Medical field adapts to growing elderly population
What, more doctors making house calls?
Someone knowledgeable actually corralling a single patient's multiple doctors?
A psychologist and a social worker ready to help an elderly person socialize?
Welcome to the future of senior health care for baby boomers.
The nation's largest generation — baby boomers, born between 1946 and 1964, with the largest spike nationally in 1957 with 4.3 million births — are expected to inundate health care services in the years to come.
Health care providers are designing new programs and ramping up others for the blitz of senior citizens who prefer to live independently and are staving off personal care homes.
No longer alone
A 103-year-old woman who lives alone in her suburban home just west of Pittsburgh is driven to her weekly beauty salon appointment by a volunteer who also does the centenarian's grocery shopping.
The volunteer companion is courtesy of Highmark's PALS (People Able to Lend Support) program, which offers a free visit by a volunteer to help with ordinary tasks.
Lynette Turoczy of Moon is a volunteer who says that her calls on the elderly give her a purpose while lifting her spirits.
“They're always saying if it wasn't for me they would have to go to a nursing home, and they are dreading that,” she said.
While medical treatment is an obvious necessity with aging, keeping seniors happy and able to function independently is another aspect of maintaining their health, according to Randy Detweiler, PALS program director.
The 20-year-old PALS program continues to grow and boasts a network of nearly 200 volunteers reaching thousands of Highmark Medicare members in 37 counties in Pennsylvania and West Virginia.
“We've proven there is a need, and you can never have too many services for the seniors,” Detweiler said.
“So many things seniors need are tiny things we take for granted, like carrying laundry up the stairs and going to a doctor's appointment,” he said.
Geriatricians look at a “global picture” of a person's health, including prognosis, goals of care, patient preference and transitions of care issues, and much more, according to Dr. Lyn Weinberg, a core faculty member for geriatric education for Allegheny Health Network's Internal Medicine Residency Program.
The AARP has sounded the alarm about the shortage of geriatricians: physicians who assess, diagnose and treat older people.
“It's a critical role becoming increasingly important as America ages,” AARP wrote, noting the country will need more than 23,000 new geriatricians by 2030, according to the American Geriatrics Society.
“There's never going to be enough geriatricians to manage the older population,” Weinberg said.
The next best thing is to train primary care physicians to lead a multidisciplinary medical team for a single patient, and it's not just doctor specialists. It's experts in managing medications from different doctors, social workers, health coaches, dieticians and others.
It gets complicated because patients' needs are complicated.
About 82 percent of older Americans require ongoing care for at least one chronic disease — the most common being hypertension, arthritis and heart disease — according to National Institutes of Health.
Managing the care of a person with multiple health issues can become fragmented, and a geriatrician can balance the medical conditions and medications while working with the family.
Some of the geriatrician training includes “polypharmacy,” which is critically looking at a long medications list and side effects.
Weinberg's favorite adage is: “Every symptom in an older adult is a medication side effect unless proven otherwise.”
A geriatrician also helps with social issues, the caregiver burden and community resources.