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July 19, 2004

Aging Boomers
Education Programs Need to Train Students for the Rising Tide
By Janet Needham, RT(R)

At the end of World War II, millions of Americans serving in the armed forces returned home. Home meant a new beginning, peacetime economics, and husbands and wives adding to or starting families. The homecomings in 1945 resulted in the baby boomer generation born between 1946 and 1964. While many boomers have passed the age of 50, those born in 1964 are just turning 40. This huge group of Americans is heading toward their peak years as healthcare consumers.

Connie L. Mitchell, MA, RT(R)(CT), spoke on “Gerontology in the Curriculum”—how these boomers will affect radiology departments in the coming years—as a presenter at the American Society of Radiologic Technologists (ASRT) Annual Conference last month in Dallas.

Mitchell is a veteran radiographer and assistant professor and radiography program director of the division of radiation science technology education in the School of Allied Health Professions at the University of Nebraska Medical Center in Omaha. Mitchell is passionate about the care of the aging and teaching those who care for the geriatric community and insisted, “This is my love, my baby. I love geriatrics!” She developed her practicum for her master’s on geriatrics. Today she integrates gerontology and geriatrics into the radiography program at the University of Nebraska Medical Center. She also authored the chapter on geriatric radiography for the 10th edition of Merrill’s Atlas of Radiographic Positions & Radiologic Procedures (2003).

Mitchell is the coauthor of a peer-review article, “Gerontology in the R.T. Curriculum,” in the March/April 2003 issue of the ASRT journal, Radiologic Technology. The article addresses concerns about teaching effective imaging skills in RT programs. Her presentation to the ASRT conference was focused on this article and was supported with her surveys and subsequent surveys of the original responders.

Mitchell explained that the definitions of geriatric and gerontology are needed to understand the difference. She said, “Gerontology is the study of aging in all aspects. This would include biological, psychological, social, and economical. Geriatrics is the study of diseases of the elderly.”

The first boomers will be 65 years of age in 2011. Their children and grandchildren will increasingly be student technologists who will provide care in this country’s imaging facilities. The need to be educated in effective care of the aging population is growing. “The students of today are the children of baby boomers,” Mitchell said. “More specifically, they are the caretakers of the future.”

Mitchell conveyed that there are not many textbooks available for radiographers or other healthcare professionals on gerontology. She uses a text by Walter C. Chop, MS, RRT, and Regula H. Robnett, MEd, MS, OTR/L, BCN (1999), called Gerontology for the Health Care Professional. Mitchell believes a combination of clinical experience and didactic information is necessary for the education of radiographers and students.
Learning about aging involves an understanding of the attitude of aging, as well as the aging process. The textbook is an excellent choice to demonstrate and inform because Mitchell said her “research indicates just spending time with the elderly does not guarantee acquisition of knowledge and attitudes for appropriate geriatric care.” She chose the textbook because it covers many aspects, including demographics, physiology and pathology of aging, social and economic concerns, nutrition, drug therapy, continuum of care, and financing healthcare.

Changing Criteria
Teaching gerontology requires teaching a brief history of aging. The criterion for older age is different today than in the 19th century. Today, what we determine as middle age was older age in the 1800s. Scientific advancements, industrial advancements, lifestyle changes, and environmental improvements all play a part in the contribution to an older society. “The Aging Boom,” an article from Microsoft’s online encyclopedia, Encarta, written by Robert N. Butler, MD, said people over the age of 60 will outnumber those under the age of 15 by the year 2050 due to a decreasing number of deaths coupled with a decrease in births. There will be long-term consequences on society because of these numbers. Therefore, Mitchell includes instruction in areas such as culture and gender differences, plus global and ethnic aging.

Understanding family dynamics is increasingly important, as are the effects those dynamics have on the care for an older family member. Learning about role-changing is an important matter today: mother to grandmother, child to caregiver, and sibling to caregiver are just a few. As society lives longer, individuals are taking on new roles and responsibilities as aging progresses.

Mitchell says that while technology and the environment are great contributors to an aging culture, the baby boomer generation is a significant reason for the increase in an older society. “As of 1996, one of us is turning 50 every seven seconds,” she said. “With this increase will come an increase in imaging procedures, and students need to be prepared to meet this challenge.” “The Aging Boom” noted that by the time the youngest baby boomers reach the age of 65, boomers “will make up 20% of the population”—a ratio that will carry on for generations.

Mitchell’s teachings reinforce the need to provide a positive rapport between radiographer and patient and the ability to make a distinction between an age-related change and a disease process. This understanding leads to the formation of quality images and improved patient care. Educating future technologists to care for the aging will allow them to adjust imaging techniques to accommodate the physical and emotional transformations in an older society and to be sensitive to the influences of aging while providing care. Mitchell stressed that it needs to become part of the imaging curriculum.

One radiography student confessed her geriatric education amounted to “talk clearly, talk loud, and don’t be mean”—good advice, but not enough for the future of good patient care. Hospital-based programs and associate degree programs lean toward incorporating modules into their programs. Unless technologists pursue a bachelor’s degree, they probably will never take a course in geriatrics or gerontology.

“Gerontology in the R.T. Curriculum” stated, “The results indicate most gerontology instruction is limited to modules or units within defined courses rather than comprehensive gerontology course related to professional practice.” Additionally, the article relates how medical imaging and radiation therapy personnel consistently care for older patients because the majority of older adults are diagnosed with at least one chronic illness. “The elderly most likely die from heart disease, cancer, and stroke,” the authors wrote. “Age is the most consistent and strongest predictor for cancer and for death from cancer.”

Adapting Curriculum
As those multitudes reach the geriatric age, the need grows for skilled radiographers and other healthcare professionals to address the diseases of the aging. Teaching students of radiography is paramount if the needs of the aging boomers are to be met. Experience helps veteran technologists communicate with the older patients. Boomers are caring for those generations that came before them and those that came after them, too. Those forty- and fifty-somethings were raised to respect and speak with respect to their elders.

Moving forward, newly graduated students will enter a workplace increasingly filled with older patients. Experienced technologists need to mentor new students and workers and teach the important people skills needed to bridge the gap until gerontology courses can be more widely incorporated in imaging curricula. The experience of previous generations flows into today’s workplace and shows up in that work ethic and the communication skills needed to relate to aging patients.

Currently, Joint Commission on Accreditation of Healthcare Organizations-accredited facilities must show that their associates are competent in “age-based communication.” These competencies range from infants to older adults. Students are not usually required to pass these tests until they are employed. Can the radiography program afford to wait for the students to be employed? A thorough education in caring for older adults would provide the workforce a better employee and a better name for the educating facility. The result would be technologists who are better prepared for the growing wave of seniors.
The ability to adapt imaging skill to those aging is as important as adapting the same skills to difficult-to-manage trauma patients. Communication skills also need to be adapted to a time when there will be far more seniors than those under the age of 15.

The past two centuries have seen a flood of medical advances, discoveries, and tools. X-rays were discovered long before the baby boomers were part of the culture. The 20th century brought vaccines, antibiotics, heart surgeries, and transplants. All those advances help people live longer. Mitchell’s point was that the education and training of healthcare workers—including those in the imaging department—need to be adapted to better serve those patients.

— Janet Needham, RT(R), is an experienced radiographer and freelance writer living in New Albany, Ind.

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