Aging of America presents unique care challenges

Soon-to-be seniors are going to need care

Statistics show that someone in this country turns 55 every seven seconds. And with the biggest wave of baby boomers, those born in 1947 — turning 55 next year — the number is only going to increase. People ages 55 to 65 are twice as likely to have the same health problems as people just 10 years younger, according to the Department of Health and Human Services. And according to the 2000 U. S. Census, the number of people ages 65 and older is expected to double in the next 30 years.

This means that every year, more and more people are going to need intensive medical care, chronic disease management, and long-term health services, and it will be up to case managers to juggle the resources they need for their care.

Consider these current statistics:

  • 18.4% of Americans age 65 or older have diabetes.
  • 17% of older adults suffer from chronic obstructive pulmonary disease.
  • 74% of all people age 75 and older have hypertension.
  • Between 15% and 30% of the elderly have urinary incontinence, a condition that is often the primary cause of institutional care for the elderly.
  • 85% of all cancers occur in people over age 50.

With the number of senior citizens increasing, case managers have their job cut out for them. At the same time that the number of elderly is increasing, strides in medical care are prolonging the lives of people who once would have died at a much younger age from stroke, heart attacks, kidney disease, cancer, or other conditions.

"The good news is that more and more people are living longer. The bad news is that the opportunities for them to crash and burn are huge," says David Kibbe, MD, chief executive officer of Canopy Systems in Chapel Hill, NC.

Most elderly require complex care for multiple chronic illnesses that involve multiple interventions. They’re frail, their health is unstable, and their care is costly, Kibbe adds.

Their care is likely to occur in a multitude of settings — the doctor’s office, the hospital, the rehab facility, the skilled nursing facility, at home with home health.

They’re probably going to need community services for care that Medicare doesn’t cover and their family will need help coping with the changes in their loved ones and juggling their care.

And somebody is going to have to keep up with all these venues, all the prescriptions, and all the interventions they need. "That’s where care coordination comes into play," Kibbe says.

In this issue of Case Management Advisor, we examine some of the aspects of health care for senior citizens. We’ll show you the importance of knowing about long-term care insurance and why your younger clients should be buying it. You’ll learn about how incrementally innovative drugs can benefit the elderly, what Department of Health and Human Services researchers found in the nation’s assisted living facilities, and ways others are managing the care of patients with congestive heart failure, one of the most pervasive and expensive chronic conditions of the elderly.