Preparing for a Public Health Need: The Aging of America

Every day, nearly 6000 Americans are celebrating their65th birthday. In 2012, that number will haveincreased by 40%, and more than 10,000 people a daywill turn 65.

Those figures only will continue to climb, as the baby-boomergeneration grows older, bringing more than 80 millionAmericans into retirement age. There has been a lot oftalk in recent years about what industries are doing inresponse to this unprecedented demographic trend. Manyin the private sector are clamoring to capture the consumermarket share of adults 65 and older.

In contrast, on the public health side, the nation seemsunprepared to meet this new challenge. Despite decades ofwarnings from policy makers, physicians, and advocates,there is still an acute shortage of geriatricians and healthprofessionals with geriatric training in the United States.

Historically, geriatric care has been an unpopular area ofspecialization for several reasons. The complexity of care forolder patients, poor Medicare reimbursement for services,and a general lack of interest in treating older patientsapproaching the end of their lives are a few of those reasons.To meet the needs of the aging population, it is imperativethat physicians, pharmacists, nurses, and others have thebest in geriatric medical training and certification.

Sears Methodist Retirement System, which currently hasmore than 830 assisted living, nursing care, and Alzheimer'sdisease care beds throughout west and central Texas, hasaddressed this issue with its internal pharmacy program. Theprogram allows our pharmacists to receive ongoing geriatricpharmacy training and tuition assistance so that they canbetter meet the pharmaceutical needs of our residents.

This program is 1 small way of addressing the fact thatTexas has a shortage of health care professionals with geriatrictraining. For example, Sears Methodist employs 2 outof a total of only 31 certified geriatric pharmacists in theentire state. I received my certification from the Commissionfor Certification in Geriatric Pharmacy (CCGP) in 2000,and my colleague at the facility in Amarillo, Beth Bagwell,PharmD, completed hers in 2001. The CCGP is the only certificationin the nation that recognizes the clinical expertiseof senior care pharmacists.

Why is this certification important? According to theAlliance for Aging Research, many older adults are using 12prescription drugs or more at any given time. Changes withaging can alter how the body absorbs, distributes, metabolizes,and clears these drugs from the body. In addition,symptoms of illness or adverse drug reactions in older adultscan be different and more difficult to recognize than thosein the young or middle-aged. It has been said that any newsymptom in a geriatric patient should first be considered apossible drug side effect until proven otherwise.

At Sears Methodist Center, when a new resident comes tolive with us, we begin by reviewing all of his or her medicalrecords and current and past prescriptions. In many cases,we are able to make immediate adjustments in dosages oreven eliminate some medications. We have seen an instantimprovement in the health of some residents just by makingminor adjustments to their prescriptions.

It is important to raise the level of awareness concerningthe shortage of geriatric training among the nation's healthcare providers. Providers and educators must recruit morehealth care students into the field of geriatrics. SearsMethodist recently established a Certified Nurse's Aid scholarshipto interest young students. Like our pharmacy program,this scholarship provides them with opportunities forcontinuing education programs, additional professionaldegrees, and certifications.

It is a truly rewarding field—one that leaves me feelingthat I have made a difference at the end of every day. Iencourage others who are currently in the field and thosejust entering the education phase to aspire to meet the needthat America has for qualified geriatricians.

Dr. Knight is vice president for pharmacy services at Sears Methodist Retirement System, based in Abilene, Tex