Although the media is dominated by topics surrounding Gen Z and the upcoming Gen Alpha, America’s population is getting older. According to a 2020 report by the Administration on Aging, 1 in 6 people (55.7 million) in the US is 65 or older. This is projected to increase to 80.8 million by 2040. However, resources dedicated to serving this growing population are scarce, and health care systems are becoming increasingly difficult for older adults and their families to navigate.
What changes can we make—at the individual, community, and policy level—to improve this issue? That’s what health care experts gathered to discuss at Fordham’s Lincoln Center campus on Monday, March 11. Over 100 professionals in the aging field attended the conference, titled “A Vision for Aging: New Directions for the Future,” and organized by the Fordham University Graduate School of Social Service’s Henry C. Ravazzin Center on Aging and Intergenerational Studies.
Dr. Janna Heyman, Professor and Director of the Ravazzin Center, welcomed the participants and underscored that it is critical to promote the dignity and well-being of older adults and their families. Heyman said the future service delivery system needs to promote justice, access, affordability, and equity and focus on improving older adults’ health and well-being, nutrition, financial, housing, and care needs.
Modern Health Care Struggles and Solutions
The COVID-19 pandemic exacerbated health care issues for older adults, said Thomas V. Caprio, MD, of the University of Rochester’s Medical Center and the conference’s keynote speaker. He described the universal challenges of aging as including:
- Chronic Illness
- Isolation and Vulnerability
- Disability (loss of function – physical, cognitive, and social)
Caprio introduced the audience to “Beverly,” an 87-year-old patient of his whose name and details had been changed for privacy reasons. Although Beverly lives on her own, Caprio explained, the past few years have taken a toll on her physical and mental health: she suffers from frequent falls, forgets to take her prescribed medication, and has been socially isolated since the start of the COVID-19 pandemic. On top of this, Beverly had seen five primary care physicians over the past four years, resulting in missed appointments and fragmented treatment.
Thomas Caprio
Sadly, Caprio said, this siloed approach to health care has become the norm. He added that along with its problematic fragmentation, the current health care system is often inconsistent and difficult to understand and navigate. Although these issues are heightened for older adults, they impact everyone.
Caprio sees a better future for the system — one centered around evidence-based practice, safety, quality, and consistency. And this work has already begun by implementing “Age-Friendly Health Systems” (AFHS).
“Evidence-based geriatric care is effective,” Caprio said. “We’re trying to look for this kind of consistency and care that can be disseminated across all healthcare systems.”
The AFHS process consists of the “four Ms,” Caprio said: What Matters, Mobility, Medication, and Mentation. They are applied to a patient’s situation with the additional context of other Social Determinants of Health (SDOH) and the surrounding community dynamic. Health care organizations can apply to become AFHS certified to show their commitment.
Caprio said leveraging an interdisciplinary team of health care professionals is crucial to ensure quality care in an age-friendly environment. However, the massive work shortage facing the medical profession is a barrier.
“I don’t think a day goes by where I don’t hear people say, ‘We don’t have enough staff,’” he said. “How do we make this an attractive area of practice, and how do we build that workforce?”
Caprio thinks it all begins with community. Providing a space where employees are valued and feel a genuine connection to the work and one another is an important first step.
“Having the sense about professional community as part of interprofessional practice is the key,” Caprio said. “People who feel valued and are working toward a shared goal brings back the heart in what we do.”
Anderson Torres
Anderson Torres, President and CEO of RAIN Total Care, Inc., also underscored the importance of community. He presented innovative practices at RAIN, and how organizations like his rely on intergenerational partnerships to bridge the divide. Torres noted that RAIN partners not only with organizations like AARP, but also local arts organizations to bring generations together over shared passions. One modality was an art show in partnership with Millenium Art Academy in the Bronx.
“We paired the older adults with designers,” he said. “You need to keep your [finger on the]pulse of the community.”
The Future of Aging
Speakers throughout the day reiterated the dilemma Caprio introduced: our older population is growing, but the workforce supporting them through old age isn’t. James O’Neal, President of AARP-NY, moderated a panel on the issue.
“In 2021, there were seven able-bodied adults for every older adult who needed care,” said Beth Finkle, State Director at AARP-NY. “By 2030, it is projected to be four. By 2050, three. And these numbers aren’t just those working in health care, but able-bodied adults in general.”
Beth Finkle
That inequality will put an increased strain on an already-struggling health care system, Finkle said. Additionally, biotech companies with longevity drug and treatment promises are finding ways to help people live longer. This is a good thing — considering America’s 50+ population’s GDP is currently the third largest in the world — but academic institutions and professional organizations need to spur interest from the younger generation to work in this field so economies can continue to benefit.
“Companies and organizations will need to service more generations at once than ever before,” Finkle said. “Sixty million Americans are living with two or more generations right now.”
Julio Urbina
Julio Urbina, Director of the Healthy Aging Program at the Fan Fox & Leslie R. Samuels Foundation, said reframing how we talk about and see aging can have transformative impacts on the field.
“Older adults are not a ‘silver tsunami.’ They are not a burden,” he said. “I think of all the potential in this room that could and is being tapped to make for a better community and country.”
Along with this new perspective, policies like loan forgiveness programs and salary realignment could also be implemented as incentives to attract workers, said Jackie Berman, deputy assistant of research at the NYC Department for the Aging. She also highlighted data outcomes as drivers for additional investment from state and federal infrastructures.
Jackie Berman
“Testimonials are good, but we need hard numbers for funding,” Berman said. “We need outcome indicators—not just how many people do we serve, but how does it impact their lives?”
Furthermore, as the White House prepares for its 2025 Conference on Aging, these issues need to be top-of-mind, said Robert Blancato, president of Matz, Blancato and Associates, and the power should be with those delivering the work.
Blancato explained that there are many new and innovative approaches to follow, and one area that can be shaped now is caregiving.
Bob Blancato
“The future of aging must be about supporting caregivers, especially family and informal caregivers,” he said. “We have a great opportunity with legislation pending in Washington to extend and expand the National Family Caregivers Support Program and to adopt a family caregiver tax credit.”
Blancato noted that change is essential and “The future of aging is everyone in this room,” emphasizing social workers’ role in the workforce.
“Social workers are the key to the future of aging policy in this country,” he said.
