The Journal of the American Geriatrics Society recently released a special issue entitled Workforce for Seriously Ill Older Adults in the Community. Diane Schweitzer, interim program director for the Patient Care Program at the Moore Foundation and Sutep Laohavanich, program officer for patient care at the Moore Foundation, penned an introduction to the special issue, providing their perspective on this topic.
Gordon and Betty Moore Foundation Special Issue Introduction
By Diane L. Schweitzer MPPM and Sutep Laohavanich, MSG
Strengthening the workforce is a critical component to delivering high‐quality, community‐based care for people living with serious illness. Our country faces an aging population; people are living longer and with more chronic conditions. Those people living with multiple chronic illnesses and in need of assistance with activities of daily living, such as eating and bathing, may be balancing multiple healthcare providers, medications, medical devices, appointments, and complex organizational tasks, with or without assistance. Nearly 90% of people aged 65 years or older want to stay in their home for as long as possible, and 80% believe their current residence is where they will always live. To provide high‐quality care to this population, the health and social systems must have the workforce capabilities and capacity to support serious illness care in the community.
To help catalyze change and to address some of the workforce challenges to providing high‐quality care for these people, the project that produced these articles brought together community‐based serious illness program experts, workforce researchers, and policy specialists to develop recommendations that could accelerate health workforce development in the short‐term (2 to 3 years). The group focused health workforce recommendations in targeted areas and developed an action plan to strengthen the health workforce, providing serious illness care in the community. Participants considered the barriers to implementing change as well as the required incentives to encourage substantial progress — all with the goal of encouraging coordinated action.
The health workforce that provides care for high‐need individuals includes not only licensed healthcare professionals, such as physicians and nurses, but also nonlicensed direct care team members who support patients in the home, such as home health aides and personal care aides. These direct care workers provide essential services of daily living in the home, including assistance with dressing and meal preparation. Informal unpaid caregivers, often family members, are vital members of the health workforce providing direct care and support. In recent estimates, more than 34 million Americans have provided unpaid care to an adult aged 50 years or older in 2015.
The care provided by this team enables individuals with serious illness to maintain a level of independence, living safely at home and in the community, whereas the alternative may be institutionalization in a skilled nursing facility that may be costlier and may be a less desirable setting than one's home.
The Gordon and Betty Moore Foundation is pleased to support this special issue of the Journal of the American Geriatrics Society. We extend our deep appreciation to the team at the University of California, San Francisco, Healthforce Center, particularly Dr Joanne Spetz, who spearheaded this work, along with the authors of the articles and the participants in the May 2018 Workforce Summit on Ensuring a Workforce to Care for People With Serious Illness in the Community. We hope the insights and practical tools provided within these articles both help and inspire healthcare professionals to move toward a future when all those living with serious illness experience the high‐quality care they need and deserve in their communities.