Geriatrics, like pediatrics, provides care for a specific demographic.
But the care for older adults – unlike the care for children – does not attract many students looking to enter the health care workforce.
“Working with frail, older people with multiple medical conditions … is not an area of care that most people would dream about,” said Phillip G. Clark, professor and director of the gerontology program at the University of Rhode Island.
“The general pattern and projections are that we need a huge amount of people trained in this area and we’re not keeping up,” he added.
On average, 10,000 Americans turn 65 every day. That’s a trend expected to continue for the next 12 years, according to Clark. Meanwhile, adults 85 and older typically have the greatest health care needs. Rhode Island has one of the highest percentage of adults aged 85 years and older in the country.
“This is kind of urgent,” Clark said. “I’m almost 70 years old, so I also have a personal sense of urgency. Before I get to the point where I need help, I want to make sure there are qualified people there I trained.”
Four of the top eight fastest-growing occupations in the Ocean State are related to health care, according to workforce projections put together by the R.I. Department of Labor and Training, and the projected demand is largely driven by an aging populace, Clark said.
While the future workforce demand is clear, however, whether it will be filled with trained individuals is not.
“There’s not an easy solution to this,” Clark said. “There are different approaches, but there’s a lot of ageism in the preparation of health care professionals, which reflects a broader ageism in our society.”
Geriatricians, too, are more often paid less than other traditional family medicine physicians and much less than specialty doctors.
The state a couple years ago received a $2.5 million, three-year grant that was extended for a fourth year to study the issue.
“Part of the challenge is to reach out to students who are thinking about going into a health profession early on and to expose them to working with older people in an effective way,” Clark said.
As part of his introduction-to-gerontology class, Clark has a fieldwork requirement for students to go into Rhode Island communities and work with older adults. The requirement, he said, is having a positive impact on students and the state’s older population.
“Students leave the class saying, ‘I never realized this was going to be such an interesting area’ ” of care, Clark said.
Health care entities working with URI largely agree.
“It absolutely has been a win-win,” said Dottie Santagata, administrator of Cornerstone Adult Services Inc. in Warwick.
About two dozen URI students have partnered with the adult-services nonprofit, which is part of the Saint Elizabeth Community network of adult services and care in Rhode Island. Cornerstone runs a nationally recognized program for individuals with memory loss called “Opening Minds through Art.”
The program partners students with program participants to create abstract art. Through two, 10-week sessions the results have been remarkable, Santagata said.
“[Students] see that they do enjoy working with this population,” Santagata said.
She remembers back to her days as an undergraduate student at URI.
“Most of the classes focused on youth and children and there were very few classes and internship opportunities with older people,” she said.
“What we’re finding through this program is that some URI students have approached us looking for additional internships and employment opportunities with us,” Santagata added.
The rapidly growing gap between the increasing number of older adults and the scant number of providers specializing in geriatric care is nonetheless far from closing. In Rhode Island, there are fewer geriatricians today than there were five and 10 years ago, according to Clark, marking a trend that will only exacerbate the growing problem.
Additionally, while other providers might have some experience caring for older adults, it’s most likely minimal at best.
“Most health care providers have zero training in geriatrics and that’s very frightening,” Clark said.
Clark isn’t entirely certain why the looming issue isn’t talked about more often, saying “people are vaguely aware.” But he suspects the national debate surrounding health care in general has pushed any awareness or discussion about geriatric care to the sidelines.
“There’s so much chaos in the health care system,” Clark said. “It’s kind of hard to say, ‘Here’s one more issue that you need to be concerned about.’ ”