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Federal Committee Says Health Care Work Force Too Small, Unprepared For Aging Baby Boomers
Posted: 04-15-2008 : RESEARCH TRIANGLE PARK, N.C.
RESEARCH TRIANGLE PARK, N.C. -- As the first of the nation's 78 million baby boomers begin turning 65 in 2011, they will face a health care work force that is too small and woefully unprepared to meet their specific health needs, according to a new report from the Institute of Medicine.
The report, Retooling for an Aging America: Building the Health Care Workforce, calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. Medicare, Medicaid, and other health plans should pay higher rates to boost recruitment and retention of geriatric specialists and care aides, said the committee that wrote the report.
The committee set a target date of 2030 — the year by which all baby boomers will have turned 65 or older — for the necessary reforms to take place.
"The problem is more than our large aging population," said Joshua Wiener, Ph.D., a senior fellow at RTI International and a committee member. "It is that the working age population is not growing as quickly as it has in the past. This will have profound implications, both for the availability of health workers and for the ability of society to fund programs like Medicare and Social Security."
According to the report, there is a severe shortage of workers in geriatric health care. Geriatrics attracts fewer specialists than other disciplines and experiences high turnover rates among direct-care workers — nurse aides, home health aides, and personal care aides. For example, there are only slightly more than 7,100 physicians certified in geriatrics in the United States today — one per every 2,500 older Americans. Turnover among nurse aides averages 71 percent annually, and up to 90 percent of home health aides leave their jobs within the first two years.
Virtually all health care providers treat older patients to some extent during their careers — and likely will do so even more frequently given that one in five Americans will be 65 or older by 2030 — so the committee suggests that they need a minimal level of competence in geriatric care.
To achieve that, the committee recommends that health care workers be required to demonstrate competence in basic geriatric care to maintain their licenses and certifications, and that all health professional schools and health care training programs expand coursework and training in the treatment of older individuals.
The committee also suggests that Medicare, Medicaid, and other health plans pay more for the services of geriatric specialists and direct-care workers to attract more health professionals to geriatric careers and to stanch turnover among care aides, many of whom earn wages below the poverty level.
Informal care givers also play a significant role in caring for the elderly. Between 29 million and 52 million family members, friends, and others tend to aging parents or other older individuals. More than 90 percent of older adults who receive care at home rely in part on informal caregivers and nearly 80 percent rely solely on family or friends. However, little is done to ensure informal caregivers have the necessary knowledge and skills.
The report calls for health care facilities, community organizations, and other public and private groups to offer training programs to help those informal caregivers provide proper assistance to their loved ones.
The study was sponsored by the John A. Hartford Foundation, Atlantic Philanthropies, Josiah Macy Jr. Foundation, Robert Wood Johnson Foundation, Retirement Research Foundation, California Endowment, Archstone Foundation, AARP, Fan Fox and Leslie R. Samuels Foundation, and Commonwealth Fund.
Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies.
Copies of Retooling for an Aging America: Building the Health Care Workforce are available from the National Academies Press; tel. 202-334-3313 or 1-800-624-6242 or on the Internet at http://www.nap.edu. Additional information on the report can be found at http://www.iom.edu/agingAmerica. A podcast of the public briefing held to release this report is available at http://national-academies.org/podcast.
RTI News Media Contacts
Email: news@rti.org
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About RTI International
RTI International is one of the world's leading research institutes, dedicated to improving the human condition by turning knowledge into practice. With projects in more than 40 countries and a staff of more than 2,600, RTI offers innovative research and technical solutions to governments and businesses worldwide in the areas of health and pharmaceuticals, education and training, surveys and statistics, advanced technology, democratic governance, economic and social development, energy, and the environment. For more information, visit www.rti.org.
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