For this segment in our Sense of Community series, Dementia in the Ozarks, we’re looking at the shortage of geriatricians—and what that means for the aging population here in the Ozarks.
As Americans get older, they require more care from professionals to help manage medical issues, including dementia. A geriatrician is a doctor who specializes in treating the health problems of elderly patients.
In Missouri, the number of doctors trained to treat these patients is not growing at the same rate as the population of older adults.
The current pandemic is throwing a curveball by targeting this exact population as high-risk for developing complications from COVID-19, the disease caused by the new coronavirus.
Statistics from the American Geriatrics Society showed the field of age-related health care is in serious trouble when it comes to numbers.
Nationally, the supply of practicing geriatricians is about one-sixth the demand. The Midwest is the hardest hit region by the shortage. According to the Alzheimer’s Association, the number of geriatricians in Missouri needs to increase eight-fold by 2050 to meet the need of an aging population.
Dr. Curtis Schreiber is a neurologist at the Missouri Memory Center in Bolivar. And we want to note that his clinic is part of Citizens Memorial Hospital, which is an underwriter with KSMU.
Schreiber says when patients experience neurological problems, including memory loss, they’re often fighting other problems related to aging at the same time.
The shortage of geriatricians makes it harder for other doctors to care for patients’ needs. An important part of a geriatrician’s job is communicating with other specialists to make sure they’re aware of other conditions that could be causing problems.
“A lot of our patients that have neurological disorders also happen to have other problems. Heart disease, cancer, diabetes, whatever – there’s a broad variety of disorders," Shreiber told KSMU.
"We need more geriatricians. Well, we need more neurologists and other specialists, too, but geriatricians are a great resource for helping manage patients with Alzheimer’s disease, especially when they have other medical conditions that make management more complicated.”
Also, according to the Harvard Medical School, geriatricians are often more aware of harmful effects that medications can have on older people. This is especially important because as people age, they tend to take more medications, and geriatricians understand how those medicines work together. They also have a solid understanding of dementia.
The shortage extends beyond geriatricians; gerentologists are people who study aging across many disciplines -- from researchers to caregivers to policy-makers, usually with the goal of improving the quality of life for the eldery. And gerentologists are also in high demand.
Dr. Ruth Walker, who teaches classes on aging at Missouri State University, says patients with dementia require a team of highly trained professionals to care for them. With fewer experts available, nursing homes have to hire workers without the same level of education and experience.
“Most of those job ads that you see going out for people to maybe do activities with those residents or something like that, they’re just asking for a high school level education, Walker said.
"So you have someone with a high school level education that’s going in there, and they may do a really wonderful job and excellent work and do the research and really know what they’re doing, or they might not, because they haven’t had that specialized training, they don’t have a degree in gerontology.”
This lack of training is a problem because patients with dementia need special care.
“It results in suboptimal care, Walker said. "At all levels. At the level of medication, at the level of diagnosis, at the level of socialization, knowing how to interact with them appropriately. All of those types of things are compromised when we don’t have trained professionals that are working with them.”
So if there's a shortage, why aren't more students majoring in gerentology?
Walker said there are a number of reasons.
"One is the lack of money. So if you’re going to go into practice, a lot of people are looking at ‘What am I going to take home? What is that money?’, so there’s lack of money. There’s a lack of status. There is also just a lack of education and programs. There are not that many programs, even at the undergraduate level, to have aging related content.”
Walker said there’s also a fear among young people about how to interact with adults with dementia, which can be overcome by working with them.
Missouri State is the only college or university in southwest Missouri offering a major in gerontology.
The department at MSU is pushing a campaign to get students interested in the field. Faculty have put up posters recruiting for the program, and they're promoting the Gerontology Club, which Walker advises.
Even with these efforts, she says the results haven't been what they would have liked.
Many students prefer to work with children, Walker says. But she has a message for those students.
“I, too, wanted to be a preschool teacher when I started in college, and so I definitely understand that pull and it’s so prevalent there. But the need is with our older adults. Getting them to transition to see that can be really rewarding and fulfilling to work with people across a lifespan. So why don’t we focus on this part that’s getting ignored.”
According to the United Health Foundation, patients who were treated by geriatricians had better patient outcomes in some scenarios--including better function when seniors were discharged from hospitals and lower nursing home admissions.