Dr. Paul Takahashi has seen a lot of change in his 20 years as a primary care geriatrician at Mayo Clinic in Rochester. Many seniors are living longer and in better health than ever before, which means emphasis is often placed on home and community-based services to help seniors live independently into their golden years.
As a health-conscious state, Minnesota has a lot to offer seniors who want to age gracefully in their communities. “We’re mindful,” Dr. Takahashi said. “Minnesota has generally done a better-than-average job of that. We’re not perfect, but we’re aware.”
For Dr. Takahashi, what’s most exciting about his job is not only diagnosing and treating illnesses, but helping the older adults he serves achieve their goals, which are not always medical. Often, seniors are looking for new ways to manage their own lives, such as wanting to be able to cook for themselves or maintain their household.
“The one thing we geriatricians all strive to have is a relationship with patients,” Dr. Takahashi said. “Part of it is medical. But the other part is people’s homes and how they live their lives.”
Dr. Takahashi said he was drawn to a career in geriatrics by his deep connections with older adults. After graduating with his MD from the University of Illinois College of Medicine in 1994, Dr. Takahashi completed his residency at Mayo, where he accepted a full-time position shortly thereafter. In 2011, he earned his Master of Public Health degree from the University of Minnesota, and has taught as a professor of medicine at Mayo since 2016. He lives in Rochester, where he and his family enjoy getting outside and seeing the natural beauty of Minnesota. They have visited 22 of Minnesota’s state parks and hope to visit them all.
With the demand for health care professionals only projected to increase as Minnesota’s senior population grows rapidly, we asked Dr. Takahashi his perspective on what our state can do to better face aging. (Excerpts edited slightly for length.)
Q: By 2030, one in four Minnesota adults will be age 65 or older. What are some of the challenges that this senior boom creates in the care and support of our seniors?
A: It’s many-fold. The wonderful part about it is that people are living longer. That’s why we’ve made investments in health care and public health – many people are living longer with good health. Age 65-75 is a pretty healthy time for most seniors now. But increasingly, people beyond the age of 75 will be living with disability, and it may impact their ability to stay at home and do the things they want to do. … It will vary a lot, but after age 75, some folks will have significant challenges.
The biggest challenge we’ll run into as a state, country and world is how we are going to care for the folks who are disabled. It will be a big strain on workers and families helping take care of loved ones. This is something we’re all going to have to deal with. The finance part of that will be there as well. We need to develop new systems to address some of these issues. Technology will help with this, but it won’t be an end-all, be-all.
Q: How have you personally seen a rising need for geriatric care in Minnesota?
A: You could ask any geriatrician or primary care provider, and they’d tell you that at least at younger older ages, people are more functional and active. They are taking better care of themselves and understand the importance of activity and connection. These are great things that have happened.
On the flip side, people are living with more disability and chronic illness. People are becoming sicker and frailer. Increasingly, people are trying to stay at home, and everyone’s trying to pull together, asking, “Can we keep mom at home?” But Mom isn’t just ill, she’s very ill, and as a state, we need to develop systems to reach out to those people. From a state perspective, waiver programs are important so people don’t have to leave their homes, and we need to provide services for them.
Overall, in the last 10 to 20 years we’ve seen more growth, and particularly over next 10 years we’ll see a lot more growth.
Q: Most seniors in Minnesota want to age well at home, and demand is rising for home and community-based services to help seniors live independently for as long as possible. How can seniors invest in their own health and safety?
A: The important thing is to maintain mobility, strength and activity. We’ve been working on that message for decades and decades. Keeping your walking plan and making sure you’re doing activities at home; these things are still critical. These are what are going to keep people at home.
But closely behind that, loneliness is a big issue with quality of life. We take for granted when we’re younger and in our working years that we have things we need to do every day. You have work, children and things you’re doing every day and you’re thinking about that consciously. As people retire and children move out of the home, it’s easy to become very isolated.
We want people involved with communities and using their gifts and talents and resources to better personkind. That’s going to be really critical. If you have connection, things like nutrition, health check-ups, keeping up on your screenings and disease management, those things all come in to that. In that way, health care is not the biggest component. Lifestyle and behavior are probably more important.
Q: As a geriatrician, you consider determinants of health as well as treatment for your patients. What are ways you have witnessed the impact of these health determinants on your patients?
A: There are a lot of determinants we’ll have to continue to be mindful of, like nutrition and access to health care. Also, the importance of community. Our community is changing dramatically in terms of diversity. How we best address that is also important.
We recognize that yes, certain illnesses and disease play a role with health. But increasingly it’s also housing, transportation, those type of things will play as much or a bigger role. Can you get out of your house? Do you have access to food within close range? Is your senior housing or your apartment on the outskirts of a town without a grocery store?
I do hope that as we move forward, we’ll have society saying we need to address these things, like delivering food to homes, developing transportation options and better integrating more diverse communities.
Q: What are some health needs you feel must be more fully addressed?
A: The hardest one is the workforce issue. It’s really a challenge. Everyone can see it in every area of service we can possibly imagine.
There are still jobs that need to be done. Health care is needed for folks who don’t have family. You can rely upon friends and things like faith-based groups to some degree, but it’s not an easy go.
Trying to find people to meet basic care needs and needs within facilities is going to be a big challenge. The math is going to be really tough on this. And finances are the other part. Even if you have resources and the ability to help pay for things, you just can’t find individual people to do the work. And it’s not just health care, it’s everything – hospitality, retail, you name it. Just trying to find the folks to get the work done is not easy. Community-based services are great but they’re labor-intensive. It’s not as expensive as going to a nursing home, but you have to have people come out and set up medications and provide services.
Q: Looking ahead, what can all Minnesotans do to help ensure our growing population of seniors can age gracefully with the support and care that they need?
A: The first step is understanding the aging process. It’s different now than it was 20 years ago. Really up until the last 30-40 years, we didn’t talk a lot about disability, nursing homes, not driving or the inevitability of moving out of your home. In 10-20 years, we’ll have a better understanding of things like how people can live with disability and still have good quality of life. We need to adapt. The more we understand the process, the easier it is to adapt.
Anna Paulson is a regulator contributor to Face Aging MN. If you want to reach her or have any questions, you can reach us at firstname.lastname@example.org. Have your own story to share? We’d love to hear from you.