Healthcare Disparities Between Older and Younger Adults Megan Coral

The Research Study Find gaps in treatment Identify obstacles Understand how professionals become interested in older adults (OA) Secret to increasing student interest

Rationale May 2007 Increase in the number of OA Unique perspective in medical care

Methods Survey 11 Professional Key Informants Synthesized data

Key Informants Physical Therapy Professors (3) Kinesiology Professors (2) Pharmacy Professors (2) Communicative Disorders Professor (1) Community Geriatrician [MD] (1) Human Development [Gerontologist] (1) Geriatric Nursing Professor (1)

Research Objectives To better understand the dimensions of healthcare disparities between younger and older adults, as identified by a sample of health professionals. To develop an understanding of how the healthcare system can be improved to better meet the needs of older adults.

Survey Instrument Domains of Inquiry: Attitudes about OA and professionals Service and training models Gaps in healthcare Favorite part of OA Students Obstacles

Results Interest in OA comes from Family School Job setting Volunteering

Quotes from the Interview “I was exposed to the subject (of older adults) as an undergraduate at the University of Colorado by a very dynamic teacher and have been interested ever since.” - Communicative Disorders Professor “As a child I spent most of my time with older relatives and I always enjoyed hearing their stories”- Geriatric Nursing Professor

Quotes from the Interview “As a pharmacist I have had the greatest impact helping older adults manage their medicine than with any other patient group and I think that is a very fulfilling feeling when you have prevented a potentially fatal problem that maybe a younger adult would have survived.” - Pharmacy Professor

Results Experience improves service Misconceptions Half: No Half: Minor Able to resolve through experience

Quotes from the Interview “I learn new things all the time from my older patients. Not only do I teach them, but they teach me something new everyday.” - Physical Therapy Professor “I had some minor misconceptions as an undergrad until I started working with older adults and realized that personality remains the same throughout life.” - Physical Therapy Professor

Results Training models based on YA Nonspecific attitudes Most agreed there is a gap Range of personal examples

Quotes from the Interview “There was no attitude about older adults, it just was not a topic.” - Pharmacy Professor “[The school I attended] did not have geriatrics courses. It was not much of a field back then.”- Community Geriatrician

Quotes from the Interview “Yes, physicians spend less time with older adults than [with] younger adults during office time and nurses spend less time [with older adults] in the hospital than [with] younger adults on an individual basis.” -Geriatric Nursing Professor “Younger adults get more aggressive treatment than older adults.” - Community Geriatrician

Supporting Research Banjeri, etal. (2006). -Bronchodilator study. Wittink, etal. (2006). -Exercise for YA & OA. Resnick. (2000). -Testing OA

Results Favorite part of OA Stories Wisdom Personalities Motivation to be healthy Diversity All they have to offer

Quotes from the Interview “When an older person dies it is like a library burning down.”- Human Development Professor “Everyone is unique- an individual puzzle of communication deficits to solve with the person. There is also a rich history of experiences.” - Communicative Disorders Professor

Quotes from the Interview “Older adults are enthusiastic and wonderful research participants.” - Kinesiology Professor “Older adults are interested in the health aspect, listen more, and try more [than younger adults].” - Kinesiology Professor

Results Students not interested in OA Ways to increase interest Experience with OA Service learning Positive interactions

Information from the Interview Geriatric Nursing Professor’s study. Pharmacy Professor has students confront stereotypes of OA.

Supporting Research Angiullo, etal. (1996). Student experience with OA.

Results Major obstacles in healthcare system Complexity Doctors Insurance Paperwork Doctors Lack of training Questions

Quotes from the Interview “The government makes it so difficult to apply for Medicare for older adults.” - Physical Therapy Professor “As the demand goes up I’m not sure what will happen to quality. Standards need to be set.” - Communicative Disorders Professor

Supporting Research Warshaw, etal. (2003). Geriatric education for med students American Geriatrics Society. (2008). ~7,600

Results Transfer of care Lack of awareness about availability Loss of information Lack of awareness about availability University Preventative care Reluctance

Quotes from the Interview “The most amount of money is spent on older adults in the last six months of life.” - Pharmacy Professor “Older adults need to be advocates for themselves, talk more openly, and question physicians.” - Geriatric Nursing Professor

Results Projected increase Gap widen Economy Presidential administration Increased demand Decrease in service Healthier lives

Quotes from the Interview “With the economy the way it is the gap is widening. The money won’t be there. Hopefully the president changes healthcare.”- Kinesiology Professor

Closing the gap Education Advocacy Awareness Funding Research Multidisciplinary teams

Benefits from the research experience Demand for service How to conduct an interview How to direct conversation Improving the healthcare system Increasing interest Increasing awareness

Value of Qualitative Interview Flexibility Change structure if necessary Personal interaction Deeper information

Future Directions Gap in healthcare Train upcoming professionals Encourage interest OA Find ways to advocate for OA

Dedication: To RR, JM, BM, EW, MC, LC, JM, and JM: all the older adults in my life and everywhere who deserve the best healthcare treatment available. Thank you Key Informants Thank you Dr. Fey-Yensan