Geriatrics Workforce Shortage: A Looming Crisis for Our Families
 |
This year, the first Baby Boomers will turn 65 years old. By 2029, all Boomers will be at least 65. This group, totaling an estimated 70 million people will have a significant impact on the U.S. health care system. The combination of the aging of the Baby Boom population, an increase in life expectancy, and a decrease in the relative number of younger persons, will mean that older adults make up a much larger percentage of the U.S. population than ever before.
The Institute of Medicine’s (IOM) landmark report, Retooling for an Aging America: Building the Health Care Workforce, states “unless action is taken immediately, the health care workforce will lack the capacity (in both size and ability) to meet the needs of older patients in the future.
The current health care workforce overall is not large enough to meet older patients’ needs. The scarcity of workers specializing in the care of older adults – the eldercare workforce - is even more pronounced. It is estimated that by 2030, 3.5 million additional health care professionals and direct-care workers will be needed. [i]
Today’s Older Adults
High-quality care for older adults, many of whom have multiple complex chronic conditions, requires a diverse range of skills for addressing their physical, mental, cognitive and behavioral needs. Today’s older adults receive a high-volume of health care services in many settings.
- Within twenty years, one in five Americans will be over 65 and an estimated 90 percent of those Americans will have one or more chronic condition.[1]
- By 2050 the number of Americans over 85, who make up the highest rates of chronic illness, poverty, and need for assistance with activities of daily living, will quadruple to 19 million.[2]
- Adults over 65 account for nearly 26 percent of all physician visits, 47 percent of all hospital stays, 34 percent of all prescriptions, 34 percent of all physical therapy patients, and 90 percent of all nursing home stays.[3]
- 7.7 million people will have Alzheimer’s disease in 2030, up from 4.9 million in 2007.[4]
CHALLENGES:
Workforce Shortfall
The current health care system is already overwhelmed by demands for geriatric care. Those specializing in the care of older adults cannot meet the current demand let alone the projected needs for eldercare.
- More than one million additional direct-care workers will be needed by 2018, according to the latest employment projections.[5]
- There are only 7,029 certified geriatricians practicing in the U.S. -- roughly half the number currently needed, and falling.[6]
- Within 10 years, nearly 70,000 geriatric social workers will be needed, yet today less than 5 percent of social workers are specifically trained in gerontological social work.[7]
- By 2020, the nursing workforce is expected to drop 20 percent below projected requirements.[8]
- In 2010, physical therapists and physical therapist assistants had demonstrated vacancy rates of 18.6% and 16.6%, respectively, in skilled nursing facility settings across the U.S. [ii]
- Only 3 percent of practicing psychologists devote the majority of their practice to older adults and the current median age of practicing psychologists is 55.[9]
- In 2001, there were about 2,600 geriatric psychiatrists. In 2005, that number was reduced to 2,100, less than half of the 5,000 that are needed to provide adequate care for the current population of older adults.[10]
Addressing Family Caregivers’ Needs
Family caregivers are the backbone of long-term care in this country. Family caregivers can face physical, emotional, mental, and financial challenges in their caregiving role. Without an investment in the eldercare workforce, even more stress will be placed on family and other informal caregivers. Due to smaller family sizes, the divorce rate, and geographic relocation – the next generation of older adults may be less able to rely on their families for caregiving.
- Seven in ten employed caregivers report making changes such as cutting back on their working hours, changing jobs, stopping work entirely, taking a leave of absence, or other such changes as a result of their caregiving role.[11]
- 43.5 million unpaid caregivers provide care to a person 50 or older annually.[12]
- The estimated economic value of all family caregivers’ unpaid care was approximately $375 billion in 2007 – a $25 billion increase over 2006.[13]
RECOMMENDATIONS:
Investing in Our Parents and Grandparents
The Eldercare Workforce Alliance (EWA) calls for a focus on recruitment, training, retention, and compensation of health care providers serving older adults, as well as reimbursement to support participation in interdisciplinary teams, as recommended by the IOM report.
The development of new models of care - that cut across physical and mental health, long-term care, social services, and community-based settings and demonstrate person- and family-centered care and interdisciplinary team practice - is essential to meet the needs of older Americans both today and in the future.
PDF document of Issue Brief
[1] Chronic Conditions: Making the Case for Ongoing Care, February 2010. Robert Wood Johnson Foundation, www.rwjf.org/files/research/50968chronic.care.chartbook.ppt
[2] Alzheimer’s Disease Facts and Figures, http://www.alz.org/documents_custom/report_alzfactsfigures2010.pdf
[3] IOM report Retooling for an Aging America: Building the Health Care Workforce
[4] Alzheimer’s Association. Alzheimer’s Disease Facts and Figures 2007 http://www.alz.org/national/documents/Report_2007FactsAndFigures.pdf
[5] PHI Fact Sheet: Who are Direct-Care Workers? http://www.directcareclearinghouse.org/download/NCDCW%20Fact%20Sheet-1.pdf
[6] AGS “Projected Future Need for Geriatricians” http://www.americangeriatrics.org/files/documents/Adv_Resources/GeriShortageProjected2009.pdf
[7] CSWE, “Why Recruit Students to Gerontological Social Work” http://www.cswe.org/File.aspx?id=31797
[8] ANA, http://www.nursingworld.org/nursingshortage
[9] American Psychological Association, www.apa.org/pi/aging
[10] AAGP, http://www.aagpgpa.org/advocacy/agenda.asp
[11] Caregiving in the US 2009 report http://www.caregiving.org/data/Caregiving_in_the_US_2009_full_report.pdf
[12] Caregiving in the US 2009 report http://www.caregiving.org/data/Caregiving_in_the_US_2009_full_report.pdf
[13] AARP http://assets.aarp.org/rgcenter/il/i13_caregiving.pdf
[i] IOM report Retooling for an Aging America: Building the Health Care Workforce
[ii] American Physical Therapy Association Research Department. From: 2010 Practice Profile Survey. Alexandria, VA: American Physical Therapy Association; 2011. Unpublished data.
GRAPH from http://www.newgeography.com/content/00266-number-people-age-65-and-older-united-states-2000-2050
