December 30, 2010

BIRMINGHAM, Ala., -- The start of the new year marks yet another milestone for America's Baby  Boom generation, one they are not likely to welcome. The first of the baby boomers turn 65 in 2011.  The boomers are getting old.

And the rest of the 76 million Americans are charging hard after this first batch. It has been dubbed the Silver Tsunami. The number of people age 65 and older will double between 2010 and 2050, with the number of those 85 and older increasing four fold. The question is, will the country be ready to meet the extraordinary medical and social needs that the boomers will require?

The answer, according to geriatric experts at the University of Alabama at Birmingham, is no. As time passes and the boomers continue to age, they will need specialized geriatric care from specialized health care professionals in specialized facilities.

"National estimates cite approximately 7,000 geriatricians currently certified to care for the rapidly growing boomer population," said Richard Allman, M.D., professor and director of the UAB Division of Gerontology, Geriatrics and Palliative Care. "Yet our society will need more than 20,000 geriatricians to accommodate the increasing demand for specialized care."

And it's not just doctors. Allman, who is also director of the Birmingham/Atlanta Veterans Administration Geriatric Research, Education and Clinical Center (GRECC) and the UAB Center for Aging, says the need for specialized caregivers for geriatrics extends beyond physicians to include nurses, therapists, dietitians, social workers and community caregivers.

"Doctors alone don't deliver geriatric care," Allman says. "You've got to have a team to optimize the quality of life for older people. We're recruiting students who are dentists, physical and occupational therapists, nurses, optometrists, psychologists and a number of other disciplines."

And these are the boomers we're talking about - traditional models of old age just aren't going to cut it. Andrew Duxbury, M.D., a UAB geriatrician, suggests that the average boomer who reaches 65 in reasonable health will live into their 80's or early 90's, and more importantly, remain healthy and active well into their 80's.

"The boomers have always gotten what they want when they want it, with the demographic numbers to push society to accede to their demands," he says. "They are not a generation to sit back and let history roll over them. They'll go out and make their own history."

He suggests that demand for such things as joint replacements, medications to improve aches and pains of aging and bypassing of clogged arteries will all skyrocket. Duxbury says the boomers will want the system to work around them and their active life styles and will not put up with all-day visits to the doctor. They won't be sitting around playing shuffle board at the retirement center.

"The boomers, with their health and vitality relatively intact into older age, will completely change how Americans conceive of what it means to be old," Duxbury points out. "In twenty years, Cher, still looking the same as today, will be on her 10th farewell tour, your average senior citizen's dance will have couples getting down to the Rolling Stones and 80-somethings will be riding their Harleys at Sturgis."

Allman says there is no public policy issue of greater importance than aging, nor one that is more ignored.

"We face institutional and cultural age-ism, and people don't want to talk about it," he says. "They think of aging as dying and not living. We've got to change the culture and get people embracing the fact that aging is a good thing. If you're aging, you're still alive, and we really want to emphasize that people can live with high levels of function and capability. The more well-trained geriatricians we have, the more possible it is to make this a reality."

Allman says there is work to be done in other fields besides medicine. Architects and engineers will need to design products, buildings and transportation facilities that are appropriate for an aged society. Educators will need to plan how to train people in mid career to do new tasks and use new technology in order to be affective workers. Businesses are going to need older workers to keep their enterprises going.

"We need public policy experts who know the impact of changing policy on health care costs, Social Security and retirement plans," he says. "We need sociologists who understand the risk of intergenerational conflict and psychologists engaged in aging work. And clearly we need optometrists and dentists and therapists and medical people in every discipline."

We need them now, and we'll continue to need them for a while.

"The last boomer will not die until sometime around 2080" says Duxbury. "They will be with us a long time."

 About UAB

Known for its innovative and interdisciplinary approach to education at both the graduate and undergraduate levels, the University of Alabama at Birmingham is the state of Alabama's largest employer and an internationally renowned research university and academic health center whose professional schools and specialty patient care programs are consistently ranked as among the nation's top 50; find more information at www.uab.edu and www.uabmedicine.org.

Challenges facing the "silver tsunami"

• The first of the baby boomers turn 65 in 2011; 76 million Americans were born between 1945 and 1964
• The number of people 65 and older will double between 2010 and 2050
• The number of people 85 and older will increase four fold
• Many boomers will active lives well into their 80s and 90s
• There are 7,000 geriatrician; 20,000 will be needed
• Nurses, physical therapists, dentists and other health professions are sorely needed
• Medications and procedures that improve or prolong life will skyrocket