Commentary on State of the Science: Interprofessional Approaches to Aging, Dementia, and Mental Health.

Abstract

It is expected that, by 2050, there will be 83.7 million adults aged 65 and older in the United States1 and 1.6 billion world-wide.2 Already there exists an unrecognized crisis in dementia and mental health care for this rapidly growing population.3 Further, the workforce with expertise in aging, dementia, and mental health/substance use (MH/SU) continues to decline, contributing to health disparities.3 As noted by both the Institute of Medicine (IOM)4 and the World Health Organization (WHO),5 interprofessional teams can play an important role in the improvement of population health outcomes for older adults. Interprofessional teams are not new to geriatrics and gerontology.6 Over the past decade, emerging strategies and models of care for interprofessional education and collaboration have built on foundations laid by several organizations.4 For example, the WHO generated the widely accepted definition and framework for interprofessional education and collaboration.5 For over 50 years, the IOM4,7–8 has supported interprofessional education and collaboration and raised awareness of workforce needs for older adults with MH/SU.3 The National Center for Interprofessional Practice and Education9 has partnered with the Robert Wood Johnson Foundation,10 the Josiah Macy Jr. Foundation,9 the John A. Hartford Foundation,9,11 and the Gordon and Betty Moore Foundation,9 to further the work of the Geriatric Interdisciplinary Team Training and Geriatric Interdisciplinary Teams in Practice programs.6,9,11 The Partnership for Health and Aging (PHA)12 developed competencies for geriatrics and gerontology. Finally, the PHA and the American Geriatrics Society13 published a position statement to support team training. Yet, despite longstanding and broad support for interprofessional education and collaboration in the care of older adults, physical and mental health disparities persist. In this supplement, Farrell et al.14 recommend a unified effort to integrate geriatric and gerontology competencies, content and principles into interprofessional curricula that are aligned with objectives for health systems science.15 Those objectives aim to transform curricula to improve population health, team-based care, high-value care, leadership, quality improvement, patient safety and health policy.15 Farrell et al.14 posit that an intentional, systematic approach by health science educators, health care systems leaders and clinicians is essential to advancing innovation for positive outcomes around aging, dementia and MH/SU. Guided by the Interprofessional Learning Continuum (IPLC) model4 (see Farrell et al.,14 Figure 1), this Commentary reinforces and extends the Farrell et al.14 recommendations by highlighting national and international innovations in interprofessional geriatrics and gerontology, especially related to dementia and mental health. The comprehensive IPLC model grew out of recognition in the IOM’s “Measuring the Impact of Interprofessional Education on Collaborative Practice and Patient Outcomes”4 that curriculum reform and collaborative practice redesign are prerequisite to improving health and system outcomes.16 In that context, this Commentary provides a discussion of curriculum reform, collaborative practice redesign and their linkages to health and systems outcomes15,16 and concludes with a brief global perspective17 on interprofessional education and practice as they relate to aging, dementia and MH/SU in older adults. Innovation exemplars in interprofessional education aim to challenge and stimulate leadership in interprofessional geriatrics and gerontology.