Our future eldercare world -- too many of us, not enough trained workers. One might want to argue with whether the current ratio is adequate, but as presented in the most recent journal of the American Society on Aging (ASA), Generations, it seems that an additional 3.5 million workers will be needed by 2030 just to maintain the current ratio of healthcare workers to an aging population -- across all aspects of care delivery. How likely are these workers to be there? A long list of negatives (stats and cited studies are from this journal) imperil the possibility -- here are just a few of them:
Young people, more interested in pediatrics than geriatrics. According to one 2007 study, the image of 'caring for the elderly' is viewed as a poor career choice; in another study, 87% of high school students considering nursing are interested in pediatrics versus nearly half of those surveyed reporting no interest in a geriatric specialty. It gets worse: in 2008, only 1.9 percent of advanced practice nurses were certified in gerontological nursing; there are 3.7 geriatricians per 10,000 adults aged 75 and older; graduate training programs for geriatric medicine remain 44% unfilled -- which is not so surprising, because the specialty has the lowest median salary among medical specialties; long-term-care RNs apparently earn $10K per year less than acute care nurses.
Direct care workforce issues are numerous. Clearly, the trend is towards aging in place at home versus in long-term care settings, confirmed in ASA predictions about the direct care worker population. By 2018, home- and community-based direct care workers will outnumber facility-based workers by nearly two to one, and a third of those will be women aged 55 and older. But these are not good jobs -- in 2009, due to the primarily part-time nature of the workforce, the median hourly wage was $10.58, annual earnings were $16,800 and -- understandably -- 46% of all direct-care workers also rely on public benefits.
Tech can help optimize care coordination, telehealth monitoring and more. As with all problem-filled social and work-related issues, these represent opportunities for innovation and change in how work is done and whether some carefully applied technologies can be useful. If you're not an ASA member, please read the report anyway -- it's only $18 -- I recommend it for all would-be tech entrepreneurs who want to reach the companion care, home health care, geriatric care, senior housing/independent living, or any of the other health-related entities that are needed to serve an aging population. The stats alone are compelling enough to rationalize and enourage the use of examples:
a) Care coordination software that enables tracking of the multiple providers who serve this population
b) Remote monitoring and telehealth technology with easy-to-configure alerts and exception management
c) Online training programs to grow expertise for those trained outside the elder-related specialties
d) Medication management packaging innovations and streamlined technology integration with pharmacies
e) Lifting assist technologies that can translate from the acute care and skilled nursing world to homecare
Overcome barriers by finding cross-generational champions. Now is the time to invite young people into the field of eldercare (worker, management, or technology) -- otherwise we will be reading this same or more dire report in 5-10 years. Young champions in any of the disciplines will need to be enticed with incentives and mentors. Ask yourself -- how many professionals go out into high schools and talk to students about why geriatric nursing specialties might be as personally fulfilling as pediatrics? How about a few organizations -- like Philips, for example, creating videos for high school students about the industry that has formed to serve older adults? How about mentor programs that are commissioned by AARP and rolled out to the states about why YOU should care about elder care? How about a championship team of entrepreneurs, caregiving professionals and community services organizations brainstorming about what can and should be done to make elder care matter more in our society? How about that brainstorming occur at the annual Aging in America meeting in San Francisco?