Seventy-six million descendants, some four children per generation, emerged out of this spectacular post-war festival after the Second World War. American culture has improved ever since. In only a fleeting span of eighteen years, the baby boom boosted the U.S. population by 44 percent. Civilization in the United States had to restructure itself to have space for the fresher ones. They essentially reformed any societal institution touched by the baby boomers, from preliminary schools to college to the family and the field of jobs, as well as their special positive advancement to the world. Baby boomers have broken the script at any point of their life and began anew. The beginners of these armies of age classes are presently beyond the scope of the retirement age of 65. The ageing baby boom intimidates America’s economic future and health care infrastructure, as per many specialists and futuristic predictors (Goldsmith, 2008).
As the baby boomers are reaching the retirement era, there are numerous issues that need concentrating on, predominantly in the healthcare sector. In reality, there does not appear to be a clear answer to the health problems confronting baby boomers and people in general in the immediate future. Citizens born between 1946 and 1964 are recognised as baby boomers. In the United States of America, there was a sudden surge in birthrates that has never been witnessed before and nothing like that has been seen since. Baby boomers now make up only over 28 percent of the overall population of the United States of America.
Because this community of individuals takes up a huge part of the global population, it is expected that when baby boomers arrive at retirement age, there will be a massive financial burden on the healthcare sector all together. As baby boomers tend to give up jobs and continue to demand long-term care facilities, there are many factors for the healthcare sector to face challenges. A dual task is created as baby boomers give up jobs. In fact, there would be a lack of nurses, since baby boomers make up a significant majority of the total nursing workforce. The second explanation is that 28 percent of the inhabitants retire as baby boomers as they require extra healthcare as a part of the ageing phase. As it is well established, there are several significant health issues that need to be worked on. Healthcare sector administrators have worked tremendously to try to find a solution. Miserably, their duties only have the least effect on the nursing team.
Healthcare firms have placed every commitment from raising pay to delivering strong reward and rewards prices. Capital does not seem to be a big factor in getting people intrigued with the nursing field. Studies suggest that nurses are not likely to grumble over their pay, and plenty will. The volume of jobs allocated to them on a day-to-day basis is typically what they worry about. As a result of shortages of adequate staff, nurses are overburdened and bear massive patient duties. Combined with this, nurses typically get into hospitals and offer direct medical services, and are expected to perform regular work with some clerical forms. These regular jobs require too much paperwork to fulfil the needs laid out by Medicare and insurance providers and claiming to be accredited by insurance companies to access patient treatment. As a matter of fact, nurses are not supposed to stay behind a monitor and address different topics on the telephone hours together (ezinearticles.com, 2009).
America‘s Health Care Crisis
The U.S. Times notes that the emphasis on health insurance has already been altered by White House executives. Bush’s top domestic policy advisor, Al Hubbard, involves working on thoughts to control budgets, increase connectivity, and build excellence. So far the Bush administration appears aiming at spoiling its signature health-care initiative, the prologue to a prescription-drug benefit for senior people contained in the Medicare agenda. Thousands of unfortunate senior citizens were stripped of the medications they used to receive at no expense, and more than twenty state governments had to compensate for the drugs. Republican decision makers are concerned about what this fiasco will cost them in the future.
Bush might, though be willing to push for more important reforms in American health care than elsewhere. According to the new Wall Street Journal/NBC analysis, both policymakers and citizens understand that the surge in health care rates is a tragedy second to the Iraq war. These investments are the source of the lethargic growth in the salaries of employees, the pervasive knowledge that the middle class of America is being compressed, and the large declines in employment.
America’s health system is massive. One can argue that it is the most expensive health care system in the country. In 2004, the United States invested $1.9 trillion, or 16 percent of GDP, on wellness. In America, health insurance is not yet as entrenched as we believe in the private sector. Usually, the state covers more than half the charge. This is, moreover the wealthy nation in which tax-subsidized employer-supported policy pays a substantial portion of health coverage.
This scheme is a Second World War legacy, as businesses, limited by pay limits, utilised health care as a means to recruit staff. That is to assume that according to survey figures, some 174 million Americans earn insurance care from their own workplace, the employer of their partner or their kin. Another 27 million purchase in-person health benefits for which they do not earn a tax advantage. In the Medicare scheme, the government chooses 40 million older citizens and injured Americans, and another 38 million are deprived by the state-federal Medicaid system. Approximately 46 million of the residual assets are not covered, and some of them, whether students or staff, go without protection at their own discretion. Actually, in hospitals, they offer emergency treatment that is covered by higher rates for any person.
