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President's Page
August 2007
Caring for our aging population:
It's about more than just their health needs
2007 DCMS PresidentAfter reading the TMA publication “Healthy Vision 2010,” most of us will agree that our Texas patients in the future will be heavier, older, and less educated, and have more health problems. A couple months ago I addressed the health and economic impact of being overweight and obese. This month I will address the impact of our aging patient population. Dependence on health care, the people providing it, and other types of support and care increase as a person ages, and so do the related costs. Individuals outside the healthcare field may not realize the scope and economic impact of these costs. My cousin was surprised that he was ineligible for citizenship in New Zealand simply because he was over 50. He had not been part of the country’s workforce during the preceding years, so had not contributed to its social support system. After age 50, odds are he would place increasing demands on that system, especially for healthcare and eldercare.
It was just 100 years ago that Dr Alois Alzheimer presented a patient with “pre-senile dementia,” a condition that eventually would be labeled with his name. Alzheimer’s disease is now the seventh leading cause of death in our nation. Its frequency increases gradually as our population ages, to the point that it now affects almost 50% of people over 80. According to the Texas Department of Aging and Disability Services, the life expectancy for a woman and a man in Texas is 82.9 and 81.3, respectively. As our patient population ages, not only do physical ailments and diseases accumulate and demand care, but even physically healthy individuals find themselves at increasing risk for developing cognitive disorders that can require increasing care.
Healthcare and eldercare needs affect each of us. Caring for our aging population means more than just looking after their health needs—ancillary support must be available. Many people may wonder why these patients don’t simply see a geriatric specialist who has the resources to help them meet their needs. First, this country doesn’t have enough geriatric specialists to support the demand, and second, more is involved than just getting a patient to the right consultant.
Despite today’s barrage of ads for senior living and eldercare facilities, the costs for such care are out of reach for the average person. Most of our seniors will be cared for by family, in family homes. I practice obstetrics and gynecology, which many may believe has more to do with young people and childbirth than issues of aging. Yet every day I encounter patients whose health and quality of life are affected by aging parents or other family members who need care—not just hands-on health care but assistance with activities of daily living such as bathing, dressing, paying bills, or preparing meals. We all have patients who are raising their children at the same time they are faced with the demands of overseeing care for a parent, grandparent, aunt, or uncle. Many of us care for the elderly themselves in our practices. In addition, your background as a physician may give you the largest portion of responsibility for the healthcare/eldercare decisions in your family. So, on many levels, your status as a physician gives you the unique opportunity to provide help and access to good information and resources, even though you may not be an expert in geriatrics.
This article provides a list of resources that can help your patients and you with eldercare issues. First on the list for both physicians and patients is The Senior Source, or Senior Citizens of Greater Dallas (www. theseniorsource.org). I recommend them as a first call for information for your patients, their family members, or your family members. For information on the broader topic of eldercare in the nation, Texas, and Dallas County, three good sources are the Texas Department of Aging and Disability Services (www.dads.state.tx.us), Health and Human Services Administration on Aging (www.aoa.gov), and the Community Council for Greater Dallas (www.ccgd.org/daaa/daaa.html). These sites are helpful to individual patients but also have areas geared toward professionals. The Texas Department on Aging has a section on what communities can do to “age well.” The HHS site has a strategic plan on aging.
Government-sponsored consumer sites include:
• National Clearinghouse for Long Term Care Information:
www.longtermcare.gov/LTC/Main_Site/Planning_LTC/Campaign/index.aspx• Eldercare Locator—part of Administration on Aging:
www.eldercare.gov/Eldercare/Public/Home.asp• US Government’s official Web portal with all kinds of links for senior issues: www.usa.gov/Topics/Seniors.shtml
• US Department of Health and Human Services healthfinder site: www.healthfinder.gov
• Official Medicare website that also compares nursing homes:
www.medicare.gov• Social Security Administration: www.ssa.gov
• HUD website for seniors: www.hud.gov/groups/seniors.cfm
A number of commercial websites also are helpful but are too numerous to list; however, many can be accessed via links from the websites listed above.
The federal Older Americans Act requires that every state have an ombudsman program to advocate for improvements in long-term care and to address complaints. The website for the Texas ombudsman program is:
www.dads.state.tx.us/news_info/ombudsman/index.html. From that site, you can retrieve Dallas County contact
numbers.Everyone in Texas is affected by eldercare, even if all they do is pay taxes that fund programs for seniors. In recognizing the 100th anniversary of Dr Alzheimer’s presentation, I hope this will stimulate discussion and action to look after our aging population as part of our work to attain the goals of TMA’s Healthy Vision 2010.
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