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September 10, 2008

AS WE AGE: An aging population having impact on health care already

By JEFF MEYERS

PLATTSBURGH -- New York's population is aging, and that growth in the number of senior citizens is already impacting the health-care system.

As the Baby Boomer generation reaches retirement age and beyond, health-care providers will be facing a double-edged problem: many more patients needing lots more care, and fewer providers available to meet that growing demand.

The message that health-care officials have begun to promote is quite simple: Maintain a healthy lifestyle now to prevent growing health concerns later.

MORE ACTIVE

"The Baby Boomers are one of the most well-educated generations of all time, with the highest disposable income available to them," said Laurie Williams, education coordinator for the Clinton County Health Department in Plattsburgh.

"They are a generation that has high expectations for their quality of life. They want to continue with that quality well beyond retirement, so they also have high expectations on health care."

With an expected increase in years spent in retirement and more money available to spend during that time, Baby Boomers are taking health care into their own hands today, Williams added.

"You're seeing more Baby Boomers participating in physical activity. You can seem them in the weight room, working on conditioning, in the pool, working on water aerobics. They are involved in more physical activity."

Debra Donahue, vice president of ancillary services at CVPH Medical Center in Plattsburgh, said nearly half of the facility users of the hospital's physical-therapy and recreation facility -- located at a renovated gymnasium-pool on the former Plattsburgh Air Force Base -- are age 50 and older.

"We might be seeing a very different focus on acute care," said Donahue, explaining that health care will continue to emphasize wellness activities throughout life to combat chronic disease during the senior years.

"We've seen increased enrollment in our diabetes-management program and our cardiac-rehab program. We're seeing people who want to get to a better place in their own lifestyle, so chronic conditions will be more controlled and patients will need less acute care in the future."

THE NEW 40'

As more Baby Boomers reach retirement and health care continues to make advancements in the overall care of the advancing population, the nation is seeing a change in the population numbers.

"Sixty is the new 40," said Nancy Smith, a registered nurse and coordinator of the Clinton County Health Department's Health Services Unit. "As people approach their golden years, they're not looking at a life of shuffleboard. They're active; they're out and about."

Health-care services for seniors are steadily being broken into two age groups, she noted: the 65-to-85-year-olds who are still involved in active lifestyles, and the over-85 people who are beginning to need increased health-care services.

"As we're living longer, we're seeing a lot more chronic problems in our people who receive home care," said Joanne Sweisz, director of the county's Home Health Care Unit.

"The people that we're seeing now (in that "older senior" group) lived through the Great Depression and two world wars. Health care was not as good when they were young, and we're seeing a lot of those chronic problems, like heart disease, now."

Programs like the Health Department's Home Care Program are designed to help people stay at home in a safe environment for as long as possible.

Health-care providers know that 24-hour nursing care will still play an important role in long-term care, but shortages of health-care providers everywhere have the industry concerned.

"Recruiting is tough," Sweisz said. "I would say that 40 percent of my nurses are below 45 (years of age), and 10 percent are below 35. As the average age of nurses continues to go up, it will become increasing difficult to replace those who retire."

The same future faces physician coverage. A physician shortage already exists in many regions of New York state, and those numbers may continue to decline as more and more doctors reach retirement age.

"We continue to entice more physicians into practice," said Dr. Wouter Rietsema, medical director at CVPH Medical Center. "Hospitals continue to employ more physicians than ever before. But we need to continue to be creative to keep up with the needs of the elderly as health-care providers age as well."

THE BIG PICTURE

Hospitals need to recognize a shift from patients admitted for medical care to more patients being treated on an outpatient level at clinics and doctors' offices.

"As the aging population increases and we face more serious chronic disease, we need to address what health care will look like in the Emergency Department, in the Cardiac Unit and Oncology Unit," Donahue said. "We need to continually analyze the population's future needs."

Communities are also taking that future role seriously.

"The State Office for the Aging and State Health Department are collaboratively looking at long-term care," said Crystal Carter, executive director for the Clinton County Office for the Aging, who heads the county's Long Term Care Council, an organization of experts from many regional areas involved in health care.

"The Long Term Care Council's charge is to look at the gaps in services in an area and to better understand what is happening at the local level so the state can be prepared for long-term-care needs," she explained.

Carter works closely with the Department of Health, Department of Social Services and the local hospital to analyze current trends in health-care needs for the aging population and what the future will bring for those seniors.

"With the changing demographics, it's important that we recognize the needs of people when they reach that age when health-care needs become more important. That 85-plus demographic is growing rapidly. As a community, we have to be prepared for that."

It's going to take a team effort, providers agree. Health care needs to find ways to expand its services and fill the holes created by its own aging population, and the aging population itself needs to continue adopting healthy lifestyles to reduce their potential for chronic disease.

jmeyers@pressrepublican.com

AS WE AGE
This is the second in a series of stories showing the impact of the aging of New York state residents.
Tomorrow: The challenges keeping young people upstate.

changing face of health care
As the Baby Boomers grow older, more Americans will be enjoying longer lives, but they will also be managing more chronic conditions, experts believe.
By 2030:
E The over-65 population will nearly double as a result of aging Boomers.
E More than six out of 10 Boomers will be managing more than one chronic condition.
E More than one out of every three Boomers "" more than 21 million "" will be considered obese.
E One of every four Boomers "" 14 million "" will be living with diabetes.
E Nearly one out of every two Boomers "" more than 26 million "" will be living with arthritis.
E Eight times more knee replacements will be performed than today.

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