The US healthcare system has some apparent influence relative to the other rich countries, who characteristically give all their citizens free investment in health care by taxation. Patrons get ample substitutes, and there is a phenomenal change. One survey of physicians published in ‘Community Affairs’ stated that in America, eight out of the ten main medical advancements over the past 30 years were instigated. Undoubtedly, there are major challenges to the American scheme especially inadequate coverage, imperfect value and high expenditure.
Major contradictions hang throughout the structure. For example, Dartmouth College’s John Wennberg, Jonathan Skinner, and Elliot Fisher have found that Medicare spends more than double as much on patients in Miami as in Minneapolis, and that the result is greater when costs are smaller. Up to 30 percent of Medicare spending is lost, they added. Treatment mistakes are widespread and study by the Institute of Medicine has shown that medical error is the eighth-largest cause of death in the world.
For decades, American health-care consumption has surpassed income increases by an average of 2.5 percent annually. Under this pattern, there have been clear sequences; for example, grouping employees into managed-care programmes specifically Health Management Organizations (HMOs), which negotiate concessions with physicians and restrict patient-accessible facilities, helped in the mid-1990s to slow down health price increases. Yet people despised HMOs, there was a political backlash, and investment went up again in the late 1990s. While the medical spending rate slowed marginally in 2004, expenses have increased by 40% since 2000. Usual insurance rates have jumped by more than 60%.
The Great Unraveling
Inflation in general is surpassed by medical expense increases; American organisations are cutting down the insurance coverage they recommend. The allocation for workers seeking health care from their own workplace has fallen from about 70% in the late 1970s to just about 50% today. The number of businesses contributing medical pay has fallen from 70 percent to 60 percent in the previous five years, with the rapid drop of small companies and others employing fewer qualified employees.
By the co-payments and deductibles, the managers of the businesses that offer health care have added additional spending on workers. Employer-offered insurance care for elderly workers has declined, even as the major car factories in America, along with Ford and General Motors, are also unable to have it. Around the same moment, the government’s woes are going to escalate. Together, Medicaid, Medicare and other visibly subsidised health services are added, such as the 45% of American health care now provides for ex-servicemen and the public sector sectors. However as American companies cut their health-care investment and, for the most part, when the baby-boomers exit facilities, the share would increase dramatically. Current trends suggest that by 2020, national health spending would double as a share of the financial sector. That may apply to a huge number of taxation, but Americans may not want to spend.
Before long, America’s health sector would disentangle as employers restrictive to their transparency and government reluctant to invest in its responsibilities. Reduced knowledge, inadequate competitiveness and skewed incentives have overwhelmed health markets. In spite of the reality that much of the costs are covered by the insurance provider or the state, neither patients nor clinicians are conscious of the real burden of expense management. Americans usually still spend $1 out of every $6 paid on their health insurance as their own expense. Physicians are typically compensated for individual services and therefore have an opportunity to conduct so many procedures. Luxurious coverage is facilitated by the enormous tax break on employer-purchased health plans. The tendency towards needless ‘defensive’ medicine is rendered worse by unethical attorneys and the risk of court proceedings.
The experience of American health care is besieged by failed attempts at structural change. In the 1940s, Harry Truman attempted to develop a scheme of universal health care. Around the same moment that Canada introduced its health reform in 1971, many American politicians wanted the same system to do so. Hillary Clinton’s 1993 health care initiative, which committed on health insurance benefits for everyone provided in the course of cautiously managed health deals and price controls, was the most recent attempt. Because of the massive influence of health-care lobbies, all those diligent work lost.
While a range of valiant health practitioners also advocate full reform, the present debate is blemished by such shortcomings. For eg, the Medical Doctor Working Group suggests that America would adopt a one-payer plan, the same as in Canada or Britain. However, U.S. lawmakers have shown no interest in a sweeping move. Instead of limiting outlays, their focus is already on increasing coverage. Since 1965, the big new strategy plan, the 2003 decision to provide Medicare prescription coverage, has been the key implementation of a federal insurance network.
