Arti Hurria: Too few workers to care for older cancer patients

July 7, 2013 | by Denise Heady

(Tragically, Dr. Hurria passed away following a car accident in November 2018.)

Arti Hurria, M.D., director of the Cancer and Aging Research Program at City of Hope, feels strongly that too little attention has been paid to the needs of older people with cancer. She's working to change that.

Arti Hurria The number of health care professionals capable of meeting the unique needs of older people is not keeping pace with the shifts in the population, says City of Hope's Arti Hurria.

She recently presented an overview of her work – and the context for it – at the annual meeting of the American Society of Clinical Oncology (ASCO), where she was honored as the 2013 recipient of the B.J. Kennedy Award for her contributions to the research, diagnosis and treatment of cancer in the elderly. Here, we offer the second in a five-part series on the most important aspects of Hurria's work – and what doctors and others need to know about treatment of the elderly.

Part 2: We have a workforce shortage

The geriatric competence of the entire workforce needs to be reviewed, the researcher said, with additional skills developed through training.

The first step: Evaluate the expected shortage of geriatricians and health care professionals capable of meeting the needs of older adults. Although the number of elderly cancer patients is increasing, the number of geriatricians is expected to decline. The United States currently has 2,620 75-and-older patients per geriatrician with that ratio set to reach 3,798 patients per geriatrician in 2030.

"We know the volume is going to be higher that what the supply is, hence there is going to be the need for partnerships," Hurria said. "We are going to be partnering with our allied health professionals, physical assistants and nurses. We’ll be involving rehab, pharmacists and social workers to help us with this care. And probably, most importantly, we are going to be partnering at home, with families, family caregivers and home-care aides."

Increasing the number of health care workers capable of caring for the elderly will require both education and training. Only 1 to 2 percent of physicians have geriatric specialization or certifications, statistics show, and less than 1 percent of nurses, physician assistants and pharmacists have geriatric education.

A recent report from the Institute of Medicine called for a "substantial focus" in our health care infrastructure to provide skilled care to this vulnerable population of older cancer patients.

Currently, the state of California requires only 150 hours of geriatric training for direct-care workers (nurse aides, home health aides, personal and home aides). Every state has similar or lower minimum hours of training needed, except Missouri which has a minimum requirement of 175.

On the other hand, a skin care specialist in California needs 600 hours of training and a hairstylist requires 1,500 hours of training, Hurria said.

"In other words, my hairstylist has 10 times the amount of training than the individual who will care for my aging parents when they need that assistance," Hurria said. "Which I think is a real statement for society, which is something we clearly need to change."

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