The World is Getting Grayer

     Once considered the new kid on the block, the United States is now aging along with the rest of the world. According to a recent report from the Institute of Medicine titled Retooling for an Aging America: Building the Healthcare Workforce, our social and healthcare systems are ill-prepared to take on the graying of America. Surprised? I don't think so.

     The statistics are staggering. By 2030, the number of Americans aged 65 or older will have doubled from its current figure of 35 million to more than 70 million, which will be approximately 20% of the total population as compared to 12% today. The number of those older than 85 will also double from 4.7 million in 2003 to 9.6 million in 2030.

     America is not alone in facing the challenges of an aging population. In Japan, researchers expect a whopping 40% of the population to be over 65 by the year 2055, which has implications not only for the provision of healthcare, but also for maintaining a viable workforce. The Machine Industry Memorial Foundation reports that by 2025 robots could be expected to be performing 3.5 million jobs formerly done by humans in Japan, and that such devices will become routine sights in all aspects of Japanese life, including monitoring the health of the elderly. While I doubt we will be staffing ambulances with electronic EMTs anytime soon, EMS agencies must address the issue of increasing geriatric call volume. With the EMS profession currently plagued by problems relating to recruitment, ED diversions, system abuse and reimbursement, it seems unfathomable to imagine how we can handle a significant increase in the geriatric population. According to the IOM, older patients currently make up nearly 40% of all EMS responses and 35% of all hospital stays; with a doubling of the elder population in just 20 years, do the math and you will see the crisis facing every facet of our healthcare system.

     The IOM report advocates a retooling of our current system to include increased geriatric training for healthcare workers and the development of technologies that would assist healthcare workers to care for older adults. As usual, the buck stops somewhere and it is hard to imagine where the funding is going to come from to support such developments, but ultimately awareness is the first step to planning a response. To read the IOM report, go to www.iom.edu.