Sometimes in this country we wait for a problem to become a full-on crisis before we make it a priority. By applying commonsense strategies earlier to certain inevitabilities, we might avoid some of the human and financial costs.
A case in point: the aging of the population. As the latest issue of the Robert Wood Johnson Foundation’s Charting Nursing's Future notes, over the next four decades, the number of Americans 65 or older will double to about 84 million — nearly 20 percent of our entire population — and 70 percent of them are expected to seek assistance in maintaining their health and well-being.
One way to prepare for the onslaught, according to the issue brief, is to embrace and expand some of the nurse-led initiatives that already have proven successful in various parts of the country. These include a transitional care model that uses advanced practice registered nurses to coordinate care for high-risk older adults within and across health care settings. There’s also the well-known Program of All-Inclusive Care for the Elderly that helps individuals to remain at home by bringing them to PACE centers two or three days a week, where they can see a primary care provider, receive physical therapy and personal care, refill prescriptions and join in social activities.
In Arkansas, nine Centers on Aging — each owned and managed by a local hospital and each employing a geriatrician, an APRN and a social worker — provide primary care and education about chronic conditions.
These programs can improve quality of life, delay or avert serious physical or mental conditions, reduce hospitalizations and save money.
To encourage the adoption of these and other effective approaches across the nation, the RWJF report urges certain policy changes, including allowing nurses to practice to their full practice authority and eliminating obstacles like requiring nurse practitioners to seek physician approval before Medicare will pay for home health services and durable medical equipment.
Most critically, nursing schools must beef up training in geriatric care. Currently, the RWJF brief points out, less than 1 percent of the nation’s RNs are certified gerontological nurses.