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America’s senior population will burgeon over the next 40 years, with those over 85 in the fastest growing bracket.

A ‘tsunami’ is in the forecast for America’s aging population

by Elizabeth Bahm
April 27, 2010

An aging population is set to overload America’s medical resources, experts warn.

“In a word, no, the health care work force is not prepared,” said Eileen Beal, an independent health journalist from Cleveland.

The Association of Health Care Journalists focused on the topic with panels such as “Preparing for the coming tsunami in aging” and “What we can learn from ‘superagers.” Their conference in Chicago ended Sunday. 

“The coming tsunami” panelists, experts from all areas of elder care, explained the collision about to occur between a shortage of professionals and an expanding aging population. Beal moderated the panel.

This rapidly expanding population of aging Americans will put new demands on areas of medicine such as geriatrics and long-term care, yet the numbers of practitioners in these fields are dropping almost as fast as the numbers of their potential patients rise. 

Herbert Sier, associate chief of geriatric medicine at Northwestern Memorial Hospital,  said that the Alliance for Aging Research projects that 14,000 more geriatricians are needed to address the needs of the current aging population. Yet numbers in the field, which currently counts 7,600 practitioners, are falling, down 22 percent in the last 10 years. 

The aging baby boomer population will mean that the numbers of those 65 and older will leap from 39 million today to a projected 89 million by the 2050, said Linnea Windel, a registered nurse and CEO of the Visiting Nurse Association of Fox Valley in Illinois. 

The jump in population will be even greater for those over 85, the fastest growing population, according to Sier. Their numbers will rise from 4 million today to 20 million in 2050.

Meanwhile, the culture of geriatric care may be contributing to the shortage of nurses and doctors entering the field.  Low pay and practice settings that appear unattractive may be driving away students. Sier suggested financial incentives for those pursuing education in the field and changes in culture of medical education.  Valerie Gruss, a clinical assistant professor at the University of Illinois/Chicago School of Nursing, said that culture change could also turn around a similar shortage in nursing homes.

Gruss said that by 2050, 5.7 to 6.5 million nurses, aides and home health workers would be needed to care for the aging population – double the force needed in 2000.  Right now, these fields face high turnover rates, contributing both to costs for facilities and creating a sense of instability for elderly residents. 

Gruss said that a cultural shift to “person-centered care,” which would respect the preferences, needs, and schedules of individual residents, would improve both quality of life for residents and address high turnover rates by empowering staff. 

“When nursing homes were first established, they were designed on the medical model of care, like a hospital,” Gruss said.  “But it's not a hospital setting, for the people that live there, this is their home.  So the medical model doesn’t necessarily fit for their quality of life.”

The good news is that a competing revolution in aging may help preserve the health of seniors, according to Barbara Hawkins, a professor at Indiana University, at the “Superagers” panel. Speakers examined the unique traits of so-called ‘superagers’ – those 85 and older yet who display little decline in physical or mental ability. 

Hawkins looked to the phenomenon of “blue zones,” a name given by researchers to areas where residents experience longer and healthier lifestyles. Hawkins said that in blue zones, ageism was scarce, and older people actively pursued their passions.

“An active lifestyle is one in which meaningful activity is paramount,” Hawkins said, emphasizing the need for purpose instead of just “busyness” in keeping a positive, healthy mental attitude.

In recent research, a group of "superagers" beat average 50 year olds on tests of cognitive function and scans of neuroanatomy. They displayed little evidence of the physical degeneration in the brain associated with age-related mental deterioration, according to Emily Rogalski, an assistant research professor at Northwestern University’s Feinberg School of Medicine.

While this study identified some cognitive traits of superagers, Rogalski reported that researchers had yet to determine what habits predicted that a person would live beyond age 85. Lifestyle varied widely among the research group – some individuals were still working while others had retired, and some followed healthy habits in diet and exercise while others smoked and exercised little. 

“The preliminary data shows there is more than one recipe for becoming a superager,” said Rogalski.

While baby boomers may have a challenge ahead as the health care system struggles to meet their needs, they may prove a powerful force in driving the cultural changes that can enable superaging. Santiago Toledo, medical director at the Rehabilitation Institute of Chicago, said that baby boomers “will change the paradigm of healthcare” by demanding innovative and alternative forms of care.

“ Think quality of life – transforming medicine, transform that life” Toledo said, predicting an increase in psychological well-being as baby boomers seek out care to improve and maintain their physical health.