Meeting the Healthcare Needs of an Aging Population
Last Updated May 28, 2019
The number of Americans age 65 and older is projected to more than double by 2060, with those over 65 projected to outnumber children age 18 and under by 2035, according to a U.S. Census report.
This “graying” of America has spurred healthcare organizations to re-think their requirements and approaches to long-term care and healthcare in general, as caring for the elderly will soon take up a bigger portion of healthcare than caring for the health needs of the young. To effectively meet this “silver tsunami,” future healthcare leaders need to be innovative, creative and open in how they treat this aging population.
Rethinking Aging
Baby Boomers were the rock and roll youth generation of the 1960s, refusing to conform and famously warning “don’t trust anybody over 30.” Baby Boomers are now well past 30 and unwilling to settle for the type of senior communities and assisted living homes their parents retired into. Instead, this generation is taking a new approach to the twilight of life, one with an emphasis on overall community living.
Replacing what AARP deems “isolated” apartments or “grim” nursing homes, senior living facilities are moving toward community-style experiences, offering any array of housing options and cultivating social and age-integrated communities. The goal: to make these “facilities” more like a neighborhood that is part of the greater community, instead of isolated entirely from it.
The NewBridge on the Charles, a continuing-care retirement community outside of Boston, features Craftsman-inspired cottages, public art, and a sleek café. Within the community, residents can occupy units for independent or assisted living, as well as access rehab or general healthcare services. Residents are active participants in the community beyond NewBridge, volunteering at a nearby elementary school. Similarly, St. John’s on the Lake is a self-contained continuing-care retirement community in a modern high-rise in Milwaukee. The facility offers a range of living options and healthcare services while connecting residents to the cultural and social options of an active urban neighborhood.
While this integrated community approach is gaining traction, truly accessible housing and continuing-care communities are still rare, with just 1% of all housing stock in the U.S. containing accessible design features for aging residents, according to a report by the AARP Foundation and Harvard University’s Joint Center of Housing Studies. One key challenge stems from younger designers simply not understanding what it is like to navigate an environment as an older person.
With this mind, some design schools and gerontology programs are forming unique partnerships with the goal of providing students with a better understanding of the physical and cognitive challenges an aging resident may face and encouraging practical design when creating environments for older people. Within Michigan State’s MS in Healthcare Management program, an emphasis on “Hospitality and the Patient Experience” equips healthcare leaders to put service quality management and patient well-being in all life stages at the forefront of care decisions.
Applying Technology Innovations
Although they may not be as tech-savvy as their children, aging Baby Boomers are typically tech knowledgeable, and as a result, expect both tech convenience and innovation in their care.
In some cases, cutting-edge technologies like artificial intelligence (AI) or Machine Learning (ML) have shown early evidence of improving outcomes for chronic conditions like diabetes, heart disease, cancer, neurological, or infectious disease, according to Healthcare IT News. Consumer technology like fitness trackers, smartphone apps, and telehealth and remote monitoring options have already unlocked better insights for healthcare providers and improved care experiences for senior patients and their caregivers.
In a collaboration between Senior Whole Health of Massachusetts and Best Buy subsidiary GreatCall, a provider of smartphones and tech geared towards seniors, a “Care Team” is able to monitor and support senior patients through GreatCall’s Lively Home monitoring system. The system is installed by Best Buy’s Geek Squad and uses sensors to monitor daily activities—food intake, sleep patterns, physical activity, mobility—and apply predictive analytics to identify behavior trends and flag anomalies. One pilot study indicates that utilizing this kind of “passive monitoring” for proactive intervention can help reduce healthcare costs by reducing the rate of unnecessary hospitalizations, while also helping seniors remain independent longer.
And when full independence is no longer an option, technology applications are expanding the reach of traditional homecare and hospice programs. Intermountain at Home from Salt Lake City’s Intermountain Healthcare integrates remote monitoring and access to round-the-clock virtual urgent care and doctor appointments via telemedicine with homecare visits to bridge shortages in palliative care. Based on current doctor-to-patient ratios, the projected shortage in hospice and palliative medicine specialists could range from 10,640 to almost 24,000 by 2040, according to a report published in the Journal of Pain and Symptom Management.
With this potential for greater care coverage and cost savings, as well patient demand, Medicare Advantage plans will begin including telemedicine within the standard benefits package starting in 2020, expanding access to telehealth services so patients can connect with their doctors by phone or video chat, regardless of where they live, according to the Centers for Medicare and Medicaid Services.
Considering the Costs of Care
While living healthier and longer is certainly everyone’s goal, longer lifespans coupled with increased costs of living have skyrocketed end-of-life care, straining government services and individual finances alike.
While “nursing homes” may be evolving into “continuing-care communities,” the cost is evolving as well. With research from Genworth Financial, a 2018 Washington Post report put the annual median cost to reside in a private nursing home room at $100,375, with the cost of at-home health aide service averaging $50,336 a year. For many seniors and their families, the costs of long-term care are simply impossible to take on.
That leaves taxpayer funded programs and government services to absorb the cost of long-term care—with strings attached. Medicaid covers long-term care needs, but typically only for seniors with limited financial resources and only for certain types of care facilities. “With Medicaid, you don’t get to choose where to live, and assisted living is not an option,” explains investment advisor Melanie Halstenberg in an interview with U.S News & World Report. For many aging Baby Boomers, a continuing-care community won’t be a viable option—traditional nursing homes that accept a limited number of Medicaid patients may be their only option.
As the adage goes, prevention is the best medicine, and many healthcare organizations are getting proactive with preventive services to improve patient health outcomes, extend the ability of seniors to live independently and cut down on costly repeat hospital stays and long-term care. Landmark Health, a provider of in-home health focuses specifically on chronically ill and elderly patients to leverage shared-savings risk arrangements in health plans, benefiting all healthcare stakeholders – insurers achieve incentives, Landmark provides quality care, and patients stay out of costlier care settings.
As the “silver tsunami” continues to surge into the healthcare system, leaders will need to be forward thinking to meet patient needs and expectations, embrace new innovations and partnerships that can bridge personnel and skills gaps and lower staggering long-term care costs. Leaders who understand both the business and patient side of healthcare management can help cultivate the creative solutions that can raise the quality and effectiveness of care for aging Baby Boomers and generations to come.