A variety of states have adopted a more drastic view. Massachusetts, for instance, may mandate everybody to provide minimum benefits, with the state supporting financial aid to underprivileged persons. Maryland has a recent statute forcing all major corporations to contribute at least 8 percent on their health insurance payroll, allegedly to halt the Medicaid scheme of the state. About the reality that the specific bill has more to do with Wal-Mart-bashing than health insurance, in 30 jurisdictions, unions are calling for identical laws.
The very enticing reforms have emerged from inside the health-care sector. The ‘Pay for Results’ is one of the innovations that improve the stimulus of doctors and hospitals to deliver more proficient and enhanced treatment by computing value and changing compensation accordingly. Karen Davis, president of the Commonwealth Fund, a forum for health-care studies indicated that there are already around 100 ‘Pay for Success’ programmes in operation. Premature substantiation indicates some effect on them (The U.S. Times, 2006).
Health Care Work Force Too Small, Unprepared for Aging Baby Boomers
John W. Rowe, professor of health policy and management at the Mailman School of Public Health, Columbia University, New York City, said that owing to the rising number of ageing people, many who live longer with added multi-faceted health criteria, the health care system is experiencing an immediate challenge, steadily exceeding the number of health care professionals with the expertise and skills to c He also stated that in coming years, the maximum number of aged patients would entail seeking innovative strategies for delivering health treatment and the obligation to provide superior economic resources. When elderly family members and associates live as energetically as they can to retain the greatest possible wellbeing, the health care system should provide ample numbers of health care workers and the ability to take care of them.
Work Force Shortage Threatens Quality of Care
Numerous studies suggest that there is a general lack of health care professionals in all sectors, although the condition of affairs of geriatric care is lower as it draws the interest of less specialists than other disciplines and instances of high wage rates for direct-care staff such as nurse assistants, home health assistants, and personal care assistants. For example, there are actually just over 7,100 physicians practising in geriatrics in the United States, which implies one every 2,500 elderly individuals. Turnover of nurse aides is 71 percent annually, and up to 90 percent of home health aides typically leave their work during the first two years.
Aging adults are in excellent health as a group and currently live longer than past generations, the study states. Nevertheless, people aged 65 are more likely than younger patients to have additional complex disorders and health insurance criteria. The typical 75-year-old American has at least three health illnesses such as diabetes or elevated blood pressure, and uses four or five prescription medications. Dementia, osteoporosis, visual dysfunction, and other age-related medical disorders produce challenges that health care professionals do not always face while nurturing younger patients.
All Providers Should Be Competent in Geriatric Care
At any point of their vocation, nearly all health care professionals take care of older patients to some degree and expected to do so much more frequently defined that one in five Americans will be 65 or older by 2030. Consequently, geriatric nursing requires a certain degree of capacity. Health care workers may be expected to show proficiency in essential geriatric care to retain their licences and certifications. In the management of elderly citizens, both health professional schools and health care preparation systems must broaden assignments and instruction.
The studies recommend health care vocations and administrators to learn about intensifying the roles and obligations of health care professionals at varying levels of preparation in order to deliver care more professionally and minimise the lack of adequately trained workers. For example, if a trained nursing assistant were willing to administer such medications, there will be more time for a skilled nurse to work on more specific patient needs. Further study into how to prepare health care workers to accept expanded roles is deemed essential, the research committee said. Since poor teaching will find direct-care workers unqualified for the hassle of their work and move forward with higher attrition rates. For direct-care staff, the nationally mandated minimum amount of hours of preparation could be increased from 75 to at least 120 hours.
Higher Salaries, Financial Incentives Needed
Although there is a rapid rise in the number of older patients, the number of licenced geriatric specialists is diminishing. In order to draw more health practitioners to geriatric professions and to stall attrition of care assistants, many of whom receive incomes below the poverty line, Medicare, Medicaid and other health insurers need to pay more for the services of geriatric specialists and direct-care staff.
In other areas, the wages of surgeons, nurses, pharmacists, social workers and others specialising in geriatric treatment fall behind those of their counterparts. In 2005, a geriatrician paid an average of $163,000, relative to $175,000 for a general internist, considering the additional years of experience required for a geriatric profession. About $300,000 a year will be received by physicians who prefer dermatology. While working more hours and more overtime, licenced nurses working in nursing homes or other long-term care institutions receive on average less than their colleagues. The main explanation why geriatric specialists receive smaller wages is the poor payment rate of Medicare for primary treatment, provided that so much of their compensation comes from the federal programme. The study advises that Medicare should improve its payment rates for treatments provided by geriatric specialists.
