At all levels of government, elected leaders itemize budget deficits and request further sacrifices. Moreover, they forecast the reduction or elimination of many social and medical programs. The adage of bad news rolling downhill is apt in these times.
Amid these cutbacks, it is tempting to turn on each other. However, one community organization has expanded its staff and outreach within the last two years by turning to each other.
The Asian Community Center [ACC] in south Sacramento is a non-profit organization whose mission is to “promote the general welfare and to enhance the quality of life for our community by identifying, developing, and providing culturally sensitive health and social services for older adults.” When Sacramento County was unable to maintain its Meals on Wheels [MOW] program in 2010, the center stepped forward and assumed its operation. ACC Volunteer Director David Morikawa mobilizes over 300 volunteers to provide over 5,000 hours of service each month. Annually, MOW delivers over 500,000 meals to over 2,000 senior residents who are housebound, particularly after a recent hospitalization. MOW coordinates meal delivery five days a week at 22 café centers throughout the county. Many of the volunteer drivers are seniors themselves. MOW by ACC serves a vulnerable population by providing food, functional assessment, and regular contact.
In my job training primary care doctors at UC Davis Medical School, I meet with CEO Donna Yee and Program/Grants Developer Linda Revilla to discuss a collaborative opportunities for our community leadership track within our family medicine residency program. By working with the center, my residents — doctors in training — would learn a valuable lesson: not all health care needs to be initiated by a physician or delivered in an examination room or hospital room. They can see firsthand that financial constraints favor those who can recognize value and draw resources from individuals who have been marginalized as being “too old.”
As medical students, the doctors in my program treated geriatric patients. However, it is unlikely that they worked with seniors outside of attending physicians. Currently, there is one geriatrician for every 2,699 Americans 75 or older. With the projected increase in the number of older Americans, this ratio will decline to one geriatrician for every 5,549 older Americans in 2030. Another contributor to the falling ratio is the lack of interest of geriatrics among medical students. A geriatrician colleague reflected that many of our future doctors avoid geriatrics because they are unfamiliar with seniors. As recently as one to two generations ago, it was common for individuals to live with or near their grandparents. With the recent changes in family structure and dynamics, that is no longer the norm. Today’s residents often see seniors as a collection of complex chronic conditions. They lack the familial experience to view seniors as independent-minded people who may prefer a dialogue and a relationship over diagnostics and treatment.
I hope the residents in the community leadership track will partner with the ACC and appreciate that leaders serve the entire community and that advanced age is not a limitation, but a wealth of wisdom.
Dr. Fong is director of the UC Davis Family Medicine Residency Network. His opinions are his own and do not represent UC Davis.