BOZEMAN -- In 2014, 46 million people age 65 and over lived in the United States. By 2030, that number is expected to reach 74 million.
Those figures, released in a 2016 report from the National Institute on Aging, are particularly sobering because the number of geriatric care professionals entering the workforce annually isn’t keeping pace with the number of men and women who each year fall into the “frail elder” population, said Peter Buerhaus, director of the Montana State University Center for Interdisciplinary Health Workforce Studies and a professor in the MSU College of Nursing.
To address this impending crisis, Buerhaus is collaborating with colleagues at Harvard Medical School and Massachusetts General Hospital to bring together 30 of the country’s top leaders in nursing, medicine and social work who will meet from July 19-21 at MSU to discuss ways to better care for frail elders -- the most vulnerable members of the country’s aging population.
“Frail elders, or the frail elderly, are people over 65 who generally have multiple health problems including chronic health conditions and/or impaired cognition or mental status and who need help with activities of daily living such as dressing, eating, walking or toileting,” said Karen Donelan, senior scientist in health policy at the Mongan Institute Health Policy Center and an associate professor of medicine at Harvard Medical School. Donelan is principal investigator of a Gordon and Betty Moore Foundation grant that is funding the meeting.
As a result of their age or health, Donelan said, frail elders may be weak, easily tired, lose weight unintentionally and may be at risk of falls, more frequent hospitalizations or infections.
“We’ll be carefully examining how many people in the country are considered ‘frail elders,’” Buerhaus said. “What are their expectations? What are the types of health conditions they have? Where do they live and where are they going to live as they age? It will be a full-scale assessment of this growing population – what do we know about them; what do we need to know about frail elders?”
The aim is to strengthen the capacity and the capability of the health care workforce -- specifically nurses, physicians and social workers -- to care of the frail elderly in the U.S., said Buerhaus, whose primary research includes forecasting nurse and physician supply.
Much needs to happen within each of those disciplines, but also across disciplines to provide better team care for the surging number of elderly people in the population, many of whom are living at home longer, Buerhaus said.
“We’re out of sync with our workforce, our health care systems and with the needs of this population,” Buerhaus said. “Our current system is built more around hospital care, but yet this is a group that wants to stay independent and live at home as long as possible.”
One part of Donelan’s project, “Aging Patients and Health Professionals: New Roles in a Changing Health System,” involves site visits and surveys to observe how the roles of patients, caregivers and health professionals change in different settings or models of care for frail elders in the community.
“We are looking at health care organizations for frail elders who live at home and in assisted living,” Donelan said. “These sites may be led by physicians, nurses or social workers. We try to understand who works in the organizations and how they work together to provide care to people at home, in health care primary care practices, or in special programs for elderly patients only.”
During the conference, participants will carefully examine national data and historical trends in the number of physicians, nurses and social workers and ways they can be educated more closely together, rather than in “silos,” Buerhaus said. They will also consider informal caregivers – family members or others who care for the frail elderly but are not professionals.
“We’re also going to look at some breakthroughs around the geriatric workforce,” Buerhaus said. “Nursing, medicine and social work have not done a good job building up the numbers of people that we need with special geriatric skill. So, we’ve got to look at some of these trends and figure out what we have to do going forward.”
There will also be a panel of Montana providers, including an MSU nursing graduate who works on a reservation, a physician and a rural clinic administrator, who will talk about the challenges and realities they face working with the frail elderly in rural environments.
Last year, Buerhaus organized a successful conference at MSU that brought together 20 national leaders who forecast nursing supply and demand. One outcome of that conference resulted in more accurate nursing workforce models.
“The models were all over the place and educators and policymakers didn’t know what to believe because some showed a shortage and others showed a surplus,” Buerhaus said. “We got the federal government and our team to go through every detail of our models, so in the end we’ll be together on this.”
Buerhaus said organizers are hopeful this conference will be similarly successful and influence top policy leaders, especially with ongoing health care reform.
Donelan attended last year’s nursing supply-and-demand conference and said it was the reason she selected MSU as the location for the elder care meeting.
“We could have held this conference anywhere in the nation,” Donelan said. “Having worked with Dr. Buerhaus’ workforce centers for many years, and having attended the meeting he sponsored last summer, I knew MSU and Bozeman would be the perfect venue for hard work and thoughtful discourse.
“National experts from all disciplines are excited about this meeting, this location and this agenda,” she said. “We feel fortunate to be meeting in such a beautiful place.”
Ultimately, Buerhaus said, the goal is for these leaders in the field to reach a consensus about the big issues facing the frail elder population and what states, legislators, technology, private caregivers and the programs that educate doctors, nurses and social workers can do to close the gaps in their care.
If all goes well, he said, MSU’s health workforce center will produce webinars that will be made available nationally so others can learn what was discussed, what gaps were identified and what needs to be done going forward.
“Sooner or later, this issue is going to involve everyone – ourselves, our parents, our relatives – and I think we can do a lot better for this population,” Buerhaus said. “It’s really a devotion to improving the care of people who are very vulnerable and frail, and yet with a better health care delivery system and a better health care team, we could improve their quality of life considerably.”
Peter Buerhaus, firstname.lastname@example.org or (406) 994-2681