TheBakersfieldCalifornian.com

The items in the geriatric sensitivity toolbox are basic: bulky gloves, dark, obstructed glasses and a pillbox full of M&Ms.

The challenge is for health workers to twist open the jar and pull out one piece of candy while experiencing tunnel vision and a loss of tactile sensation.

Stepping into the shoes of an older adult for just a few minutes is often enough to increase empathy levels, said Frances Wilson, a clinical nurse specialist at Kern Medical Center who teaches the sensitivity class to Cal State Bakersfield nursing students.

"We have a growing elderly population but the needs of the older population have gone ignored," she said. "We're educating the front-line caregivers."

Wilson is a Kern County geriatric scholar and part of a five-year effort to coordinate and expand geriatric care at KMC and the university. The program, which is federally funded and administered through UCLA's geriatric education center, is helping Kern County prepare for the coming wave of aging baby boomers.

The program's leaders are quick to cite this statistic: Every day, another 10,000 Americans turn 65. Training these 25 healthcare workers across disciplines -- from social workers to physical therapists -- will trickle down throughout the county and create a more synchronized approach to elder care, scholars say.

And that coordination could culminate in a geriatric center at Kern Medical Center, a creation that could help the county hospital distinguish itself in an increasingly competitive healthcare field.

"One of the things we liked about Kern was they really needed a lot of geriatric education," said Rachel Price, the deputy director of UCLA's California Geriatric Education Center. "We're training a select few to infuse geriatrics into Kern, and we're really hoping these 25 will become leaders."

'Critically unprepared'

In Kern County, about a third of the population is considered baby boomers or older, according to a 2011 report from the county's Aging and Adult Services Department. Baby boomers -- who currently range in age from 48 to 66 -- number nearly 178,000 countywide.

"Geriatrics is absolutely becoming a booming area," added Dr. Eric vanSonnenberg, KMC's chief academic officer.

The entire nation faces a dearth of geriatricians and other health workers prepared to handle those needs. A 2008 Institute of Medicine report found that older adults "face a healthcare workforce that is too small and critically unprepared to meet their health needs." That report estimated there is just one physician certified in geriatrics for every 2,500 older Americans.

In Bakersfield, there are only about a handful of board-certified family or internal medicine doctors who have a subspecialty in geriatric care, according to the American Board of Medical Specialties. But Kern County's geriatrics scholars say the way to address the growing need is not simply to train more doctors.

Approaching aging care requires practitioners across all disciplines to think differently and communicate more. Take a patient who comes in with an altered mental state, among other ailments. The physician can access the patient and prescribe medications, but those might present a financial burden for an aging adult on a fixed income. The social worker can step in and discuss the financial situation, perhaps consulting with the pharmacist who can come up with an alternative generic pill that could save more than $100 a month in costs.

The pharmacist would also communicate side effects of any medications, such as an increased risk for falling. The nurse can then take extra steps to more carefully monitor the patient's movements.

Geriatric scholars

On a recent Thursday at Kern Medical Center, a lecture room was packed with doctors, nurses, physical therapists, social workers, medical students and residents -- all taking advantage of a regular geriatric lecture series that's part of the effort.

Dr. Susan Mackintosh, who traveled from Western University of Health Sciences in Pomona for the presentation, spoke about team behaviors, and learning how to work together to address an elderly patient's needs. Along with the medical team, a comprehensive approach to care may also include a veterinarian or spiritual leader.

"We need to think beyond traditional qualifications," she said. "Take a 360-degree view when putting together a team."

As well as attending these lectures, scholars come up with individual projects, such as Wilson's sensitivity education workshops with the glasses and gloves. They also serve as broader ambassadors, educating everyone around them about the distinct needs of this population.

Eventually, they'd like to create a more formal approach to this inter-professional care, such as coming together to officially review a patient's case.

"We would all share observations and concerns," Ryan Gates, a pharmacist and leadership scholar. "We'd see the issues through the eyes of other professionals, from their viewpoints."

A geriatric center

Rose McCleary, a CSUB associate professor of social work who is involved with this effort, said her ultimate dream is to see a local geriatrics center, a hub for coordinated elder care.

"If they get accessed by an interdisciplinary model, you're going to look at the whole person, not just one piece, and get a more correct diagnosis," she said. "We just don't have that now."

And that could help KMC better position itself to attract patients who could choose to go elsewhere but may be drawn to the county health center for its coordinated care.

That dream might not be so far in the future. Paul Hensler, the county hospital's CEO, said the center is a realistic possibility, which could be created before the grant ends in about four years. He's seeking to recruit a board-certified geriatrician who would anchor the effort.

Hensler envisions a center housed in a medical office building downtown that would tap into UCLA's expertise as well as that of KMC and CSUB's growing number of scholars.

For now, though, those scholars say they're just hoping to make a difference in the lives of the geriatric population they serve. The stakes are often a lot higher for older adults who end up at the hospital, said Geoff Smith, a physical therapist.

"It's not uncommon for someone who falls never to go home to independence again," he said. "If you address their needs before their final fall, it will add to their freedom."