Retooling the Health Care Workforce for an Aging America: A Current Perspective

Abstract

A 2008 Institute of Medicine (IoM) report outlined a vision for health care and a workforce capable of addressing health and extended care needs of our aging population. It highlighted dramatic shortages necessitating bold action and outlined recommendations aimed at building a sizable and qualified workforce. This study updates report findings and progress made on its recommendations. Through review of publicly accessible, internet-based literature and government and professional organization websites, current workforce data and recent policy changes are compared to the report’s statistics and recommendations. Direct comparisons are limited by changing definitions, context, and data collection and analyses methods. Future workforce need projections are estimated using reports from various sources. Inability to forecast medical advances, socio-economic changes, and world events impacts the accuracy of these projections. Nonetheless, clear conclusions emerge despite such limitations. Progress toward fulfilling the IoM goals is variable and insufficient. The current and projected numbers for all geriatric health providers remain inadequate compared to estimated 2030 demand. Challenges in meeting estimated needs persist essentially unchanged. The 2008 IoM framework and recommendations remain relevant and constitute an important roadmap to complete unfinished goals. Initial findings from this update provide a platform for developing practice and policy reforms.

Adult Day Program Directors’ Experiences Managing the COVID-19 Pandemic

“…When efforts and attention were forcefully turned to LTC, services suffered further along the prevention end of the health care continuum. For example, the redeployment of ADP staff inadvertently narrowed the already limited health care workforce available to provide vital community supports (Dawson et al, 2020; Foley & Luz, 2020; Lefebre et al, 2020). Research has yet to fully document client deconditioning and caregiver stress, burden, or burn-out that resulted from the closure and restriction of ADP in-person health and wellness services during the pandemic.…”

Evidence assessment and narrative synthesis of the key characteristics of older people living in service-integrated housing facilities, and their ‘accommodation journey’

“…Roller-Wirnsberger et al's (2018) report on the workforce caring for older people in 22 European countries calls for a fully competent, integrated and co-ordinated, multi-disciplinary workforce that can support the comprehensive health and care needs of older people with multi-morbidity and frailty. Foley and Luz's (2021) review of government and professional organisation documents and workforce data in the USA agree, and argue for a sizeable workforce trained in all aspects of integrated gerontological care. Initiatives such as the Enhanced Care of Older People workforce strategy (Thompson et al, 2018) are supporting integrated workforce planning across sectors, professions and roles in an attempt to upskill the workforce across the system, but is essential that such initiatives include opportunities for SIH staff development as well as community and primary care staff working into SIH.…”

“…The plan required that care home care models should be designed around what residents want and need with regard to healthcare as well as accommodation with care support.Significantly, this requires a redesigning of the workforce around resident need in order to offer residents better, joined up healthcare and rehabilitation services. In many respects, the plan reflects healthcare services' realisation that effective care for older people requires a for older people in twenty two European countries calls for a fully competent, integrated and co-ordinated, multi-disciplinary workforce that can support the comprehensive health and care needs of older people with multi-morbidity and frailty Foley and Luz's (2021)…”

Adapting a whole health model to home-based primary care: Bridging person-driven priorities with veteran and family-centered geriatric care.

“…). Family caregivers are also critical partners in service delivery for older adults as there is a significant shortage of geriatrics-trained health care providers (Foley & Luz, 2020).…”

“…One important role that HBPC plays is to support veterans and their informal caregivers through facilitating access to care, developing shared goals, care coordination, and providing emotional support (Shafir et al, 2016; Smith-Carrier et al, 2018; Wool et al, 2019). Family caregivers are also critical partners in service delivery for older adults as there is a significant shortage of geriatrics-trained health care providers (Foley & Luz, 2020).…”