Older Americans feel that the health care system rarely accounts for the totality of their health care wants and needs, including behavioral health.
About half of those age 65 and older (45%) say their doctor asks about their mental health. Even fewer, about 40%, consider their cognitive and brain functioning.
“Older adults are stuck in a health care system that is not responsive to their goals and preferences,” Terry Fulmer, president of The John A. Hartford Foundation, said in a news release. “Boomers want health care that maximizes their health and ability to function, and they want their providers to listen to them.”
The John A. Hartford Foundation, a nonprofit focused on issues older people face, partnered with Age Wave, a research and consulting firm focused on population aging, on the poll, which was conducted by The Harris Poll.
Overall sentiment from the older adults surveyed by these groups presented an ironic mismatch between the survey data and other data sources. Those aged 65 years and up engage with the health care system the most. Personal health care spending for this group is over 5 times higher than for children and about 2.5 times higher than for working-aged adults, according to national health care expenditure data. Of all physician office visits tracked by the CDC in 2018, 33% were for those 65 and older, the largest single group in the data.
Yet, most older adults (82%) said that the health system is not prepared for the needs of their generation, the Harris Poll found.
The poll also highlighted disparities in how people felt about their behavioral health, depending on segments of the demographic. Rural respondents reported lower levels of “excellent” or “very good” mental health (57%) compared to urban respondents (65%). Those reporting low financial resources also reported lower levels of good or better mental health (50%) compared to those with high financial resources (76%).
“[Low financial resources respondents] are more likely to want their health care providers to spend more time understanding what matters to them, better managing pain and chronic conditions, and suggesting ways to address mental health issues,” the survey report states.
It also states that mental health takes a big hit as functional health declines: 68% of older adults with no functional health limits report very good or higher levels of mental health. Compare that to 56% of respondents with one or two functional health limits and 36% for those with three or more.
While the health care system has largely focused on extending lifespans, nearly all older adults (94%) said quality of life is more important than the number of years lived, the study report states.
The public and private sectors have recognized the need to reassess how they approach the senior population. Lawmakers have made sporadic efforts to rework the legal foundation for Medicare, the public health plan for seniors. This year and last, the Centers for Medicare & Medicaid Services (CMS) rolled out several reforms to existing policies and provisions related to behavioral health services for seniors.
One example from the private sector: the digital mental health provider Talkspace Inc. (Nasdaq: TALK) expects to provide therapy services to seniors nationwide via Medicare coverage by the end of 2024.
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