BY: JULIE TROCCHIO, RN, M.S.
Changin' Times
One of the most popular songs of the mid-1960s was Bob Dylan's classic, "The Times They Are A-Changin'." The song was a reflection of the times — the Kennedy assassination, the Vietnam War, the Beatles, the civil rights movement, the Cold War, and so on.
The 1960s also marked the time when the baby boomers (people born between 1946 and 1964) started graduating from high school. Today, Dylan's song rings true for baby boomers, which is the largest population group in U.S. history at 80 million people, according to the U.S. Census Bureau. The first wave of this generation (3.2 million) turned 60 years old in 2006 and will be eligible to receive Social Security benefits for the first time this year, according to the bureau.
Defined by experts as the "silver tsunami" for this generation's indisputable impact on society, baby boomers are starting to have a profound influence in the fields of aging and long-term care services. In this era of change, the following trends will have implications for Catholic health care providers:
Changing Expectations
"Rising seniors" hold different values and preferences from persons who received long-term care in the past. They are likely to want their own room, and demand more say in the care. They may not want to live in isolated conclaves with other seniors.
Changing Needs
As the life span of Americans increases, chronic illness has become the leading factor in health care spending, hospitalizations, morbidity and mortality. New models of chronic disease management may replace the current primary/acute care system of care.
Changing Workforce
Retirement is being postponed for much of the older population in this country. This is happening because of economic necessity, sustained vitality and continued interest in work. Older workers can fill vital needs in health care, but also raise issues for health care employers.
Changing Long-Term Care Culture
The culture change movement in long-term care has moved from the "pioneers" to "settlers." A long-term care facility that has not embraced "resident/patient centered care" will find itself behind the times.
Changing Technology
Technology borrowed from other fields, including aerospace, is being applied to institutional and home-based care with great success. Home monitoring and prompting systems will allow many older people to remain longer in their homes and telemedicine is changing the face of home care, especially in rural areas of the country.
The Changing Continuum
Health care leaders have talked about a continuum of care for many years, but work being done by Medicare and Medicaid agencies and other insurers is poised to make it really happen.
Special Needs Plans, a private-managed care option to traditional Medicare, along with the Program of All-Inclusive Care for the Elderly (PACE) and new payment demonstrations are bundling costs in a way that demands a full continuum of services, from low acuity to high, low cost to high.
Changing Sources and Sites of Care
Home and community-based long-term care is outpacing institutional long-term care. Another change is the growing involvement of churches and other religious congregations in parish nurse and wellness programs. When will long-term care and senior services be provided in the future? Wherever older people are!
So, the times are a-changin'. Catholic health care will be shifting too. In this issue, Health Progress describes the challenges and opportunities facing us today and in the years ahead, and showcases some of the innovations within our ministry.
— Julie Trocchio, senior director, continuing care ministries, Catholic Health Association, Washington, D.C.