Psychology soon to be challenged by the coming “age-wave”
By Paula E. Hartman-Stein, Ph.D.
The longevity revolution, one of the most extraordinary events in human history caused by the aging of the Baby Boomers, can produce “wonderful and important roles for psychologists,” according to gerontologist, futurist, and consultant, Ken Dychtwald, Ph.D.
He sees the aging of our population as the core issue of healthcare, but views the current healthcare system as “profoundly misaligned with the needs of the population.” Troubled and disappointed with behavioral healthcare, he said, “I don’t feel the field of psychology has fully engaged the age wave.”
In a keynote address at the Managed Health Care Congress in Baltimore in mid-April, Dychtwald outlined his forecast for the future as well as potential solutions for problems of America’s aging society.
He emphasized that all healthcare professionals need basic additional skills in the care of the older adult, yet most medical students and psychology graduate students are not required to take such courses. The lack of emphasis in competent older adult care results in errors and increases of healthcare costs, said Dychtwald.
He critiques the predominant model taught in graduate geropsychology programs as a limiting sickness model of older adult mental health that focuses on dementia and depression, rather than a wellness model that emphasizes the psychological dimensions of maturity, development of wisdom, creation of positive legacies, and nurturing of positive intergenerational relationships.
Dychtwald, former co-director of the Berkeley-based SAGE Project, the first preventive health research program for older adults, described several new roles for psychologists who work with aging Boomers. Therapeutic themes include the need for helping adults cope with life’s transitions, grow stronger with loss, and develop a sense of creativity and generativity in old age, similar to the model of Erik Erikson and his wife, Joan.
The linear life plan is becoming a thing of the past, according to Dychtwald. “First you learned, then you fell in love and it lasted forever, you worked, you retired, and you died.” The new-old are in the midst of a cyclical life plan, with more opportunities for re-marriage in older age, adult education becoming a growth industry, and opportunities for career changes in mid life and beyond, with the option of coming in and out of retirement.
Dychtwald predicts the emergence of the empowered, informed patient who may read more articles about his symptoms than the clinician because the information is available on the Internet. The responsibility of the care of the patient should ideally be mutually shared between clinician and patient.
This older adult of the future will be impatient, not willing to tolerate long waits for appointments or time spent in the waiting room. The new-old patient will demand more integration of their healthcare, insisting that specialists, including the psychologist, communicate and coordinate with the primary care physician.
More group programs will emerge for education and management of chronic disease, he predicts. Dychtwald mentioned Dr. Dean Ornish’s approach to cardiac care as a good example of a program that includes both dietary prescriptions and the use of psychological encounter groups to help maintain cardiac health.
In the future it will be commonplace for clinicians to have websites and email addresses that they provide to their patients. In large group practices he predicts that a designated staff member will field email questions and respond to patients’ messages.
Both physicians and psychologists need to help their patients achieve healthy aging by integrating preventive therapies into their practices. “The clinician of tomorrow needs to motivate patients to do a better job of taking care of themselves, so their bodies will go the distance.” The psychologist has the unique role of helping the boomers develop fit bodies through stress management and exercise compliance strategies, but just as importantly to figure out what can be done to remain productive throughout the life cycle.
He expects that the managing of healthcare will persist, but the models are still evolving. He believes there will be three tiers of patient care, with people with more money getting better medical attention and customized services. Wealthier aging boomers will likely spend large amounts of money to stay looking and feeling young as long as possible.
Dychtwald contends that the perception of psychology by the American public is largely shaped by Oprah Winfrey. “Her brand is about forgiveness and transcending trauma. She hasn’t given much thought to maturity.” In his view that is a remaining challenge for psychological practitioners of tomorrow.
Dychtwald is author of several best-selling books including Age Wave and Age Power and founding president of Age Wave LLC,
Paula E. Hartman-Stein, Ph.D. is a clinical psychologist, trainer, and consultant in Kent, Ohio, specializing in the care of older adults and their families. She edited the 1998 book, Innovative Behavioral healthcare for older adults. She can be reached through her website, www.centerforhealthyaging.com.