Health Policy Term Paper

1. To: Sen. Susan Collins [R-ME], Chair of Senate Special Committee on Aging
From: Marisa McCarty
Date: December 15, 2018
RE: Shortage in healthcare professionals trained in geriatric care
Problem Statement: What strategies can the United States to increase the number of students
who attend medical school and graduate programs specialized in geriatric care to meet the needs
of a rapidly growing older population?
Background: The United States will face a major healthcare provider crisis in the coming years
with an expanding demand for geriatric care professionals and a proportionally dismal supply.
The American Geriatrics Society estimates there will be a 45% increase in demand for geriatric
care, and nearly 30% of Americans aged 65 and older require specialized care from a certified
geriatrician. The steeply rising number of adults entering the older population does not compare
to the modest increases in the number of doctors specializing in geriatric care.
As life expectancies increase, there will be more people who require specialized care for chronic
illnesses associated with aging. The American Journal of Public Health estimates nearly 20% of
the United States population will be aged sixty-five years or older by 2030. The sandwich
generation, individuals who are simultaneously caring for their aging parents and younger
children, will face more challenges as their parents age and manage multiple chronic conditions.
Some conditions allow for aging adults to remain active while others are crippling diseases.
Either way, families who are faced with assisting their parent or grandparent manage these
conditions without proper support from geriatric care professionals will be placed under more
stress and highest quality care may not be delivered to the aging adult. Older adults may also
experience mental health issues related to losing complete independence or their other chronic
age-related illness. The Online Journal of Issues in Nursing reports that in 2002 over five
thousand geriatric psychiatrists were required to meet current mental health needs of older adults
and only two thousand four hundred practicing geriatric psychiatrists in the United States.
Further, there are fewer geriatric educational requirements for doctors and nurses entering the
medical field. In general, the American Nurses Association expects a 20% deficit of registered
nurses by 2020. They also report programs and courses for geriatric care are diminishing and
only fourteen of the nation’s one hundred and forty-five medical schools require students to take
at least one specialized geriatrics care course. With an older adult population nearing forty-three
million people in 2018 as reported by the American Geriatrics Society and a geriatric work force
totaling at approximately seven thousand professionals, the United States faces a major deficit
between supply and demand. Geriatric care is vital to educate our older population of their care
needs and empower them to become advocates for better access to quality care.
Landscape: The key stakeholders regarding the shortage of geriatric care providers are the aging
adults, their family members, current and future healthcare providers, and communities.
There are several key areas of concern regarding care for elderly adults. They include family
support, educational requirements for geriatric care, and access to specialized care. Each of these
factors are exacerbated by the overall shortage of geriatric care professionals. These issues will

2. only continue to become more prevalent as more individuals reach over age sixty-five.
Family Support:
Many older adults live on a fixed income which inhibits their access to medications and care if
they are not covered by their insurance. It is up to the aging adult or their family members to
determine ways to get these necessary but expensive medications. In some situations, elderly
adults must choose between their medication, nutritious food, or utility bills each month. Their
adult children become responsible for providing their care, and some families are not in the
position to use outside resources for help due to finical ability.
Educational Requirements:
The current healthcare workforce will not meet the needs of the quantity of elderly adults in the
approaching years. Presently, minimal geriatric educational requirements for doctors and medical
students exist which will prove to be an issue once the entire baby boomer population transitions
to older adulthood. Further, there is a disproportional amount of new geriatric care professionals
entering the medical field compared to the upcoming unprecedented increase in the older adult
population.
Access to Care:
Another concern regarding increased availability of specialized care for older adults are the costs
associated with more workforce training and educational programs for families. However, the
spending required for increased need for medical care can be alleviated by community health
departments providing more programs for older adults and their families which might reduce the
need for formal care givers that must be covered by insurance. Each stakeholder has the ability to
advocate for change and create a healthcare environment that is more conducive for elderly
individuals.
Policy Options: There are several policy options that would create a better care environment for
older adults.
The Geriatrics Workforce Improvement Act (GWIA) includes two main programs that will
drastically improve the outlook of the geriatric workforce. This Act establishes and formally
funds the Geriatric Workforce Enhancement Program (GWEP) and reestablishes and also
enhances the Geriatric Academic Career Awards (GACA). GWEP would authorize funding to
promote education and engagement with family caregivers by using professionals to accurately
determine the care needs of aging adults. This will also provide better care for elderly individuals
who require at home care as well as care at a facility sure to certain chronic conditions. GWEP
also promotes the integration of geriatric care into primary care provider facilities to create easier
access to specialized care workers. Moreover, GACA works to develop the current and future
healthcare workforce through training programs and career development opportunities.
Advantages:
• Creates a workforce that is more equipped to provide care for aging adults.
• Improvements in access to care through the integrated primary care facilities.
• Improvements in family relationships due to the decreased stress surrounding the care of
the elderly family members.
• Provides funding for future endeavors to increase the geriatric care workforce
• Increased funding to support the expansion of the geriatric care workforce
Disadvantages:

