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Preparing For The Coming ‘Silver Tsunami’


Aging nation lacks safety net, policies and workforce needed to care for millions of seniors

There aren’t enough caregivers to care for the giant baby boomer population, according to Dr. Christopher Callahan.

Callahan, the founding director of the Indiana University Center for Aging Research, has been named the 2016 recipient of the American Geriatrics Society’s prestigious Edward Henderson Award.

He spoke with Life Matters Media about the need for full-time caregivers, the aging population and costs of cognitive decline.

Callahan spent decades as geriatrician and aging researcher exploring the effects of depression and Alzheimer’s disease. Callahan co-authored a 2012 Institute of Medicine report that found nearly one in five older adults have one or more mental health conditions or problems stemming from substance abuse.

Dr. Christopher Callahan
Dr. Christopher Callahan

There are more ‘glamorous’ fields of medicine. Why study seniors, especially those facing cognitive decline?

Over the past 30 to 50 years, people have been living longer and longer lives. We have a lot more people that are living into their 70s and 80s than really ever in history.

The biggest risk factor for Alzheimer’s disease is living a long life, so age.

We have now a giant population of older adults that is arriving in their 70s and at great risk. But this was knowable a good 20 years ago. You knew that if trends continued there was going to be something like 10 million adults in the U.S. with Alzheimer’s disease. So, I studied the scope of the problem.

Because there’s no treatment for it, people live five to ten years with Alzheimer’s disease; they are mostly cared for by their families. The family caregiver is the main source of support for these older adults.

It is estimated that every 67 seconds, someone in the U.S. becomes diagnosed with dementia. The population is expected to increase dramatically as millions of baby boomers age. Unfortunately, there’s also a shortage of geriatricians. 

We’re going to have a doubling of the people with Alzheimer’s disease and yet, we don’t have specialists to take care of them. What’s the alternative? We need new models of care that explore alternatives to specialty care.

New models should focus on how to provide additional education, support and services to the family caregiver. They all build on the foundation of the family caregiver, which is usually a spouse or daughter.

What if we shifted some of the money we spent on hospitals, doctors and nursing homes and made it available to family caregivers? Might we keep seniors living in their homes longer? That’s what everyone wants, and it’s less expensive, if people stayed in their homes.

Does the media cover this issue enough?

One of things that we worry about with this issue is that caregivers and people receiving care tend to be invisible.

They, in a sense, make themselves invisible because of a perceived stigma.

People like you and me don’t always see them and see the magnitude of it. They are hidden. Reporters, I think, have a responsibility to help the nation know that this is going on. It affects almost every family.

Will Ferrell just scrapped a controversial film in which he would play President Ronald Reagan. The story would poke fun at the Reagan’s dementia. In the script, an ambitious intern is tasked with convincing him that he is an actor playing the president in a movie. 

What are your thoughts about people poking fun at seniors facing cognitive decline? 

One of the things that we try to stress with families is to focus on the patient’s strengths. We tend to think of dementia as a ‘yes or no’ phenomena. But it’s not really like that.

Parts of your brain age differently, so you can have someone who has part of their brain impaired and the majority of their brain working just fine. We want to emphasize the patient’s remaining capacities and work to organize things around those strengths.

I think most people who aren’t in a caregiving situation are unaware. I don’t hear of people with family members with dementia purposely denigrating, making fun of them or causing harm.

I think people don’t understand. We’ve always thought of mental illness of being ‘all or none,’ but that’s not how it is. There are shades of grey. Some people are ill one day and fine the next.