Who is providing the predominant care for older adults with dementia?
A primary care clinician most often serves as the predominant source of care for Medicare beneficiaries with cognitive decline, but once people move into a long-term care facility, nurse practitioners (NPs) also provide an important segment of predominant care, according to a new Johns Hopkins study published in The Journal of Post-Acute and Long-Term Care Medicine (JAMDA).
The crucial role of NPs as predominant dementia care providers in nursing homes highlights the growing demand for highly trained NPs who have been educated in the cross-curriculum aspects of clinical disease management, comorbidities and dementia care. Key shifts are already beginning in NP education for this growing demographic, including “changes in their training that consolidate adult care and gerontology,” the study authors write.
Geriatrics, neurology, cardiology and geriatric psychiatry are the physician specialties most active in caring for older adults with dementia, either as primary care providers or consultants. However, less is known about whether these specialist-clinicians have dementia-related training, and if so, how much, the study noted.
Of greater concern are the troubling shortages in all specialties involved in dementia care: “The Bureau of Labor Statistics for the United States predicts a 34% increase in demand for NPs from 2012 to 2022 and a need for 36,000 geriatricians by 2030, which is a five-fold increase from the current 7147 certified geriatricians in the United States,” the study authors write. “There are even fewer geriatric psychiatrists, 1554 in the United States in 2012, and the demand for neurologists already exceeds the supply of 14,338 in practice in 2012. Because of the projected shortfalls of providers relative to the large population with dementia, we need a better understanding of who provides a substantive amount of care to dementia patients in the United States to target educational or other resources that will ensure access to high-quality dementia care in the future.”
By 2050, an estimated 13.8 percent of the U.S. population will have some form of dementia, with the largest increase in the 85+ age group, notes the Alzheimer’s Association.