GRAND Magazine - July 2009 - 19

G R A N D PA RT N E R S F O R G R A N D PA R E N TS determined by our personal behaviors. Maintaining a healthy lifestyle can reduce heart disease, hypertension, non-insulin-dependent diabetes mellitus, colon cancer, and osteoporotic fractures—most of the most common diseases of aging. Our healthcare system should be focused on helping and motivating us all to compress the various diseases of old age into the shortest possible time at the very end of life – and thereby raise the odds of living long and well (which would please both Mr. Spock and Dr. Spock). (I wonder why Michael Moore neglected to mention selfcare in his otherwise provocative documentary Sicko? Was it because it’s far easier to “blame the system” than it is to take responsibility for one’s own role in the problem?) Solution #3: Replace medical incompetence with aging-ready healthcare professionals When the leading edge of the baby boom arrived in the mid-1940’s, America and its institutions were totally unprepared. Waiting lists and long lines developed at hospitals across the country, apartments and homes didn’t have enough bedrooms for boomer kids and there was a shortage of baby food and diapers. With the coming age wave, we should be preparing armies of “aging-ready” healthcare professionals. We aren’t. Less than one percent of all the physicians in America have been trained and certified as geriatricians. However well-intentioned they may be, most primary-care physicians have received little or no continuing education in geriatrics. The same holds true in nursing, allied health, and pharmacology. Every medical school in the United Kingdom has a department of geriatrics. But with 130 medical schools, there are, amazingly, only thirteen such departments in the entire United States. Because of limited geriatric competency, every week our physicians make millions of costly mistakes: misdiagnoses, inappropriate surgeries and punishing complications due to faulty medication management (polypharmacy). If AARP, the AMA, the Centers for Medicare and Medicaid Services and all health insurers required physicians, nurses, and other health professionals to attain basic geriatric competencies in order to be eligible for reimbursement, mistakes and do-overs would shrink, and we’d have better-cared-for older adults at a far lower cost. Solution #4: Palliative care: death with dignity A century ago, 75 to 80 percent of all deaths took place at home with family and friends on hand. Roughly the same percentage of all deaths now occur in institutions— hospitals, extended care facilities, and nursing homes. In fact, Medicare spends approximately 28 percent of its total budget on patients in their last year of life— sometimes when the attempt to prolong life merely means an expensive, inhumane, high-tech death. And something that no one seems willing to talk about is the fact that the extension of dying in this fashion all too often becomes a capitalist feast as some medical companies see their profits grow, the longer the dying process is extended. We’d be wise to shift the emphasis for the dying patient to “palliative care” or hospice care — which focuses on the relief of symptoms, controlling pain, and the provision of emotional and spiritual support for the patient and their family. Such treatment requires relatively little apparatus and technology, is much less costly than the procedures currently in place in most hospitals and provides for a far more humane and dignified last stage of life. The Challenge Ahead On January 1, 2011, the first baby boomer will turn 65. Whether we grow old sick, frail, and dependent - or vital, active, and productive - will depend on our ability to dramatically alter the orientation, strategies, skills, and financial incentives of our current healthcare system. And so, while we’re focusing now on the coverage and financing of our damaged healthcare system, we should also focus on re-visioning healthcare’s purpose – to create long-lived, productive and healthy men and women. Ken Dychtwald, PhD is the President & CEO of Age Wave. He is a psychologist, gerontologist and bestselling author of fifteen books on aging-related issues.

GRAND Magazine - July 2009

Table of Contents for the Digital Edition of GRAND Magazine - July 2009