From: Reuters
Published April 14, 2008 01:52 PM

Expert panel urges improvements in elderly care

By Will Dunham

WASHINGTON (Reuters) - The U.S. health care workforce is drastically unprepared for the coming surge in the number of elderly people, and urgent steps are needed to ensure they get the care they will need, experts said on Monday.

An Institute of Medicine report recommended a series of steps to bolster the number and training of health care workers who care for the elderly amid concern they will be swamped as the 78 million baby boomers begin hitting age 65 in 2011.

"The impending crisis, which has been foreseen for decades, is now upon us," an institute panel headed by John Rowe, a professor of health policy and management at Columbia University in New York, wrote in the report.

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The committee called on the federal government to require more training for direct-care workers -- nurse's aides, home health aides and personal care aides who do a lot of the hard work in caring for older people.

It urged the Medicare health program for the elderly to raise reimbursement rates for services by geriatric specialists to attract and keep people in geriatric specialties.

And the panel said medical schools and health care training programs should expand course work and training in treating the elderly. It recommended that hospitals embrace training of residents in all settings where the elderly receive care, including nursing homes and assisted-living facilities.

The nonprofit, independent institute provides advice to U.S. policymakers.

Rowe said older people use a disproportionate amount of health care services. Twelve percent of the U.S. population is over age 65, using 26 percent of doctor visits, 35 percent of hospital stays and 34 percent of medicines.

"When they are 20 percent of our population in 2030, they will dominate the health care system," Rowe said.

Doctors who specialize in geriatrics get paid less than other doctors, with the number of certified geriatricians actually dropping in recent years, down to about 7,100 nationwide. Few nurses are trained specifically in geriatrics.

The report detailed higher turnover rates among direct-care workers. For example, up to 90 percent of home health aides -- who help elderly people with ordinary health needs at home -- leave their jobs in the first two years.

The panel urged that the federally required minimum number of hours of training for direct-care workers be raised from 75 to at least 120.

"Health care professionals like nurse's aides and home health aides -- in California and other states -- have lower requirements for training than dog groomers and crossing guards," Rowe said.

States should allocate funds to be added to Medicaid payments that cover many services provided by direct-care workers, according to the committee.

"Recruitment and retention is especially dire among direct-care workers. They receive low wages and few benefits, they have high physical and emotional demands placed on them, and they are at significant risk for on-the-job injuries," according to the report.

(Editing by Maggie Fox and David Wiessler)

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