We Boomers Are Changing The Healthcare Landscape

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Kendra and Jay Jeffcoat are the quintessential baby boomer couple.

Kendra, 69, recently retired after a long and successful career as a college professor.

Jay, 70, who spent his college years as student body president at the University of California, Santa Barbara, protesting the Vietnam War, continues to work full time as a corporate attorney in San Diego.

In January 2013, Kendra was diagnosed with stage 4 lung cancer, which had metastasized in her brain. She never smoked, nor was she around secondhand smoke.

But as Healthline noted in November 2014, lung cancer among women who don’t smoke is on the rise.

Kendra endured brain surgery, several courses of chemotherapy, and a clinical trial for a cancer vaccine.

She is now being treated with Opdivo, a new immunotherapy medication from Bristol-Myers Squibb that helps a person’s immune system fight cancer. It was approved last year by the Food and Drug Administration (FDA).

The emergence of immunotherapies is considered a game changer in the treatment of cancer. Kendra and her husband are pleased that this new treatment is available.

Kendra said she was shocked when she was first diagnosed, but age has given her the wisdom to deal with it.

“The joy of being over 60 is that a person has the experience and wisdom to deal with the realities of a crisis with joy, hope, and laughter,” she told Healthline. “Each round of chemo, radiation, vaccine therapy, and now immunotherapy, provides an opportunity for a roller-coaster ride from sadness to hope. You must be strong and surround yourself with optimistic people who love you deeply enough to tell you the truth. Being a baby boomer, I can see the ironies and humor of life, and thrive joyfully in the midst of whatever challenge I meet.”

Added Jay, “We have a great life. We’re both very active, I exercise every day. We spent three weeks in Ireland last year. We’ve been to South America. And we hope to take a river cruise in St. Petersburg, Russia, this year. These new treatments hopefully will allow us continue enjoying our life.”

Baby boomers turning 70

The oldest members of the baby boom generation turned 70 this year.

But this group of nearly 75 million men and women born between 1946 and 1964 still see themselves as young and essential.

The boomers are determined to stay young, hip, and healthy.

Today, the generation that preached “don’t trust anyone over 30” is heeding Dylan Thomas’ call to “not go gentle into that good night.”

They’re stubbornly raging against the dying of the light as they set out to prove they aren’t done just yet.

As a result, this generation is having a profound influence on healthcare in the United States with a unique set of demands, and challenges.

Boomers are the creators, as well as the recipients, of massive innovations and breakthroughs on multiple health fronts, from new, less toxic cancer treatments to an all new paradigm for American emergency medicine.

Overall health concerns

Baby boomers dominated the American cultural landscape for decades.
They don’t appear too eager to relinquish that crown.

But they’re clinging to a greased rope.

Popular culture and social media are now largely shaped and defined by millennials, the young men and women, ages 18 to 35, who now number 75 million.

Generation X, which is made up of people aged 36 to 51, is also projected to pass the boomers in population by 2028, according to the Pew Research Center.

Although there are plenty of misconceptions about boomers, perhaps the biggest one is the notion that they are healthier than previous generations.

In fact, a new United Health Foundation study of the health of senior Americans found that boomers will be entering their senior years with “higher rates of obesity and diabetes and lower rates of very good or excellent health status, putting significant strain on the healthcare system.”

In fact, the Trust for America’s Health recently noted that 62 percent of Americans between the ages of 50 and 64 currently have at least one chronic condition, such as heart disease, because of obesity.

In an interview with Healthline, Dr. Dilip Jeste, professor of geriatric psychiatry and director of the University of California, San Diego, Center for Healthy Aging, explained why boomers aren’t quite as healthy as one might think.

“With many jobs requiring more sedentary work, longer commuting, more television watching, etc., middle-aged baby boomers were found to have less average physical activity than middle-aged folks from previous generations,” said Jeste.

“While smoking has become less common, physical activity has not increased,” he added. “On top of that, sodas, sugar-rich juices, and double cheese burgers are making the diet more unhealthy.”

