Addressing the Community‐Based Geriatric Healthcare Workforce Shortage by Leveraging the Potential of Interprofessional Teams

Abstract

As Americans live longer lives, we will see an increased demand for quality healthcare for older adults. Despite the growth in the number of older adults, there will be a decrease in the supply of a primary care physician workforce to provide adequately for their care and health needs. This article reviews the literature that explores ways to address the primary care workforce shortage in a community-based geriatric healthcare setting, with special attention to elevating the role of nurses and caregivers and shifting the way we think about delivery of care and end-of-life conversations and planning. The shift is toward a more integrated and collaborative approach to care where medical and nonmedical, social services, and community providers all play a role. Several models have demonstrated promising positive benefits and outcomes to patients, families, and providers alike. The goal is to provide high quality care that addresses the unique attributes of older adults, especially those with complex conditions, and to focus more on care goals and priorities. The many barriers to scaling and spreading models of care across varied settings include payment structures, lack of education and training among all stakeholders, and, at the top of the list, leadership resistance. We address these barriers and make recommendations for a path forward where healthcare providers, policymakers, patients, families, and everyone else involved can play a role in shaping the workforce caring for older adults. J Am Geriatr Soc 67:S400-S408, 2019.

Moral distress and burnout in caring for older adults during medical school training

“…Collectively, these prior studies suggest that moral distress in caring for older adults may be one of many reasons why the number of medical graduates choosing a subspecialty career in geriatrics is inadequate and declining [23]. By 2025 there will be a shortage of nearly 27,000 geriatricians in the United States [24]. Physicians who care for adults, regardless of specialty, will increasingly have to manage complex care decisions for their older adult patients, and therefore may be at greater risk for experiencing moral distress and its negative consequences.…”

Commentary on the Geriatric Healthcare Workforce: Leveraging the Potential of Interprofessional Teams

“…Flaherty and Bartels, published in this issue, have examined the current state of the healthcare workforce and have shown that the primary care workforce needs to be better prepared to care for older adults. They propose several approaches to address this concern.…”

“…Flaherty and Bartels make a compelling argument for expanding the role of caregivers. In the current healthcare climate, caregivers have been increasingly meeting patient care needs at home.…”

“…Flaherty and Bartels also make a compelling argument for expanding the role of nurses. The escalating problem of multiple chronic conditions in older adults is another public health challenge that registered nurses are embracing.…”

Introduction to the Special Issue on the Workforce for Seriously Ill Older Adults in the Community

“…This special issue of the Journal of the American Geriatrics Society presents these papers, along with a summary of the recommendation developed at the summit. The articles address a range of pertinent topics: advance care planning and integration of care planning into primary care, clinician communications regarding prognosis and patient preferences, strategies for building a culturally competent workforce, a vision for the palliative care workforce, supporting family caregivers and direct care workers, and linking patients with social services …”