Age-Old Problem as Americans Grow Older, the Number of Medical Specialists Lags Behind

Article excerpt

Byline: Warren Wolfe Minneapolis Star Tribune

By day, Hanaa al-Khansa is a fourth-year medical student at the University of Minnesota, hoping to practice family and pediatric medicine.

But on evenings, weekends and holidays, she's part of a small but significant experiment that could ease the widening gap between the needs of America's increasing population of elders and the supply of specialists who serve them.

She and her husband live amid people in their 80s, 90s and 100s at Augustana Apartments in Minneapolis. Recently, she walked the halls, delivering holiday treats. It was a way to check on frail neighbors and to master subtle lessons of aging that will help her be a better physician.

"You learn to listen with a different ear, to ask about problems in terms of daily life not 'How is your gait?' but 'Did you get to the grocery store today?'" said al-Khansa, 26, whose family emigrated to Duluth, Minn., from Malaysia a decade ago.

The leading edge of baby boomers is about to turn 65, eligible for Medicare, the federal health care program for the aged. Nationwide, for the next 18 years, about 10,000 more boomers will join them each day.

"But we're not ready for them," said Dr. Robert Kane, a physician and nationally known expert who heads the University of Minnesota's Center on Aging. "Doctors, nurses, social workers, psychiatrists, dentists, pharmacists you name a geriatric specialty, and we're short."

The looming consequences are serious. The nation has 7,200 certified geriatricians, one for every 2,500 older Americans. Some experts suggest that five times that many will be needed by 2030, when the country's aging population will have nearly doubled.

Scores of programs in Minnesota and beyond aim to develop specialists to care for the swelling ranks of the aged. Community colleges are training aides to work in nursing homes and home care. The university is training gerontological nurses and nurse practitioners a step between nurses

and physicians.

Professionals with geriatric training can improve older clients' quality of life and lower medical costs by providing appropriate help, experts say.

"But a lot of people seem afraid to work with seniors," said geriatric social worker Christie Cuttell, 36, at Augustana Care Center, across the street from al-Khansa's apartment building.

Most older people remain active and independent, but advancing age brings many chronic health conditions.

"An 85-year-old with heart disease may also have diabetes, respiratory problems, arthritis and maybe the beginning of dementia, with five different doctors and 15 prescriptions," said Thomas Clark, who operates a commission in Virginia that has certified about 2,250 geriatric pharmacists nationwide. …