SON: Connections - Winter 2003

Headlines | Briefly | From the Deans Desk

Care will be community-based in 2032
By Heather Young

Glen Hiemstra envisions a future dominated by a variant on hospital based care. I suggest that by 2032 the system will have evolved more towards community based care and application of technology in those settings. Compelling demographic and philosophical trends will drive this change. In the 2000 U.S. Census projections, two important factors were highlighted: the dependency ratio and the growth of minority elders. The dependency ratio, which grew from 9.1 older adults per 100 workers in 1930 to 20.5 per 100 in 2000, is projected to grow to 35.7 by 2030. This will create a functional scarcity among younger generations, with higher demands on fewer for informal caregiving, and with proportionately lower social security benefits. A good many 55-year-old adults will be involved in the lives of both their grandparents and grandchildren.

Between 2000 and 2030, the percentage of elders will increase by 328 percent for Hispanics, 285 percent for Asian and Pacific Islanders, 147 percent for American Indians and Aleuts, and 131 percent for African Americans, compared to 81 percent for Caucasians. The need for cultural competence in services for older adults, multilingual fluency and the use of technological advances for translation will grow concomitantly.

The consumer-directed care movement already has momentum in community settings. By 2030, it will have evolved so that individuals (not ‘patients’) and their families will be monitoring their own health parameters. In community settings, nurses will be vital resources to the health-care team led by the consumer, and will coordinate, teach, and partner with assistants and kin to provide direct support for consumer health and life goals.

Heather Young is director of the de Tornyay Center on Healthy Aging and research associate professor of Biobehavioral Nursing and Health Systems.

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