The Graying of America
In general, Americans are living much longer than their grandparents or great-grandparents. Just a few generations ago, people who reached 50 or 60 were considered to be "old." Today, people are living into their seventies and eighties. And it's not that uncommon to hear reports of people celebrating their 100th birthday and beyond. Although we haven't discovered the "fountain of youth," medical advances and better preventive care will help older folks live long, productive lives.
According to the American Geriatrics Society, more than 34 million Americans - that's roughly 12 percent of our population - are 65 or older. Within the next 50 years, that number is expected to triple. The fastest growing segment of the elderly population is the over-85 group.
Health Care for Seniors
Older Americans often have special healthcare needs. By the time they reach 75, many have two to three chronic medical conditions (such as diabetes, heart disease, lung disease, or arthritis). Mental decline, the need for assistance with daily activities, and financial concerns can also take their toll. Assessing a patient's needs and finding the most appropriate types of treatment and support can be tricky.
To provide better care for seniors, some hospitals have developed Geriatric Evaluation and Management (GEM) programs. Programs like GEM have a team of geriatric specialists to assess the specific needs of each patient. The team usually includes a board-certified geriatrician, nurse or nurse practitioner, social worker, and psychiatrist. During the first visit to the program, patients undergo a comprehensive evaluation of physical, mental, and emotional health. The team also evaluates memory, hearing, vision, balance, and capacity to perform routine daily activities (such as shopping, cooking, grooming, and the ability to maintain finances). A review of medications is important because patients often take several medications, and some drugs may cause side effects, interact with each other, or alter the effectiveness of the medications. Family members of the patients are encouraged to participate in the process. In some cases, a social worker may need to visit the home to determine if there are any safety concerns or other specific needs.
After the initial assessment, the team meets to develop a customized plan for the patient. A course of action may include recommendations for medication and medication compliance (taking the drugs exactly as recommended), counseling, and social or community services. If the patient has a primary care doctor, the team works closely to convey their recommendations to the physician as well.
Nurse clinical coordinators stay in contact with the patient by telephone - often once a week - to make sure patients are following the recommended plan. The social worker ensures patients are getting access to needed community services (such as "Meals on Wheels", home nursing care, or adult day care). Patients also have periodic follow-up visits with the GEM team.
The Graying of America