Jeste said boomers also have higher rates of depression, anxiety disorders, and substance abuse than the previous generation. The precise reasons for this are not known, Jeste said, but there are several possible explanations.

“Baby boomers are more open to diagnoses of mental illnesses than the previous generations, and are more likely to seek treatment for them,” he said. “Talking about their own depression or taking Prozac or Zoloft is not as much of a stigma for them as it was for previous generations.”

Jeste said that primary care clinicians are also more open to diagnosing and treating these mental illnesses now than they were 30 years ago.

“There is growing social anomie, with globalization, mobility, increased competition for jobs, higher divorce rates, more single-parent families, and rapid changes with technology, resulting in greater stress,” he said.

But Jeste added that boomers overall are optimistic and determined to stay young and live longer, and that for the most part this is a healthy way of looking at life.

“The main thing is that aging is not just physical. There is, of course, a psychosocial element,” he said. “We are all in part responsible for our own aging. Our center looks at aging in a positive sense. We try to help people enjoy the process. People do become more accepting as they age.”

Breakthroughs in cancer treatment

When it comes to cancer treatments, baby boomers like Kendra Jeffcoat are at the “leading edge” of the precision or customized medicine paradigm, said Dr. Razelle Kurzrock, director of the Center for Personalized Cancer Therapy at the UC San Diego Moores Cancer Center.

“This model will see the introduction of a new way of doing clinical trials,” Kurzrock said. “This concept is applicable to all our clinical trials, since genomics tells us that each patient and tumor is unique. Boomers will see this new paradigm enacted and should be at the forefront of pushing it forward.”

Dr. Sandip Patel, assistant director of the Clinical Trials Program at Moores, added that baby boomers are a key patient group in the development of novel therapies that not only work better against cancer, but are substantially less toxic than traditional chemotherapy.

“These include immunotherapies and targeted therapies in particular, with a focus on developing approaches to personalize therapy based on each individual’s unique cancer,” Patel said. “A large majority of our cancer clinical trial patients at UCSD are in the baby boomer generation.”

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Patel said the hospital provides multidisciplinary care “to best help baby boomers fight their cancer on all fronts: supportive and palliative care, psychosocial support groups, as well as some holistic medicine approaches such as acupuncture.

This new wave of innovation in cancer treatment, Pavel noted, “is happening just as baby boomers are approaching the age in which they may need these novel therapies.”

Dr. Ezra Cohen, associate director for translational science at Moores, said it is “not unrealistic to think that the baby boomers will be the generation that experiences the most substantial transformation in treatment ever, with even cures where we never imagined.”

But Cohen added, “They are also the generation that has to help make this happen, and they can by participating in research, lobbying public funding sources, and providing support. It is up to all of us to end cancer.”

Boomer emergency rooms

Another burgeoning new trend in healthcare is the advent of geriatric emergency departments geared specifically to boomers and other seniors.

UC San Diego Health, in a partnership with West Health, a nonprofit health organization, is currently designing a state-of-the-art senior emergency care unit to be housed within the future Jacobs Medical Center, a 10-story, expansion of UC San Diego Health’s La Jolla campus that opens later this year.

Largely answering to the fact more than 10,000 baby boomers in the United States turn 65 years of age each day, the new emergency department will focus on geriatric medicine, acute care screening, urgent care, case management, and social and psychiatric care.

With a focus on fostering “successful aging,” the department will also facilitate home- and community-based care options when possible.

“We are delighted to partner with UC San Diego, a leader in aging initiatives, to create an innovative environment for delivering outcomes-based senior emergency care,” said Shelley Lyford, president and chief executive officer of the West Foundation and the West Health Institute. “This model will serve as a catalyst for broader adoption of improved senior emergency care here and across the nation.”

Dr. Vaishal Tolia, an assistant clinical professor at UC San Diego Health whose primary specialty is emergency medicine, told Healthlne that emergency departments are “re-examining the role we play.”

“We are no longer isolated as a separate section,” he said. “We see ourselves now as the central gatekeepers as far as who gets hospitalized, and as a referral point and safety net for all kinds of patients.”

