Ageing baby boomers pose big challenge
Expert on end-of-life care, Prof Brian Kensel sees a lot of positives in the Irish system, writes RONAN McGREEVY
ONE OF the biggest challenges facing the western world is how to deal with the baby boomer generation as they enter old age.
Some 64 million people were born between 1945 and 1964 in the United States alone in the optimism of the post-war period. The UK, France, Germany, Canada, Australia and New Zealand had similar spikes in population.
That generation changed the world and were the first to create a youth culture as we know it today.
However, they are now getting older and in the coming years will become increasingly dependent on the younger generation.
Because of Ireland’s peculiar demographics and the effects of mass emigration in the 1950s, the baby boomer generation did not occur until a decade later, but the same challenges will have to be faced up to eventually.
How to deal with the issue has preoccupied Prof Brian Kensel, a former aide to US senator Jay Rockefeller, and an expert on long-term and end-of-life care.
Prof Kensel was in Ireland last week to check out the role of two of his MBA students at Kiltipper Woods, a nursing home and care centre in Co Dublin.
He sees a “lot of positives” to the Irish system.
“I’ve been very impressed with the long-term care provision in Ireland. A larger percentage of some of the decisions are paid for out of pocket so the consumer has more choice.
“The system in the United States is generally paid for by third-party payers. When the consumer actually pays a larger portion out of their own pocket, that can be a positive thing.”
He believes the baby boomer generation will be more demanding for long-term care than their parents. “Culturally we have grown up in a different era in terms of expectations, even in terms of retail and other service organisations.
“Baby boomers are looking at settings that are more specific to their needs at the time. They might start in an independent living unit, they might move to assisted living that provides some level of support and then on to skilled nursing care.
“In America we have gone down that path. We have seen a portion of long-term care go home though home help care is a pretty significant cost.”
He believes there needs to be more integration of care. Chronic disease management is something that needs a more focused approach, he said, and there needs to be more of a focus on trying to detect problems earlier, before the symptoms become more severe and the costs escalate.
“It sounds good, but it is not as easy as it sounds,” he said. “The theory is that if we spend a little bit more in trying to do that, we might be able to prevent some of the higher costs of hospitalisations at a later date.”
According to Prof Kensel, western countries will have choices to make, but those choices do not necessarily mean rationing of care.
“We spend a lot of money on tertiary and high tech care. We need to balance that with primary care, prevention and turn that triangle upside down.”
He also believes that individuals have their own responsibilities as far as ensuring that they remain as fit and healthy as they can which will greatly enhance the quality of their lives in old age.
This includes not smoking, watching your weight and keeping alcohol consumption at a moderate level.
To that end, many insurance companies in the United States charge a higher premium for those who smoke.
Such incentives are not available in our public health system, but Prof Kensel believes there should be some method of rewarding those who live a healthier lifestyle.