A Review of Demographic and Infrastructural Factors and Potential Solutions to the Physician and Nursing Shortage Predicted to Impact the Growing US Elderly Population

Cohen, Steven A.

doi:10.1097/phh.0b013e31819d817d

Cited by 59 publications

(34 citation statements)

References 38 publications

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“…Technological advances, such as the development of biomarkers for the early detection of pathological changes in the brain, may aid in the proper diagnosis of AD within diverse populations, while a greater understanding of certain patient and caregiver attitudes toward dementia may facilitate care. Given the shortage of primary care physicians (PCPs) in the U.S., especially for the elderly, 14 bridging ethnoracial disparities in dementia will depend upon interdisciplinary efforts between PCPs, nurses, neurologists, psychiatrists, and others.…”

Section: Introductionmentioning

confidence: 99%

Diversity and Disparity in Dementia

Chin

Negash

Hamilton

2011

Alzheimer Disease &Amp; Associated Disorders

333

200

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Debate exists regarding differences in the prevalence of Alzheimer’s disease (AD) in African Americans and Hispanics in the United States, with some evidence suggesting that the prevalence of AD may be considerably higher in these groups than in non-Hispanic whites. Despite this possible disparity, patients of minority ethnoracial groups often receive delayed diagnosis or inadequate treatment for dementia. This review investigates these disparities by conceptualizing the dementia disease process as a product of both biological and cultural factors. Ethnoracial differences in biological risk factors, such as genetics and cardiovascular disease, may help to explain disparities in the incidence and prevalence of AD, while race-specific cultural factors may impact diagnosis and treatment. Cultural factors include differences in perceptions about what is normal aging and what is not, lack of adequate access to medical care, and issues of trust between minority groups and the medical establishment. The diagnosis of AD in diverse populations may also be complicated by racial biases inherent in cognitive screening tools widely used by clinicians, but controlling for literacy level or using savings scores in psychometric analyses has the potential to mitigate these biases. We also suggest that emerging biomarker-based diagnostic tools may be useful in further characterizing diverse populations with AD. Recognizing the gap in communication that exists between minority communities and the medical research community, we propose that education and outreach are a critical next step in the effort to understand AD as it relates to diverse populations.

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Section: Introductionmentioning

confidence: 99%

Diversity and Disparity in Dementia

Chin

Negash

Hamilton

2011

Alzheimer Disease &Amp; Associated Disorders

333

200

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“…Predictions for those over the age of 65 as a percentage of the total population for eight countries in the year 2020 are: Australia, 16.8%; Canada, 18.2%; France, 20.1%; Germany, 21.6%; Japan, 26.2%; New Zealand, 15.6%; United Kingdom, 19.8%; United States, 16.6%[2]. One challenge of this population aging phenomenon is the expected shortage of gerontological health care workers as the workforce ages with the general population[3,4]. Another challenge is the certain rise in health care costs as the baby boomer cohort enters old age.…”

Section: Introductionmentioning

confidence: 99%

Older adults' satisfaction with a medication dispensing device in home care

Reeder

Demiris

Marek

2013

Informatics for Health and Social Care

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Introduction Older adults with multiple chronic conditions face the complex task of medication management involving multiple medications of varying doses at different times. Advances in telehealth technologies have resulted in home-based devices for medication management and health monitoring of older adults. We examined older adults’ perceptions of a telehealth medication dispensing device as part of a clinical trial involving home health care clients, nurse coordination and use of the medication dispensing device. Methods Ninety-six frail older adult participants who used the medication dispensing device for 12 months completed a satisfaction survey related to perceived usefulness and reliability. Results were analyzed and grouped by themes in the following areas: Ease of Use, Reliability, Medication Management Assistance, Routine Task Performance and Acceptability. Results Nearly all participants perceived the medication dispensing device as very easy to use, very reliable and helpful in management of their medications. Eighty-four percent of participants expressed a desire to use the machine in the future. Conclusion The technology-enhanced medication management device in this study is an acceptable tool for older adults to manage medication in collaboration with home care nurses. Improved usability and cost models for medication dispensers are areas for future research. Trial Registration clinicaltrials.gov identifier: NCT01321853

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“…Healthcare costs continue to rise as medical care becomes more complex and the burden of disease shifts toward chronic illnesses 4. The current nursing shortage5 and a projected physician shortage6 fuel the search for lay professionals who can deliver and coordinate care effectively. A recent focus on racial and ethnic disparities in health outcomes has also motivated novel methods of serving disadvantaged populations 1.…”

Section: Introductionmentioning

confidence: 99%

Role Development of Community Health Workers

O’Brien¹,

Squires

Bixby

et al. 2009

American Journal of Preventive Medicine

134

102

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Background Research evaluating community health worker (CHW) programs inherently involves these natural community leaders in the research process, and often represents community-based participatory research (CBPR). Interpreting the results of CHW intervention studies and replicating their findings requires knowledge of how CHWs are selected and trained. Methods A summative content analysis was performed to evaluate the description of CHW selection and training in the existing literature. First-level coding focused on contextual information about CHW programs. Second-level coding identified themes related to the selection and training of CHWs. Results There was inconsistent reporting of selection and training processes for CHWs in the existing literature. Common selection criteria included personal qualities desired of CHWs. Training processes for CHWs were more frequently reported. Wide variation in the length and content of CHW training exists in the reviewed studies. A conceptual model is presented for the role development of CHWs based on the results of this review, which is intended to guide future reporting of CHW programs in the intervention literature. Conclusions Consistent reporting of CHW selection and training will allow consumers of intervention research to better interpret study findings. A standard approach to reporting selection and training processes will also more effectively guide the design and implementation of future CHW programs. All community-based researchers must find a balance between describing the research process and reporting more traditional scientific content. The current conceptual model provides a guide for standard reporting in the CHW literature.

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A Review of Demographic and Infrastructural Factors and Potential Solutions to the Physician and Nursing Shortage Predicted to Impact the Growing US Elderly Population

Cited by 59 publications

References 38 publications

Diversity and Disparity in Dementia

Diversity and Disparity in Dementia

Older adults' satisfaction with a medication dispensing device in home care

Role Development of Community Health Workers

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