ELDER CARE: New Ways of Caring for Seniors

      In light of the country's mounting elderly population, physicians, family members and policymakers are trying to navigate the myriad options for elderly health care and living arrangements. Geriatrics is "becoming a burgeoning field," as experts predict the country will need 20,000 new specialists in the upcoming decades. West Virginia is bracing for a particularly hard hit, as the state with the oldest median age is finding itself with few geriatricians and little options to remedy the situation. "There's been a national effort to at least recognize that geriatrics is a growing field where we need more doctors," said Dr. Mike Lewis, associate vice president for health services at West Virginia University. At the same time, the state can't turn out enough geriatric specialists to keep pace with its senior population, in part because of the difficulty of luring physicians into a field that pays poorly. The geriatrics fellowship at WVU can only produce two doctors a year, "certainly not as many as this state needs," said Dr. William Harris, who has been a family practitioner for 25 years and recently earned his geriatrics qualification. "Primarily, you have your general internists and your family practitioners," he said, noting that such doctors have "been filling that need for a long time, long before the current emphasis on geriatrics." But in older patients, "the care becomes tremendously complex," and "someone who isn't focused on giving care to the elderly simply can't give the same level of care" (Moore, Charleston Gazette, 8/23).

Taking on the Task
      Advocates across the country are wrestling with many of the same issues. Here's what some of them are saying:

• Nearly 300 South Carolina seniors attended a forum Monday to offer their opinions on "what the state can do to serve them better." Most called on the state to help them live at home longer. Speakers' comments were forwarded to the governor's transmission subcommittee on seniors, family issues and social services (AP/Charleston Post & Courier, 8/25).
• "Washington is in the lead" among states "on a quest to figure out how to take care of its growing numbers of elderly people," the Seattle Times reports, noting that the state has been one "of the most aggressive in shifting elder care from nursing homes to cheaper and less-institutional alternatives." Indeed, Washington and Oregon are among the only states in which a greater percentage of their elderly population receives care at home or in the community rather than at skilled-nursing facilities. From 1995 to 1998, the number of Medicaid recipients in Washington nursing homes dropped 12%; the number receiving alternative forms of care increased 30% (King, Seattle Times, 8/24).
• According to North Carolina's Area Agency on Aging, about one-fifth of the state's over-60 population and 30% of its over-85 population lives at or below the poverty level. It is clear that something will have to change, said Richard Gottlieb, the executive director of Senior Services in Forsyth County, predicting that there "will be a lot of attention paid to long-term care, housing for the elderly, special car features, clothes" (Ellison, Winston-Salem Journal, 8/22).

It's Time
      The current issue of Time takes a look at "the world of assisted living," noting that such facilities are home to 25% of the 2.2 million Americans who living in housing for seniors. "The assisted-living movement has really changed the way people age," said Assisted Living Federation of America President Karen Wayne. "We've proved that people don't want to be in institutional settings." Care for the elderly will feature prominently in the 21st century, as the market is expected to balloon from $86 billion in 1996 to $490 billion by 2030 (Greenwald, Time, 8/30 issue).