In the last few weeks I've been telling people that I feel more confident of eventually improving care for older adults than at any time in my 13 years in philanthropy. Part of that confidence stems from the inevitable effects of demographic change itself. As the share of the U.S. population 65+ ticks up from 12 to 13 to 14 percent and the leading edge of the baby boom cohort turns 65 next year, awareness of aging in society, including special needs in health care, should become commonplace.
To make that happen, we need to keep putting the message out there that care should—and CAN—be improved. So it is very reassuring when what seems like a long, long media drought is broken by a flood of coverage in our hometown paper of record, the New York Times. (Disclosure - my wife works there, albeit in a different section with no connection to health care issues.) It began a couple of weeks ago with a piece on hospitalists working to improve the discharge process and reduce readmissions through our project BOOST (May 26, 2010 - New Breed of Specialist Steps In for Family Doctor by Jane Gross) and continued this Saturday with a sort of follow-up piece (June 19, Patient Money, Aftercare Tips for Patients Checking Out of the Hospital by Lesley Alderman). This second article not only included the names of the projects and leaders (The Care Transitions Intervention and Eric Coleman, BOOST and Mark Williams), but also mentioned the Foundation as a funder of this work.
Testimonial on Care Transitions Intervention
Then for Father’s Day this past Sunday there was a major New York Times Magazine piece, What Broke My Father’s Heart by Katy Butler. Butler showed the need for more appropriate, sensitive care for older adults at the end of life by sharing the story of her father’s last years. (Aside--as of Tuesday morning, this story had generated 422 comments and was closed to further posts!) The Times followed this on Monday with a front-page story on delirium among hospitalized older patients that mentioned leaders in geriatrics like Sharon Inouye, MD, and Beeson Scholar Malaz Boustani, MD, as well as the American Geriatrics Society itself. Oddly, the delirium story did not actually mention the name of Dr. Inouye’s intervention program HELP (Hospital Elder Life Program) in the print version. Then, Tuesday’s business section presented Geisinger’s version of nurse-enhanced primary care for the chronically ill. The Foundation is disseminating this type of care through the Guided Care program.
I am very happy to have this level of attention to aging care. Taken together, these stories do all the things we need to drive change: they detail what is wrong with the care most older adults receive today, they make the issues personal and memorable with human stories, they talk about the interventions and innovations that can make life better for older people, and they highlight some of the leaders and organizations involved in the work. In passing they also combat ageism, as they make the ongoing contribution of older adults and their human value clear; even people who can descend into raving delirium without appropriate care can recover and eventually return to lives of meaning and value people of any age would be proud to be living.
However, we need to do one more thing--we need a call to action. Consumers, people, family members, and health care leaders need to start asking, no demanding, that health professionals have these sophisticated skills and employ these special models. Consider joining the Campaign for Better Care. Ask if your hospital has the Care Transitions, HELP, or BOOST programs. Ask if your hospitalist, primary care physician, nurse, and other health care workers have training in geriatrics. If they don’t, if you can, go somewhere else. If you can’t, let them know that you will expect it in the future. The dirty little secret of all of this “news” is that none of this is new--all of the work described in these stories is at least 5 to 10 years old, and countless older adults have been and will continue to be hurt by less than acceptable medical care until we act.