This literature review seeks to analyze primary vs secondary sources of evidence concerning actualizing better health and healthcare access for American older adults. Notably, the share of the US residents over 65 years old is quickly expanding, with the cohort over 85 years old, known as the “oldest old,” experiencing the fastest growth (Hand et al., 2020). People who live to be older in America, are confronted with a complex set of competing factors that will result in a longer healthy life for some and significant increases in frailty and impairment for others. Modern medical improvements will undoubtedly continue, but as disabling diseases build in aged bodies, it is likely that ongoing success in combating deadly illnesses may uncover the spared residents to a higher danger of frailty and impairment (Tinetti et al., 2019). The rapid growth in the number of older individuals in the population, which reflects the aging of American society, is the result of two significant demographic occasions: the considerable rise in life expectancy and the baby boom. At the community level, this population change will put a lot of strain on America’s already-fragile healthcare, public health, and other services for the elderly (Hand et al., 2020). Although past advances in life expectancy have been impressive, the news in America is not as encouraging.
However, the Medicare policy has universal cover for almost everyone aged 65 and over, which is a significant victory for older Americans (Canham et al., 2020). When Medicare was first created in 1965, only about half of the elderly population had hospital cover, and ageing households were significantly less adequately covered than younger households. Although the focus is now rightfully on future beneficiary expansion, Medicare has previously effectively absorbed an expanding number of individuals it supports in the past three decades.
The healthcare demands of older persons with various chronic illnesses, which account for the bulk of Medicare costs, are insufficiently met. For America to attain higher-value healthcare, effective administration that involves the elderly, family nurses, and physicians in collaboratively determining patients’ desires and objectives, as well as the implementation of tailored care plans, is critical (Canham et al., 2020). Although there are evidence-based approaches to care management, most models have had irregular and delayed adoption. Many excellent techniques to improving the delivery of care for older people have been created; nevertheless, challenges with transmission and implementation, frequently due to a lack of funds, have arisen. According to Hand et al. (2020), the existing and projected future insufficiency of the US labor force, comprising both the sum of employees and the quality of their preparation, are significant impediments to the American healthcare system’s ability to provide desirable high-quality services to the expanding elderly figures.
There is a distressing scarcity of appropriately skilled geriatricians, caregivers, social laborers, and community well-being experts in the US. The expected sum of board-certified geriatricians is 7,500, which is less than half of what is required, and the number of geriatricians in training is woefully insufficient (Tinetti et al., 2019). The reasons are numerous, but one major constraint is the significant financial disadvantage that geriatricians face. Internists or family clinicians who complete extra training to become geriatricians might assume significant revenue reductions despite their increased competence if they work under fee-for-service structures, which remain to dominate healthcare payment.
Canham, S. L., Custodio, K., Mauboules, C., Good, C., & Bosma, H. (2020). Health and psychosocial needs of older adults who are experiencing homelessness following hospital discharge. The Gerontologist, 60(4), 715-724. https://academic.oup.com/gerontologist/article-abstract/60/4/715/5522096
Hand, B. N., Angell, A. M., Harris, L., & Carpenter, L. A. (2020). Prevalence of physical and mental health conditions in Medicare-enrolled, autistic older adults. Autism, 24(3), 755-764. https://journals.sagepub.com/doi/abs/10.1177/1362361319890793
Tinetti, M., Dindo, L., Smith, C. D., Blaum, C., Costello, D., Ouellet, G., … & Naik, A. (2019). Challenges and strategies in patients’ health priorities-aligned decision-making for older adults with multiple chronic conditions. PLoS One, 14(6), e0218249. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0218249