Recommendation 1-1: Congress should require an annual report from the Bureau of Health Professions to monitor the progress made in addressing the crisis in supply of the health care workforce for older adults.1

While increasing the supply of workers is important, numbers alone will not solve the impending crisis. Current models of care delivery often fail to provide the best care possible to older adults, and they often do not promote the most efficient use of existing workers. While a number of innovative models have been developed to address these shortcomings, most have not been widely adopted. In short, to meet the health care needs of the next generation of older adults, the geriatric competence of the entire workforce needs to be enhanced, the number of geriatric specialists and caregivers needs to be increased, and innovative models need to be developed and implemented such that the workforce is used more efficiently and the quality of care is improved (Box S-2).

Enhancing the Competence of All Providers

The geriatric competence of virtually all members of the health care workforce needs to be improved through significant enhancements in educational curricula and training programs and then assessed through career-long demonstrations of this competence. There are a number of challenges to the geriatric education and training of health care workers, including a scarcity of faculty, variable curricula, and a lack of training opportunities. Furthermore, both education and training need expanded content in order to address the diversity of health care needs among older adults.


For professionals, one notable way in which training is inadequate is the lack of exposure to settings of care outside of the hospital. Since 1987 hospitals have been allowed to count the time that residents spend in settings outside the hospital for graduate medical education funding purposes, but many residents still do not spend significant amounts of time in these alternative settings. Because most care of older patients occurs outside the hospital, the committee concluded that preparation for the comprehensive care of older patients needs to include training in non-hospital settings.


The committee’s recommendations are numbered according to the chapter of the main report in which they appear. Thus, Recommendation 1-1 is the first recommendation in Chapter 1.

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