3. • Some elderly individuals may not be able to access a primary care facility with geriatric
care due to their location or financial stability.
• Families are only able to provide in home care if there is someone who is available and
capable to manage their elder’s needs.
• GACA may not provide enough incentives to promote further professional development
for geriatric care.
• The bill has not been passed through legislation and may require more support from other
members of congress to be successful
Provide more information to college students regarding the increasing opportunities in the
geriatric field of healthcare. Through adverts on college campuses with relevant organizations
and informational sessions, more medical students in the next generation of care providers will
be aware of the ever-increasing demand for geriatric care. This will provide the opportunity to
alleviate the shortage of doctors for geriatric care by creating interest in students entering the
medical field.
Advantages:
• Inspiring a new generation to enter the workforce specializing in gerontology will
create more opportunities for elderly individuals to access the care they need.
• The information and research regarding the need for geriatric medical professionals is
already available on multiple internet formats.
• More individuals will be informed about the shortage of care providers.
Disadvantages:
• Some students may not have the desire to provide services to elderly individuals
based the obstacles related to Medicare
• Funding may still be an issue if there is not enough spending authorized through
GWEP and GACA.
• Some campus organizations may lack the funding or reach to spread the information
regarding the need for geriatric care professionals
Create public geriatric education programs in county health departments to further increase
access to geriatric healthcare. These steps will promote access to healthcare and education to
aging adults as well as provide opportunities for their families to become involved in their care
no matter their socioeconomic status. Most health departments already have information
regarding prevention and maintenance of chronic age-related illnesses; however, elderly
individuals may not be able to access this information due to their ability to travel or access to
the internet. Current programs can be altered to become more accessible to older adults through
advertisement in the community and traditional forms of publications.
Advantages:
• Increased access to healthcare for elderly adults through public efforts.
• Increased education among aging adults and their families to provide better care and
promote advocacy for change in healthcare policy for older adults.
• Decreased stress on the family associated with providing care for their aging parents
or grandparents
• Promotes better care at home for aging adults with chronic age-related illnesses
Disadvantages:

4. • The increased funding to health departments may not be feasible to create programs
at every location.
• Programs may be limited to certain facilities depending on the age characteristics of
the population in the health department district.
• Requires more funding for the public health department to implement new programs
• The information may not reach all members of the community due to their access to
transportation or location
Recommendations: The Geriatric Workforce Improvement Act offers a promising start to
facilitate change with in the medical field for aging adults. It creates a vast amount of
opportunities for future and current healthcare professionals to consider geriatric specialization.
The issue is simple; there are not enough medical professionals practicing in geriatric care, and
the number of professionals entering the workforce will also fail to meet the future demand for
geriatric care physicians. Increased funding will provide the necessary support for more
education and programs to create increased access to care and close the gap in specialized care
for older adults. GWIA would authorize an increase in funding; however, more calculations and
research should be completed to discern amounts and disbursements. Not only will the increase
in funding support GWEP and GACA, it may also provide the opportunity to provide funds to
public health outlets to advertise care and education for older adults. The baby boomer
generation is aging and soon the number of adults aged sixty-five and older will become a
surmountable proportion of the total population in the United States. It is vital that health policies
are enacted now to predict and alleviate the growing issues in the healthcare workforce for
geriatrics.

5. References
American Geriatric Society. (2018, May 22). New geriatrics legislation in senate highlights
bipartisan collaboration across congress aimed at better present, future for us all as we
age. Retrieved from https://www.americangeriatrics.org/media-center/news/new-
geriatrics-legislation-senate-highlights-bipartisan-collaboration-across
American Geriatric Society. (n.d.). Geriatric workforce by the numbers. Retrieved from
https://www.americangeriatrics.org/geriatrics-profession/about-geriatrics/geriatrics-
workforce-numbers
Anderson, L. A., Goodman, R. A., Holtzman, D., Posner, S. P., & Northridge, M. E. (2012
March). Aging in the United States: opportunities and challenges for public health.
American Journal of Public Health, 102(3), 393-395.
Bennett, J. A., & Flaherty-Robb, M. K. (2003 May). Issues affecting the health of older citizens:
meeting the challenge. Online Journal of Issues in Nursing, 8(2).
Collins, S. M. (2018, May 21). S. 288- Geriatrics Workforce Improvement Act. Retrieved from
https://www.congress.gov/bill/115th-congress/senate-bill/2888/text