Baby Boomers and their Mental Health Care Needs: Can Medicare Rise to the Challenge?
During their young adulthood in the decades following the Second World War, the “baby boomers” were symbolically viewed as the driving force of optimism and opportunity in our society. As these citizens have grown older, however, there has been growing concern as to how the baby boomers’ medical needs will be cared for by a system that may not be able to meet these needs. As the first of the baby boomers turn 65 this year, the strength of the Medicare system will be tested. Because mental health has only been recognized fairly recently as a valid illness in society, the newly introduced mental health care policies are revealing a shortage of geriatric mental health care providers that was not apparent before. It is clear, however, that the mental health needs of the baby boomer generation are great.
Information gathered by the Center for Disease Control and Prevention (CDC) between 1999 and 2005 showed a 20% increase in suicide rates among adults between age 45 and 54, according to the online Discovery Fit & Health article “Do Baby Boomers Have a Higher Incidence Rate of Depression than Other Generations?” by Cristen Conger. Although the cause of these increased suicide rates is unknown, several factors that have emerged with the aging baby boomers provide logical hypotheses.
According to an article entitled “The Baby Boomer Generation” on the website of ValueOptions, a company that describes itself on its website as “the nation’s largest independent behavioral health care and wellness company,” a plethora of educational, professional, and lifestyle options became available to the baby boomers, options that their parents were not able to take advantage of. This same article explains that this led to a strong spirit of optimism among baby boomers, but the consequences of such enthusiasm are now being made known. Eager to enter the work field, baby boomers have, over the course of their lives, overscheduled themselves and pushed for more, leading to an overwhelming amount of stress that may be a potential cause of the depression some are facing, according to Conger’s article.
Furthermore, according to the ValueOptions article, there are two reasons why many baby boomers continue to work in their old age: because they fear they will lose their identity if they retire or because it is financially necessary. The article also states that because baby boomers often had kids later in life and because medical advancements have allowed for greater longevity, they now have to take care of both their children and their elderly parents. Finally, this article suggests that, compared to the lifestyles of their parents, baby boomers have lived lavishly. From financial decisions to choices regarding their health, the baby boomers lived large. Now, several health consequences of these decisions, such as diabetes, elevated cholesterol levels, hypertension, heart disease, and obesity, are beginning to present themselves, the article points out.
Additionally, a 2010 article entitled “Policy Issues in Mental Health among the Elderly” by Karen M. Robinson, PhD, from Nursing Clinics of North America, points out that, according to the CDC, roughly 1 in 8 baby boomers will be diagnosed with Alzheimer’s. This equates to about 10 million people. According to Robinson, 49% of the current population over the age of 85 lives with dementia. In the CDC’s own words, “the debilitating nature of [dementia] and the intensity of care required guarantee that a particularly heavy demand will be placed on the US health care system.”
The burdened health care system, combined with a scarcity of psychiatric nurses, has resulted in insufficient care to fulfill the mental health needs of the baby boomer generation, as Robinson points out. In recent years, two changes to the U.S. health system were passed that could potentially help to address this insufficiency. Robinson explains that the first of these acts, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, reduced limits on outpatient visits, thus decreasing costs for those who are in therapy. This act could prove to be quite significant, as therapy visits may decrease the number of hospital visits. Perhaps more importantly, Robinson points out that the act has also allotted financial protection to severely ill patients who face high costs from intensive mental health treatments or inpatient care. The Medicare Improvements for Patients and Providers Act was also enacted. Robinson explains that, as a result, copayments for mental health care will gradually be reduced from 50% to 20%, which is the Medicare copay for other outpatient healthcare. More prescription mental health medications will also be covered under this act, according to Robinson.
Though these changes are powerful, their effect in solving the problems at hand is limited by the inadequate number of geropsychiatric nurses (GPNs) or Registered Nurses (RNs) trained in geriatric health. In her article, Robinson states that the GPN profession only evolved in the 1970s as a blend of geriatric and psychiatric nursing. Now, only 16% of psychiatric nurses have special training in geriatrics, according to Robinson. According to the Institute of Medicine’s (IOM) report entitled Retooling for an Aging America, which Robinson cites in her article, in 2030, “America will need 3.5 million more health care workers for older Americans. This projection includes an anticipated need for 868,000 more RNs and 231,000 more licensed practical and vocational nurses…[additionally] a shortage of 500,000 nurses is projected to occur by 2025.”
Robinson points out that the average Psychiatric-Mental Health RN (PMH-RN) is around 50 years old. The fact that these nurses may be retiring soon, given their baby boomer status, would contribute to the shortage of nurses as well. However, a study conducted by Val Palumbo and colleagues, published in Nursing Economics in 2009, found that 58% of RNs would consider continuing to work after retirement. However, as the IOM’s report demonstrates, it remains that more RNs must be trained and hired in order to fulfill the mental health needs of aging baby boomers.
As of now, it appears that the problem in caring for baby boomers with mental illnesses is largely due to a lack of appropriate health care providers. As more and more baby boomers reach Medicare-qualifying age in the next few years, it is clear that the strength of America’s health care system will be tested.