HealthLeaders, an HHL sister publication, recently spoke with Medstar Health elder care directors about what the industry must do to prepare for the influx of an aging population.
 
HL: What needs to be done to prepare for the influx of older adults in the healthcare infrastructure? How can health systems and physicians work with state or federal organizations to prepare for this?
 
George Hennawi, MD: It's important that we start advocating and educating the public, policy-makers, and the media on what's coming. If you ask Americans what some of their concerns are, in older adults, aging is not a concern for them or it's not ranked high as a concern for the country. We should start thinking about the silver tsunami, a term I've heard, and so we should start thinking about this and making it a big part of our public knowledge, public policy advocacy, etc. That's one piece we need to change.
 
Out of the folks that I see as a physician, and I see a lot of patients who want to stay at home, I don't have the support structure to keep them there because they can't afford to stay there. The key issue, from my perspective as a physician, is we need to change the paradigm of long-term care.
 
When we say ''long-term care,'' what we think about is nursing homes, but I think long-term care starts by supporting folks to stay at home when they need that support. Supporting them by having caregivers that are trained, qualified, and well-compensated to take care of them at home in an affordable way. Many people cannot afford caregivers in the home. [We need to] create or support more long-term care insurance that is affordable to everybody, that is easily accessible, that is subsidized for those folks that we care for who don't have much of an income, and that will allow them to tap into this insurance if they need to stay at home.
 
A big part of the message is changing the paradigm of long-term care from a reactive approach—you end up in a nursing home, we'll support you when you run out of money—to putting the investment up front, create bridges that will support you when you need the support so you can live at home for as long as you need to, in the hands of trained caregivers that will care for you. I think that's the paradigm that we're talking about, and today I believe that paradigm is reactive. I think we need to move to a paradigm that will allow people to invest in this early on and stay at home as long as they desire to.