Preparing for a Public Health Need: The Aging of America

JULY 01, 2004
Marla Knight, RPh, PharmD, CGP

Every day, nearly 6000 Americans are celebrating their 65th birthday. In 2012, that number will have increased by 40%, and more than 10,000 people a day will turn 65.

Those figures only will continue to climb, as the baby-boomer generation grows older, bringing more than 80 million Americans into retirement age. There has been a lot of talk in recent years about what industries are doing in response to this unprecedented demographic trend. Many in the private sector are clamoring to capture the consumer market share of adults 65 and older.

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

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

Sears Methodist Retirement System, which currently has more than 830 assisted living, nursing care, and Alzheimer's disease care beds throughout west and central Texas, has addressed this issue with its internal pharmacy program. The program allows our pharmacists to receive ongoing geriatric pharmacy training and tuition assistance so that they can better meet the pharmaceutical needs of our residents.

This program is 1 small way of addressing the fact that Texas has a shortage of health care professionals with geriatric training. For example, Sears Methodist employs 2 out of a total of only 31 certified geriatric pharmacists in the entire state. I received my certification from the Commission for 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 certification in the nation that recognizes the clinical expertise of senior care pharmacists.

Why is this certification important? According to the Alliance for Aging Research, many older adults are using 12 prescription drugs or more at any given time. Changes with aging 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 adults can be different and more difficult to recognize than those in the young or middle-aged. It has been said that any new symptom in a geriatric patient should first be considered a possible drug side effect until proven otherwise.

At Sears Methodist Center, when a new resident comes to live with us, we begin by reviewing all of his or her medical records and current and past prescriptions. In many cases, we are able to make immediate adjustments in dosages or even eliminate some medications. We have seen an instant improvement in the health of some residents just by making minor adjustments to their prescriptions.

It is important to raise the level of awareness concerning the shortage of geriatric training among the nation's health care providers. Providers and educators must recruit more health care students into the field of geriatrics. Sears Methodist recently established a Certified Nurse's Aid scholarship to interest young students. Like our pharmacy program, this scholarship provides them with opportunities for continuing education programs, additional professional degrees, and certifications.

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

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