An article published in the October issue of the Journal of the American Chiropractic Association1 suggested a growing need for more chiropractic research and investigation into the effects of chiropractic care for geriatric patients. According to the article, an estimated 17 percent of the average chiropractic practice is aged 65 or older.2 Seventeen percent may not seem high, but when you consider that the nation's nearly 33 million 65 and older population comprises less than 13% of the national population, it would seem that seniors have already discovered the benefits of chiropractic care. Keep in mind, this number does not include the nearly 76 million baby boomers (1946-1964), the first of whom turned 50 this year. In the annual survey conducted by the ACA in 1994 published in 1995, greater than 50% of all patients seen by chiropractors were over the age of 45.3 The 1995 survey published in 1996 shows 48.7% of the average practice is aged 45 and older. By the year 2030, it is predicted that 20% of the population or one in five adults will be 65 or older. Our practices will continue to "gray" with increasing numbers of middle-aged and older patients.
Chiropractic research on aging and geriatric concerns is happening but there is a long road ahead. Palmer College Research Center has received a federal contracts from the U.S. Health Resources and Services Administration to assess the status of chiropractic education and training for geriatric patients on a national basis. It will determine what training chiropractors receive and whether additional training or interdisciplinary experience would be beneficial.
Other researchers, such as Ian Coulter, PhD4 of the RAND Corporation, focus on the effectiveness of a comprehensive geriatric assessment, follow-up health education and preventive care in subjects 75 and older. These researchers seek to determine whether aging chiropractic patients experience a better quality of life and a healthier aging experience than elders who are not chiropractic patients. The findings are encouraging but more research is needed.
It is almost impossible to pick up a newspaper or a magazine without finding some mention made of "alternative health." Nutrition, exercise, lifestyle changes, visualization, mind-body connections, and chiropractic are hot topics for an army of readers. The Associated Press reports that there are currently 100 million Americans suffering from chronic ills such as arthritis and diabetes, costing the nation $425 billion dollars a year. These numbers are expected to jump to 148 million Americans in 2030 at the cost of $798 billion. The AP article goes on to say that the vast majority of people who suffer from chronic conditions are not just older adults but people of working age5... your patients. While chiropractic has had both positive and negative exposure, some publications targeting the aging population. The AARP's Modern Maturity,6 with a circulation of 22 million bimonthly, sparked a significant number of inquiries to the ACA when it published, "Health Extra: Alternative Medicine Goes Mainstream."
My point is that what we in chiropractic have been waiting for is upon us. This nation simply cannot afford a sick, aging population. Chiropractors are the best suited and positioned health care professionals to care for an aging population, if our awareness and knowledge includes specific differences regarding geriatric communication, assessments, needs, considerations and management goals. We have not yet tapped this huge senior population. Many of us have not considered the impact chiropractic could have on the lives of millions in terms of maintenance of functional ability (keeping people in their own homes as long as possible), and significant impact to the nation's economy in terms of health care dollars saved.
In the meantime, while the researchers are analyzing data and collecting information, those "aging patients" continue to come to your office and you need some place to go for information. Who you gonna call?
Geriatric Education Centers are a nationwide network that offer both short and long-term education and training opportunities for health care professionals. These centers were originally established in 1983. Currently there are 47 centers across the country. Twenty of these centers receive funding from the Bureau of Health Professions of the Health Resources and Services Administration working towards a set of objectives that may include: advanced training to health care professionals in geriatrics; expanding and strengthening instruction in treatment methods for the elderly; support training and retraining of faculty who teach geriatrics and related subjects and establishing new affiliations with health care facilities (ambulatory care centers, senior centers, nursing homes etc.) to provide clinical training in geriatric care. As examples:
References
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
