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Pages 1-14

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From page 1...
... Indeed, the education and training of the entire health care workforce with respect to the range of needs of older adults remains woefully inadequate. Recruitment and retention of all types of health care workers is a significant problem, especially in long-term care settings.
From page 2...
... The committee focused on a target date of 2030 -- by which time all baby boomers will have reached age 65 -- because it allows enough time to achieve significant goals, yet it is not so far in the future that projections become highly uncertain or advances in health care treatment or technologies change the medical landscape too greatly. Although the target year of 2030 may not seem to imply a sense of urgency, the contrary is true, as the preparation of a competent health care workforce and widespread diffusion of effective models of care will require many years of effort.
From page 3...
... Although older adults make up only about 12 percent of the U.S. population, they account for approximately 26 percent of all physician office visits, 47 percent of all hospital outpatient visits with nurse practitioners, 35 percent of all hospital stays, 34 percent of all prescriptions, 38 percent of all emergency medical service responses, and
From page 4...
... While a full consideration of likely health expenditures is beyond the scope of the committee's charge, committee members were mindful of financial realities during the course of their deliberations. Whether or not the current patterns of health status and utilization continue, one prediction is certain: the future elderly population will have a greater collective need for health care services than those who have come before it.
From page 5...
... The Bureau of Labor Statistics predicts that personal- and home-care aides and home health aides will represent the second- and third-fastest growing occupations between 2006 and 2016, which will exacerbate current shortages. As of 2007, there were 7,128 physicians certified in geriatric medicine and 1,596 certified in geriatric psychiatry.
From page 6...
... Professionals For professionals, one notable way in which training is inadequate is the lack of exposure to settings of care outside of the hospital. Since 1987 hospitals have been allowed to count the time that residents spend in settings outside the hospital for graduate medical education funding purposes, but many residents still do not spend significant amounts of time in these alternative settings.
From page 7...
... States should also establish minimum training requirements for personal-care aides. Recommendation 6-2:  Public, private, and community organizations should provide funding and ensure that adequate training opportunities are available in the community for informal caregivers.
From page 8...
... technologies and health information technologies, including remote technologies, that increase the efficiency and safety of care and caregiving. Recommendation 4-1:  Hospitals should encourage the training of resi dents in all settings where older adults receive care, including nursing homes, assisted-living facilities, and patients' homes.
From page 9...
... Informal Caregivers Informal caregivers -- most often family members and friends of the patient -- play an enormous role in the care of older adults, and there is growing awareness of the benefits of providing them with better training and improving their integration with the formal health care team. Informal caregivers often feel insufficiently prepared to assist with home-based technologies, medically oriented treatments, or even basic tasks such as lifting and feeding.
From page 10...
... For example, in spite of their extra training, junior faculty in geriatric medicine have lower compensation than junior faculty in family medicine or internal medicine. The Geriatric Academic Career Awards (GACAs)
From page 11...
... Overall, the successful recruitment and retention of direct-care workers depends on a significant culture change to increase the quality of these jobs through improvements in the job environment and adequate financial compensation for their current and expanding roles. Recommendation 5-2:  State Medicaid programs should increase pay and fringe benefits for direct-care workers through such measures as wage pass-throughs, setting wage floors, establishing minimum per centages of service rates directed to direct-care labor costs, and other means.
From page 12...
... ; and the streamlining of administrative and regulatory requirements. Payers need to also eliminate existing impediments to the use of innovative models by older patients, such as Medicare's copayment disparity for mental health services.
From page 13...
... For example, many successful models require providers of different disciplines to work collaboratively in interdisciplinary teams, but reimbursement for team care is currently lacking, and many providers are not trained to work effectively in teams. Also, several successful models of care require members of the health care team, including patients and their families, to take on new roles and assume greater levels of responsibility.
From page 14...
... This includes the use of ADL technologies and health information technologies, including remote technologies, that increase the efficiency and safety of care and caregiving. CONCLUSION The United States today faces enormous challenges as the baby boom generation nears retirement age.


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