This unprecedented “elder boom” will have a profound effect on American society, particularly the field of healthcare. Is the U.S. health system equipped to deal with the demands of an aging population? Although we have adequate physicians and nurses, many of them are not trained to handle the multiple needs of older patients. Today we have about 9,000 geriatricians (physicians who are experts in aging-related issues). Some studies estimate a need for 36,000 geriatricians by 2030.
Many doctors today treat a patient of 75 the same way they would treat a 40-year-old patient. However, although seniors are healthier than ever, physical challenges often increase with age. By age 75, adults often have two to three medical conditions. Diagnosing multiple health problems and knowing how they interact is crucial for effectively treating older patients. Healthcare professionals —often pressed for time in hectic daily practices—must be diligent about asking questions and collecting “evidence” from their elderly patients. Finding out about a patient’s over-the-counter medications or living conditions could reveal an underlying problem.
Lack of training in geriatric issues can result in healthcare providers overlooking illnesses or conditions that may lead to illness. Inadequate nutrition is a common, but often unrecognized, problem among frail seniors. An elderly patient who has difficulty preparing meals at home may become vulnerable to malnutrition or another medical condition. Healthcare providers with training in aging issues may be able to address this problem without the costly solution of admitting a patient to a nursing home.
Depression, a treatable condition that affects nearly five million seniors, also goes undetected by some healthcare providers. Some healthcare professionals view depression as “just part of getting old.” Untreated, this illness can have serious, even fatal consequences. According to the National Institute of Mental Health, older Americans account for a disproportionate share of suicide deaths, making up 18% of suicide deaths in 2000. Healthcare providers could play a vital role in preventing this outcome—several studies have shown that up to 75% of seniors who die by suicide visited a primary care physician within a month of their death.
Healthcare providers face additional challenges to providing high-quality care to the aging population. Because the numbers of ethnic minority elders are growing faster than the aging population as a whole, providers must train to care for a more racially and ethnically diverse population of elderly. Respect and understanding of diverse cultural beliefs is necessary to provide the most effective healthcare to all patients. Providers must also be able to communicate complicated medical conditions or treatments to older patients who may have a visual, hearing, or cognitive impairment.
As older adults make up an increasing proportion of the healthcare caseload, the demand for aging specialists must expand as well. Healthcare providers who work with the elderly must understand and address not only the physical but mental, emotional, and social changes of the aging process. They need to be able to distinguish between “normal” characteristics associated with aging and illness. Most crucially, they should look beyond symptoms and consider ways that will help a senior maintain and improve her quality of life.