Fey-Yensan, Nancy [faculty advisor, Department of Human Science and Services]
healthcare; older adults; interviews; professionals
The Centers for Disease Control (CDC) states that within the next few decades, adults aged 65 and older will represent 20% of the US population. As a result, health professionals will see an increase in the number of older patients they treat and as such, must be knowledgeable about the aging process and age-associated issues in order to provide appropriate treatment. Often, older patients do not receive care that is of comparable quality to that provided to younger adults. This original research project was designed to identify perceived barriers to providing appropriate and high quality treatment to older adults and discover strategies that improve care by conducting one-on-one, qualitative interviews with clinical experts representing seven medical disciplines.
Eleven healthcare professionals from the University of Rhode Island specializing in the areas of physical therapy, communicative disorders, nursing, pharmacy, kinesiology, and human development, as well as a geriatrician (MD for older adults) were identified as key informants for this study. Domains related to health care disparities in geriatric care were identified and an open-ended, qualitative survey was developed by the student. There were two objectives for this work: 1) to capture the characteristics of healthcare disparities between younger and older adults and, 2) to show how key informants thought the healthcare system could be improved to meet the healthcare needs of a growing geriatric population. All interviews were tape recorded and lasted between 10 and 60 minutes. The qualitative data were synthesized into common themes.
The current gap in the quality of healthcare that older adults receive particularly from primary care physicians was recognized by the key informants, who also identified some disinterest among their current students in working with this population. One way to change the attitudes of undergraduate students could be to increase the opportunities available to work with older adults. Many of those interviewed said that their own interest in providing care to older adults came from having direct, positive experiences with older adults in their own families, having enthusiastic professors and taking exciting courses about aging, and working directly with older adults. These personal experiences have shaped course requirements for URI students, that is, most of those interviewed require their students to complete service learning projects in a variety of settings with older adults. They hoped that these direct experiences would influence students, so that they would come to enjoy older adults’ wide range of personalities, wisdom, diversity, and high motivation to be healthy – all qualities identified by the key informants as their favorite aspects of working with older adults.
The healthcare system is full of obstacles that prevent older adults from receiving optimal care. Obstacles include the complexity of the system, difficulty understanding insurance reimbursement and benefits, and problems filling out paperwork to be eligible for Medicare or Medicaid. Most primary care physicians are not adequately trained to treat older adults, often do not ask the right questions of older adults to get desired responses, and do not work within effective interdisciplinary teams. The key informants in this study suggest advocating for change to improve care which included expanded and focused training of students to increase knowledge and enrich perceptions about aging patients, increasing funding to study the health-related needs of older adults and increase healthcare access, and shifting the standard of care paradigm to one that is interdisciplinary in nature.