“I don’t know that boomers will have a lot of different disease profiles, although we may see more degenerative joint disease and hip and knee replacements,” says David Smith, MD, CMD, president of Geriatric Consultants in Brownwood, Texas. The good news is that centers have already become proficient at treating many conditions—such as dementing illnesses and chronic kidney disease—that boomers will bring with them to long term care.
However, Smith notes, “We will probably see some other issues that have been less common to date.” Hepatitis C, Smith says, will likely be more common in nursing centers when boomers start to use this care setting. He notes, “This is the generation that became sexually active after the pill but before AIDS. At the same time, drug experimentation and use were more common. As a result, they were at risk of Hep C.” He added that those with the highest-risk lifestyles are more likely to need nursing center care sooner.
“Because of their lifestyle and history, they may not have a solid support system to live independently,” he suggests.
In addition to Hepatitis C, nursing centers may possibly see more boomers with mental illness, Smith says. Some state mental hospitals may see nursing centers as an alternative for their aging patients as they develop geriatric syndromes. As a result, nursing centers may need to be prepared to take patients with mental illnesses beyond Alzheimer’s disease and dementia—including schizophrenia, bipolar disorder, anxiety disorders, and substance abuse.
Different Expectations
Whatever their health issues, boomers will expect a different kind of nursing center than their parents. Smith says, “Culture change and resident-centered care will be absolutely essential.” He adds, “Boomers will want to be active in and in control of their care. They are more likely to ask questions and make their concerns and interests known.”
Younger generations also will have an impact on boomer care, says Smith. “They tend to be less mission-oriented and generally don’t have the same level of family cohesion.” This will make it less likely and/or practical for younger people to keep aging relatives in their homes and provide support. However, he stresses that family connections are driven by region, ethnicity, and other factors, and all of these must be taken into consideration.
A Perfect Storm
Creating a perfect storm of challenges, Smith notes, is that more people will require public funding for care and the pressure on the system will mean fewer benefits. “The bus isn’t in the depot yet, but we need to be thinking about it and preparing,” he says. “We need to be prepared to discuss costs.” Patients increasingly will want to know what various treatments involve, how they might be beneficial and contribute to positive outcomes, and what they will cost.
Moving forward, boomers are likely to drive creativity in care settings. “As facilities reach the end of their architectural life and new facilities are built, I would like to see more pods with a common building for the kitchen, laundry facilities, etc.,” Smith says. At the same time, centers generally will have to do a more effective job of providing meaningful activities, computers and Internet access, and technology in the form of robotic pets and assistive and tracking devices.
Many of the changes that boomers encourage or enable will be positive for everyone. With a better use of technology, for instance, Smith says, “CNAs and others will be able to spend more time and care and less time on reporting and documenting it.”