Tolia said his department visited several of the geriatric emergency departments around the country to try to learn best practices.

“We learned that there is no standard to call yourself a geriatric emergency department, there is a lot of variability in places that call themselves geriatric ED’s,” he said. “There are some hospitals that call themselves geriatric EDs, but they do not have a dedicated space or staff. They maybe have a couple of additional things for that patient population but no real established criteria.”

Tolia said a new focus on geriatric emergency departments is improving the overall experience for the patient.

“No one wants to be there and we are want to create a positive, comfortable environment where family can be involved, where we can assist folks that have vision or hearing issues, where patients are safe,” he said. “Just as there are architectural features in pediatric departments, where you see colors, cartoons, things that make it comfortable for a child, we are doing some of the same things with geriatric ED’s including making sure the floors are not slippery and that the acoustic and sound are good.”

In response to this booming trend, the American College of Emergency Physicians (ACEP), American Geriatrics Society (AGS), Emergency Nurses Association (ENA), and Society for Academic Emergency Medicine (SAEM), recently issued a comprehensive set of guidelines covering everything from staffing to education to handling common problems of aging, such as falls, delirium, and dementia.

“Geriatric emergency departments first appeared in 2008, but this is the first time there has been a standardized template for how they should be set up and how care for older patients should be delivered,” Alex Rosenau, past president of ACEP, said in a statement. “It is important that the special needs of these vulnerable patients are met appropriately in the emergency setting. As of 2010, there were 40 million people in this age group, and many of them will be emergency patients at some point.”

Breakthroughs in dementia prevention

Other issues that are on the minds of baby boomers as they get older are Alzheimer’s disease and dementia.

There are significant new clinical trial results in Alzheimer’s, the most common form of dementia.

While scientists from the Netherlands have found that a six-year, nurse-led vascular care intervention did not lead to a reduction of all-cause dementia in a cognitively healthy population, fewer cases of non-Alzheimer’s dementia were observed in the intervention group compared to the control group.

In addition, the scientists saw fewer cases of incident dementia in a subgroup of people in the study with untreated hypertension who were adherent to the intervention.

The study observations suggest that “the benefits — or the head and the heart— of assessing, treating, and managing heart health risk factors as we age,” Maria C. Carrillo, Ph.D., chief science officer of the Alzheimer’s Association, said in a statement.

An article in May 2015 in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, noted that “there is sufficiently strong evidence, from a population-based perspective, to conclude that regular physical activity and management of cardiovascular risk factors (diabetes, obesity, smoking, and hypertension) reduce the risk of cognitive decline and may reduce the risk of dementia.”

Desert trip a bad trip?

Perhaps the final big national bash for the baby boom culture is the upcoming Desert Trip, a megaconcert in the Southern California desert featuring six of the most iconic musical acts and artists in the baby boom canon.

That would be Paul McCartney, Bob Dylan, the Rolling Stones, the Who, Neil Young, and Roger Waters of Pink Floyd.

Predictably, the jokes are already flying about this concert, which folks on social media are calling “Oldchella” or “AgeCoach.”

Among the quips:

“They’ll be trading selfie sticks for walking sticks.”

“Instead of acid, the drug of choice at Desert Trip will be antacid.”

“Has anyone called the Hells Angels to police Desert Trip?”

Desert Trip takes place over two weekends in October at Empire Polo Club, the site of Coachella.
But unlike Woodstock, one of the boomers’ defining events, this one is unlikely to see much mud or protests.

The event, which is already sold out, is expensive and not for those boomers on fixed incomes.

The demographics of the Desert Trip audience will likely cut across four generations. But there will undoubtedly be many boomers in attendance, which poses some interesting health and safety challenges for planners.

Could some aging boomers attempt to relive their Woodstock or Monterey Pop Festival days and take drugs and dance all night?

When asked what precautions the concert planners are taking in terms of providing doctors, nurses, first aid stations, and more at the concert site, a spokesman for the Desert Trip declined to comment.

In other words: Boomers, if you’re headed for Desert Trip, take good care, because apparently you’re on your own.

By Jamie Reno