Allison Musante, ELS, is the associate editor of Clinical Geriatrics and Annals of Long-Term Care: Clinical Care and Aging. E-mail her with thoughts on this post at amusante@hmpcommunications.com, or post comments directly below.
I am a member of Generation Y. The boundaries of my generation have been amorphously defined to include anyone born between the early 80s and the early 2000s. Let’s say for the sake of argument that the oldest members of Gen Y are currently in their late 20s or early 30s. Rather than splitting hairs about the ages of Gen Y’s, most people agree it’s the attitude that defines us; some descriptors—not all flattering—that have been applied to Gen Y’s include entitled, competitive, value-driven, and, most importantly, tech-savvy. Whenever we need to answer a question, e-mail, texts, Google, and our endless supply of apps all provide us with instant gratification. Perhaps the biggest concern with this behavior to healthcare professionals is the spread of misinformation and the often erroneous self-diagnosing.
But why should geriatricians pay any mind to Gen Y’s?
According to a recent report by AARP, an estimated 33.9 million American adults provide unpaid care to older adults (aged 50 years and older). More than half of these caregivers are between the ages of 18 and 49 years. With more than 70 million adults expected to reach retirement age over the next decade, one can assume that the number of Gen Y caregivers will rise dramatically as well—whether by choice or by necessity.
Further, the demands on Gen Y caregivers are expected to be greater and unlike those of any other generation that cared for their aging parents. I recently had the opportunity to interview Michael Gordon, MD, MSc, FRCPC, co-author of a new book titled Parenting Your Parents: Straight Talk About Aging in the Family. In the book, Dr. Gordon and his co-author Bart J. Mindszenthy, APR, FCPRS, LM, point out that because of advancements in medicine, adults are living longer, but often have complex medical issues that require a higher level of care and treatment and for longer periods of time than previous generations, which had much lower life expectancies and fewer options in life-prolonging interventions.
Dr. Gordon and Mr. Mindszenthy explain that the new generation of caregivers is forced to make many personal and financial sacrifices to be able to provide good care to their aging parents, such as taking time off work to take their parents to doctors’ appointments and to provide assistance with activities of daily living. Also, many caregivers are often faced with making many difficult decisions about end-of-life care. Aside from the ethical and medical considerations involved in end-of-life care, these decisions can become infinitely more complicated when there are disagreements among family caregivers about the best course of action for their aging parent. In their book, Dr. Gordon and Mr. Mindszenthy present 24 case scenarios in which family tensions can affect care; for example, when parents’ cultural and religious views are different than their children’s.
So what does all of this mean for geriatricians?
In the past couple of years, “patient-centered care” has been the healthcare buzzword. The American Geriatrics Society, for example, recently published an evidence-based resource titled Patient-Centered Care for Older Adults with Multiple Chronic Conditions. This and other similar position papers acknowledge that many older patients wish for their family caregivers to be included in the decision-making process, and in many situations, these family caregivers act as healthcare proxies. Yet, despite this generation’s unique set of demands, there is not much information out there on facilitating conversation with Gen Y caregivers about the healthcare of their aging parents.
In Parenting Your Parents, Dr. Gordon and Mr. Mindszenthy discuss the geriatrician’s role in each of the 24 caregiving case scenarios, offering their perspectives as well as practical advice.
Another good resource was published earlier this year by Eisner Amper, an accounting firm. Although these tips are about handling Gen Y patients, these same tips can be applied when dealing with Gen Y caregivers, as many of them are highly involved advocates for their loved one.
Here are a few take-home points from the tip sheet:
- They will expect their doctors to be as attuned to technology as they are, so consider using a tablet for faster paperwork processing during visits.
- They will often come into your office having done at least some basic online research about the possible condition and treatment of their loved one, so be prepared to correct any misinformation by having hand-outs ready, as well as recommending reliable websites for more information.
- They will demand service, such as appointment availability, timeliness, staff courtesy, and proper billing, so prevent or minimize confrontation with dissatisfied caregivers by providing ongoing training and incentives for your staff members.
- They will be highly cost-conscious and concerned about the benefits of their loved one’s insurance, so be prepared to provide quality and service justifications for your fees, and as appropriate, discuss less-expensive alternatives and ways of avoiding future cost.
Please be sure to look for the full interview with Dr. Gordon about Parenting Your Parents next month, in the November 2013 issue of Annals of Long-Term Care, in print and online.