Health care for elderly deficient Staffing, training fall short in Maine

AUGUSTA – Maine’s health care providers aren’t adequately prepared to serve the state’s growing population of seniors, members of a panel at the Governors’ Conference on Retirement and Aging suggested Tuesday.

The state has a growing staffing shortage, an inadequate number of doctors with significant training in gerontology, and a disjointed collection of medical services.

“We have a very scattered response to the needs of the elderly population,” said Nona Boynik, senior vice president of MaineGeneral Health, which runs hospitals in Augusta and Waterville.

Four panelists at the Augusta Civic Center all contributed their own details about the lack of coordinated services to meet the needs of older Mainers.

They said:

. There is too much focus on the sick and not enough on prevention;

. Regulations prevent nurses from easily specializing in geriatrics;

. Paperwork swamps nurses and contributes to their rush to other work; and

. Diverging reimbursement sources fragment long-term care.

A central problem in arranging care for seniors is finding the staff. William Gillis, chairman and president of the Maine Healthcare Association and president of Clover Healthcare, said that in 31 years things have never been as bleak in terms of finding help.

“It has never ever been as bad as it has been now,” Gillis said. “This is a very difficult period of time and it has been for anyone in health care.”

Theresa Shipps, director of nursing at the University of Maine, discussed some of the problems in filling nursing positions. The average age of nurses in Maine is closing in on 50, she said, and, as they age, the nurses have more difficulty with the physical aspects of caring for patients.

There isn’t much of an effort from the state to fund new slots for nursing students, she said. In fact, next year UM will likely cap admissions, she said.

Meanwhile, many licensed nurses have left the profession. Shipps said a prime reason is the blizzard of paperwork that goes with the job these days.

“Who wants to be a nurse interacting with documents instead of patients?” she asked. “The reality is the work is boring.”

Later, Boynik said she thinks one of the solutions to the crisis is to redefine the work of nurses to make the job more about patient care and less about paperwork.

Shipps said licensing regulations also diminish the ability of those with a strong interest in gerontology to focus on that segment. She said nursing students now have to have too much generalist training before they can focus on a specialty.

She would like students to have the option of narrowing their focus earlier in their training.

If there aren’t enough gerontology-focused nurses there also aren’t enough doctors with specialized training in Maine. The fourth panelist, Dr. Steve Shannon, dean of the college of osteopathic medicine at the University of New England in Biddeford, said there are too few physicians with geriatric training. Just 2 percent of physicians nationally have that training, he said.

In Maine, fewer than 80 physicians have such training although he said the need is for at least 250.

Shannon said UNE is working to increase geriatric training of its osteopathic students.

He said the best way to improve care was to develop team approaches to care and to coordinate services for the elderly.

“Unless we do this in an integrated way with the disciplines it’s still not going to work,” he said.