Are Nurses the Solution?
A recent report put out by the Institute of Medicine (IOM) – the research of which was led by Dr. Dan G. Blazer, psychiatric and behavioral science professor at Duke University Medical Center – has found that care providers are simply ill-prepared for an aging population it failed to anticipate. The amount of people who are now living longer, requiring substantially more healthcare – both physical and mental – has been termed a “silver tsunami.” In addition, it seems like the mental wellbeing of these individuals is gaining even less attention than the already inadequate physical healthcare.
Almost 20 percent of Americans who are 65-years and up, suffer from a variety of mental health issues. Substance abuse is also an issue, often to do with a declining mental capacity, or the fact that as people age, they cannot tolerate the same kind of medications prescribed to their younger counterparts. In addition, since there is such a lack of geriatricians in America (see Dealing with an Aging Population) – only one geriatrician for every 2,500 Americans – it is not surprising this is becoming such a widespread problematic phenomenon, especially since the aging population is likely to increase more than double in the next 20 years.
Medicare and Medicaid to Step Up?
So what’s the solution? Already there is too much pressure on America’s health care systems to further extend themselves to help the aging population and baby boomers. Yet still, the IOM’s study findings is pointing the finger. It is calling for these health care programs to “overhaul payment rules” and prioritize care, counseling and other services the aging population they serve, needs. Currently, this is not the case at all. Indeed, both Medicare and Medicaid do not cover such treatments. This exacerbates the problem.
But Blazer is insisting that somehow the problem be solved now, or else, the “older population and their extended families will suffer the consequences.” At the end of the day, the report has called on policymakers to step up and sort everything out. It was argued that Congress has to provide extra funding to “evaluate, coordinate and facilitate the efforts of health care workers taking on these enormous challenges.”
NICHE to Help Baby Boomers?
A nurse-led program seeking to improve healthcare quality could possibly provide some relief to this issue. A study – undertaken at Johns Hopkins University School of Medicine – indicated that the Nurses Improving Care to Healthsystem Elders (NICHE) program “could be an effective model for improving hospital quality and safety for older adults.”
Right now, six systems are being investigated by Medicare Innovations Collaborative to test out potential new programs whose goal it is to improve the care for Medicare patients who suffer multiple chronic conditions. This study would suggest that Medicare is trying to look at how it can help the elderly population more, at least in hospitals, but that is a start.
So what does NICHE actually do? It offers a variety of tools that can be used to improve hospital care specifically for the elderly population which is much more prone to picking up infections, etc., while they are being treated in these facilities. It seeks to increase the availability in hospitals of equipment used specifically for the elderly, as well as other resources needed by nurses for treatment.
One of the main priorities of the program is to improve the knowledge base for nurses while encouraging leadership skills. Hospitals working with NICHE, appoint a Geriatric Resource Nurse (GRN) who leads other nurses on the unit. The GRNs are given a specialized-education course on how to nurse adults, along with consistent mentorship and support from a full interdisciplinary team.
The Future of Geriatric Care
While indeed this NICHE program is certainly not a solution to the issue discussed above and still much needs to be done, it is certainly a step in the right direction and is indicative of the fact that Medicare is at least on board vis-à-vis the recognition of eldercare in hospitals.