“Usually, when you wade out into the ocean, you don’t know exactly when a wave will roll in, and it’s often hard to estimate, from a distance, how large a wave is coming at you. But in this case, we know when and where this wave will hit the shore.” (from the introduction of Blueprint for Change)

Readers of Health Populi should be well aware of the age wave that’s hitting the U.S., the aging of Baby Boomers (so-called aging hipsters) and maturing of already-older Americans. The demographic phenomenon is well-documented by that demographic Delphi known as the U.S. Bureau of the Census in the report, 65+ in the United States.

That report’s bottom-line: that one in five Americans will have reached 65 by 2030, compared with 12% today. That’s 70 million Americans 65+ in 2030.

What are the health implications of this aging population? The American Psychological Association (APA) has researched and developed an approach they call integrated health care. APA spells out the concept, and drivers behind it, in its latest report, Blueprint for Change: Achieving Integrated Health Care for an Aging Population.

The APA’s report recognizes that the U.S. health system isn’t nearly ready to receive the hordes of aging Americans hitting their 60s, 70s, and 80s. The Association calls our system “broken,” and finds that our health system puts aging adults at risk. The risks occur because of the nature of older peoples’ health: that is, multiple morbidities that naturally happen in older age, compounded with a fragmented care approach of our current care model.

Thus, the APA argues for integrated and interdisciplinary health care. The central theme of integrated care is that clinicians of a care team are indeed on a team and communicate as such. This approach is enabled through health information systems that are shared by the team.

Eight principles underlie integrated care as the APA defines it:

1. Sensitivity to ageism
2. Familiarity with the roles of other health team members
3. Respect for differences in health processes and beliefs among team members
4. Awareness and productive treatment of conflict among team members
5. Use of conflict resolution skills
6. Receptivity to increasingly diverse forms of communication (such as virtual teams)
7. Ongoing assessment of treatment and treatment outcomes
8. Sensitivity to issues of multicultural diversity and marginalization.

Health Populi’s Hot Points: Note that at least 5 of the 8 underlying principles of integrated health care have to do with the interaction of the care team. The APA anticipates no small amount of turf issues when it comes to the interdisciplinary aspects of the concept, or the communication required to delivery continuity-of-care to the aging person. “Teams may have problems of territoriality to overcome,” the APA recognizes in its Blueprint. Psychologists know a lot about group dynamics. This report is an important contribution to the growing work on reforming our health system with the patient at the center.