How Healthcare Should Prepare For Burgeoning Older Population

Part of a global trend, the U.S. is transitioning towards becoming a “superaged society” where 20% of Americans will be 65 or older by 2025. The United Nations declared 2021-2030 the Decade of Healthy Aging as a global collaboration to improve the lives of older people, their families, and the communities in which they live.  Led by the World Health Organization (WHO), the “Decade” initiative offers payer and provider organizations an opportunity to assess their achievements toward and recommit to improving the health and quality of life for older adults.

Decade of Healthy Aging 4 areas of focus

The Decade of Healthy Aging is aimed at galvanizing collaboration among stakeholders to act on 4 key priorities when approaching senior healthcare and beyond:

1. Change how we think, feel and act toward age and aging.
2. Facilitate the ability of older people to participate in and contribute to their communities and societies.
3. Deliver person-centered integrated care and primary health services that are responsive to the needs of the individual.
4. Provide access to high-quality LTC in home- and community-based settings for older people who need it.

Ageism: Change how we think, feel and act toward age and aging

Globally, one in six adults aged 60 years and older experience abuse every year. Over 64% of staff report perpetrating some form of abuse in the past year from a systematic review and meta-analysis. 

Ageism, which includes stereotypes, prejudices, and discrimination towards others or oneself based on age, has been touted by the WHO as a major reason why the elder abuse receives so little attention. Research has revealed that one in five adults over 50 has experienced ageism in a healthcare setting. Globally, 60% of adults report that older people are not respected.

Addressing ageist stereotypes in healthcare for older adults

Stereotypes portray senior adults as fragile, cognitively impaired, and having less value to society, supposing that poor health is inevitable with age, so it should just be accepted. What’s vital is to dispel misconceptions about aging and reduce prejudice by providing accurate information and counter-stereotypical examples. Intergenerational interventions can also reduce intergroup bias and stereotypes.

Evolving attitudes towards aging and senior healthcare

Healthcare organizations should audit their organizational, care, and financial policies for inherent age bias. Going even further, they can identify and address ageist attitudes and misconceptions through educational activities to enhance empathy with senior adults. Various simulation tools and technologies can help employees experience the world through challenges that many older people face. Role-playing toolkits provide easy-to-replicate opportunities to build compassion and develop skills and respect for senior adults while meeting their needs.

Age-friendly environments: Help older people to participate in and contribute to their communities and societies

Age-friendly environments consider the unique needs of older people when creating physical spaces, as well as networks for connecting, education, services, and support. Related to healthcare, the John A. Hartford Foundation and the Institute for Healthcare Improvement launched a program called Age-friendly Health Systems (AFHS). Accredited organizations align their priorities with principles like equality, dignity, and respect for older adults, working to ensure safe and evidence-based senior healthcare. Their program is based on the evidence-based 4M framework and practices -- (what Matters, Medication, Mentation, and Mobility.

• What Matters:  Know and align care with each older adult's specific health outcome goals and care preferences, including, but not limited to, end-of-life care and across settings of care.
• Medication: If medication is necessary, use Age-Friendly medication that does not interfere with What Matters to the older adult, Mobility, or Mentation across settings of care.
• Mentation: Prevent, identify, treat, and manage dementia, depression, and delirium across settings of care.
• Mobility: Ensure that older adults move safely every day in order to maintain function and do What Matters.

Changing ageist attitudes starts with providers and practitioners

Ageism research conducted in the fall 2020 with various primary healthcare provider roles speaks to the need for greater awareness, education, and programmatic advocacy. “While more than 90% of providers agreed that older patients ‘require a different approach to care than younger patients,’ only 50% of physicians and physician assistants and 69% of nurse practitioners said they always consider a patient’s age in routine care. Only 36% of the surveyed physicians said they ask their older patients what matters to them.” 

Payers and providers can look at each intake, onboarding, care delivery, and communication touch point or operational process from the vantage point of a patient of advanced age and, at a minimum, ask the question, “What matters most to you in receiving care/services from us?”

Integrated senior healthcare: Deliver person-centered care and primary health services

Person-centered care acknowledges older adults as competent persons who deserve full respect and the right to establish and maintain social relations and make decisions for themselves. Yet, disparities in care are exacerbated for older adults. 

Research by the Center for Consumer Engagement in Health Innovation found that out of 12K patients, 25% of Hispanic patients and 17% of Black patients over 50 never had their preferences considered. Only seven percent of White patients reported the same experience. The consequences of not having one’s preferences taken into account meant that 23% of patients were less likely to use home care, 14% less likely to have outpatient surgery, and 39% less likely to take prescription medication. When patients don’t feel considered, and are less likely to pursue their care plan, it can lead to worsening illness and exacerbations to increase mortality and disability risk, as well as increases the cost of higher-acuity care.

Addressing senior preferences influences patient satisfaction

The report, “Tracking Progress on Person-Centered Care for Older Adults,” defines person-centered care as “based on a holistic approach to healthcare that takes the whole person into account instead of a narrow perspective where the focus lies on an individual’s illness or symptoms.” 

Their research revealed that patients who are more satisfied with their healthcare are 1.25 times more likely to have had their preferences considered at least sometimes, demonstrating how satisfaction can be impacted by having priorities addressed. Conversely, the data show that as a person ages, the odds of having care preferences considered decline by roughly three percent per year of age. 

Payer and provider organizations can ask and address patient preferences through a quality improvement approach, searching for if and where aging adult care preferences are being taken into account, which is a key tenant of person-centered care. 

Long-term care: Provide access to high-quality LTC in home- and community-based settings

Because older adults are living longer and with higher rates of chronic disease and disability, long-term care needs will continue to experience accelerated growth, particularly as Baby Boomers age over the next 30 years. 

Whether LTC care is provided in the home or community-based settings, they are crucial not only for quality of life and independence for seniors but also to help control healthcare costs. However, a shortage of LTC workers that will only grow requires innovation, technology, and collaborative models of private-public-NGO partnerships. 

Aging in Place, remote patient monitoring,  digital health solutions, and connected care all offer ways to scale certain aspects of long-term care, particularly when coupled with appropriate uses of artificial intelligence and remote care teams.

Providing better healthcare to a growing senior population

If you would like to discover how to address the unique needs of older adults better and how your services and care are delivering what they want and need, turn to RTI Health Advance. We can ensure that your strategies, programs, policies, and operations match your intention for person-centric care. We can also assess the impact of interventions focused on senior adults and their effects on care quality, population health, and health equity to determine these programs' economic and community value.

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