicine Institute for Successful Aging in Erie, Pennsylvania. “All physicians will be called upon to promote successful aging by partnering with their patients to maintain their health and prevent disease.”

Treatment at home

Dr. Cavalieri envisions care shifting from the hospital to the patient’s home with a team of geriatricians, nurses and other health care professionals visiting the home to provide care. RowanSOM already integrates home care into its curriculum on geriatric care.

“There is already a shift toward in-home care and hospitals dedicating resources to avoid readmissions. These measures include a home safety evaluation and nurse visits to identify any red flags in recovery that could lead to readmission,” Dr. Lin says.

Greater emphasis on disease prevention

At the heart of all this is the need for high-quality primary care focused on disease prevention that could lead to a population that is not only older but also healthier. DOs’ unique training means they’re particularly well-suited to care for elderly patients, Dr. Cavalieri says.

“The osteopathic medical profession’s focus on primary care and holistic approach to care puts DOs in the ideal position to enable elderly patients to live longer and better lives,” Dr. Cavalieri says. “If patients stay physically and mentally active as preventive measures, they can often remain independent into their eighth and ninth decades of life and avoid or delay hospitalization and nursing home placement.”