With support from a number of private organizations, the IOM examined what this explosion of older people will mean for the nation and how it can prepare to meet the challenges certain to arise. Retooling for an Aging America: Building the Health Care Workforce (2008) finds that the current workforce is too small and woefully unprepared to provide an adequate level of high-quality care to this growing population group, and it calls for a series of bold initiatives—starting immediately.
Among the initiatives, a national effort is needed to train all health care providers in the basics of geriatric care. Such training may be undertaken in health professional schools and health care training programs or through other means. A national push also is needed to better prepare family members and other informal caregivers to tend to older people, as well as to prepare these individuals to take more active roles in their own care. To foster such efforts, Medicare, Medicaid, and other health plans should pay more for the services of geriatric specialists and direct-care workers to attract more health professionals and to staunch turnover among care aides, many of whom earn wages below the poverty level.
Governments at all levels, along with a spectrum of health care organizations, need to do more to disseminate innovative models of care delivery that have proved efficient and cost effective for older adults. Diffusion of such models has been minimal, often because current financing systems do not provide payment for features such as patient education, care coordination, and interdisciplinary care. Because no single model of care will be sufficient to meet the needs of all older adults, Congress and public and private foundations should significantly increase support for research and programs that promote the development of additional innovative care models, especially in areas where effective delivery models are lacking, such as in preventive and palliative care.
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Nov 3 20256 mins