Will you ever be able to afford to retire? According to the Pew Research Center, 10,000 baby boomers turned 65 today. Roughly the same number will turn 65 tomorrow and the day after that. In fact, it is estimated that over the next decade 10,000 people will turn 65 every single day. That’s because the baby boomer generation represents a huge bulge in the population—76 million people born between 1946 and 1964. When so many baby boomers retire will the medical profession be ready for them?
When Baby Boomers Retire What Do They Want?
As baby boomers retire most want enough money so they don’t have to worry about the basic necessities of life. Many would like to be able to travel or engage in activities that are fun or gratifying.
They also want to be healthy enough to enjoy their retirement. They don’t want to become sidelined by chronic illnesses or the side effects of medications. And everyone wants to avoid dementia that might put them in a nursing home.
The Least Glamorous Specialty: Geriatrics!
Is medicine ready for the boomer bulge? There are not enough physicians specializing in taking care of older people today. That’s largely because primary care such as geriatrics has not been as valued or rewarded as specialties like cardiology, gastroenterology or dermatology have been.
Over the next dozen years the shortage will become more acute. In 2008 one of the country’s most eminent geriatricians, Dr. John Rowe, testified to the Senate that the U.S. health care system is “woefully unprepared” for the impending demand. He went on to say:
“The U.S. health care system is in denial about the impending demands. Little has been done to prepare the health care workforce for the aging of our nation and the current supply and organization of the health care workforce will simply be inadequate to meet the needs of the older adults of the future. For example,
- Today there are only a little more than 7,000 certified geriatricians, a 22 percent decrease from the year 2000. Some expect this number will continue to decline.
- Today, there is only about 1 geriatric psychiatrist for every 11,000 older adults; at current rates of growth, in 2030 there will only be one for every 20,000.
- Less than one percent of nurses, pharmacists, and physician assistants are specialists in geriatrics; less than 4 percent of social workers specialize in aging.
- Health care professionals, including doctors, nurses, social workers, and others receive very little training in caring for the common problems of older adults such as confusion, incontinence, and falls.
- The federal standards for the training of nurse aides and home health aides have not changed since they were mandated over 20 years ago. The state of California, for example, requires more hours than the federal minimum, but has even higher standards for dog groomers, crossing guards, and cosmetologists.
- Informal caregivers, the family and friends of older adults, are also ill-prepared for their significant roles in the care of older patients.”
What’s the Big Deal?
As people grow older their bodies handle drugs differently. Changes in liver and kidney function make many senior citizens more sensitive to potential side effects. As a result, a medication at a dose that was just right for someone at age 50 may not be safe for the same person at 75.
Prescription Drugs And Dementia:
Moreover, there are some medicines that may contribute to dementia. While this is not much of a concern for a 35-year-old individual with plenty of brain reserve, a 65-year-old with emerging health concerns may not have the same resilience.
One reader told of her family’s experience:
“My elderly mother had started falling so often that my siblings and I were seriously considering nursing home care. My brother gathered all her medications and took them to her doctor.
“A review of the meds showed that mom was on six different blood pressure medications. Every time the doctor changed her medication, the old one was not discontinued. Neither her doctor nor the pharmacist had caught this.
“It has now been over a year since mom’s medications were corrected. She is 92 years old. She has not fallen even once since the adjustment to her meds and is still living at home.”
Older people can easily end up on duplicative medications for a range of problems. Here is another reader’s story:
“My husband was in a beautiful, expensive rehab facility after a stroke. After only five days, he was hallucinating and became fearful and combative. I didn’t recognize this person.
“I requested a psychiatrist consultation. He said, ‘Your husband is on NINE different medications! Three would be more than enough.’
“I took my husband home and got rid of everything but his blood pressure meds. Then he got better. My point is: You, or your loved one, must be diligent at all times, and take charge of your care. Ask questions!”
Watch Out, Do Your Homework, Protect Your Loved Ones!
Anticholinergic drugs interfere with the ability of the brain to process information. Acetylcholine is a crucial neurotransmitter. It is essential for adequate cognitive function. It comes as a great surprise to many health professionals (physicians, nurses and pharmacists) to learn how many different kinds of medicines have anticholinergic activity. We have prepared a comprehensive list of anticholinergic drugs at this link.
Many visitors to this website have reported memory problems or confusion associated with anticholinergic drugs. Here is just one:
Ruth in Elkins, West Virginia had a scary experience:
“I ended up in the hospital ‘off my gourd.’ I didn’t even know what had happened until later in the week. I am on several anticholinergic medications such as Elavil (amitriptyline), gabapentin, Benadryl (diphenhydramine or DPH), Vistaril (hydroxyzine), Phenergan (promethazine), Claritin (loratadine), Zantac (ranitidine) and tizanidine.”
Ruth was indeed taking many medications with anticholinergic activity. Her “body burden” was extreme. Gabapentin does not have anticholinergic action, but it too can affect cognitive function. A geriatrician would have likely discovered that Ruth had too many meds on board that could negatively affect brain function.
We have written a comprehensive review on this entire topic in our book Top Screwups. We have included the Beers list of drugs that are inappropriate for people over 65 years of age. We also have our Top 10 Tips to Surviving Old Age. Here are just a few:
- Make sure your doctor likes older people. (This is not a given.)
- Minimize the number of drugs you take
- Beware bad drugs (check out the Beers list!)
- Avoid anticholinergic drugs if possible
Here is a link to Top Screwups. If you are getting close to 65 or have passed that magic number, this book is crucial for your good health. Perhaps you know someone who has already retired. This could protect them from some dangerous drug situations. Share your own story below in the comment section.