Direct-care staff are more likely than jobs in other sectors to lack health benefits and use food stamps. For direct-care staff, the median salary in 2005 was $9.56 an hour. The committee recommended that states could distribute funding to be applied to Medicaid premiums to raise salaries, covering the bulk of treatment rendered by direct-care staff.
Family Members, Other Informal Caregivers Need Training
The study recommends that health care providers, social agencies, and other public and private organisations have educational agendas to enable family members, acquaintances, and other informal caregivers provide sufficient assistance to their relationships and minimise the distress they may feel in handling the desires of an aged peer or parent. Patients and informal providers must be regarded by health professionals as an integral part of the health care system, the study said. It is predisposed to elderly parents or other aged individuals affecting 29 million and 52 million relationships, acquaintances, and others. About 90% of older adults who embrace home care depend in part on informal caregivers and almost 80% rely entirely on partnerships or associates. Nevertheless, barely anything is done to guarantee that casual caregivers have the understanding and skills needed.
It is recommended that state attorneys general should accept free caregiver preparation curricula as a means for non-profit hospitals to potentially fulfil their prerequisites to provide their local population incentives in substitution for their tax-exempt status. In addition, government entities may ensure the enhancement in expertise that can support elderly patients handle their state of affairs and control the critical conduct of daily life, and can even assist informal caregivers to take care of their loved ones.
Medicare Hinders Delivery of Quality Care
While the aim of this report was not a full assessment of Medicare, the analysis group found out many areas that the agenda obstructs the stipulation of dominance services for older people, together with the poor compensation rates of Medicare, its focus on the treatment of temporary health issues rather than the monitoring of serious illnesses or age-related diseases, and its lack of coverage The study notes that Medicare and additional public and private insurance programmes ought to remove deterrents that hinder the implementation of new forms of clinical delivery by health care professionals, such as interdisciplinary community care that could enhance the health of patients and decrease costs. The report noted the challenges with making improvements to Medicare and the economic situation threatening the programme, which is projected to run out of money by 2019.
The research was funded by Josiah Macy Jr. of the John A. Hartford Fund, Atlantic Philanthropies. Foundation, Robert Wood Johnson Foundation, California Endowment, Arch Stone Foundation, AARP, Fan Fox and Leslie R. Samuels Foundation, Retirement Research Foundation, and Commonwealth Fund. Founded in 1970 under the agreement of the National Academy of Sciences, the Institute of Medicine provides politicians, health practitioners, the private sector, and the public with self-governing, purposeful, evidence-based advice. The National Academies (The National Academies, 2008) include the National Academy of Sciences, the National Academy of Engineering, the Institute of Medicine, and the National Scientific Council.
Uneven Distribution of Doctors, Nurses may Make Shortage Worse
The federal government has estimated that America will be out of 24,000 physicians and nearly 1 million nurses by 2020. As per a study submitted by PricewaterhouseCoopers, health care workers would be unequally dispersed throughout the world. In the meantime the existing trend in health care will hold would-be nurses and doctors out of the field of healthcare. It is predicted that all nurses in the nation will continue to decrease after 2010. When baby boomers start to hit the age of 65 and need further preventive services, several nurses would enter the retirement level, according to a U.S. reading from 2004. The Health and Community Care Agency. Registered nurse vacancies are estimated to range from 400,000 to nearly 1 million. Texas would have to deal with a deficit of 27,000 registered nurses by 2010, according to the Texas Healthcare Alliance. Compared to 2004, the minimum requirement for registered nurse vacancies rates in Texas hospitals is currently 10.2 % -19 percent higher.
Compared to the supply and demand of nurses, forecasts for supply and demand for medical doctors are more unclear. According to a 2006 report by the Association of American Medical Schools, one-third of all practising physicians are reportedly over 55 years of age. Few of the specialists claim that because they are better monetarily trained, they may give up work before nurses. The Department of Health and Human Services foresees a net deficit of 24,300 doctors by 2020. According to the Price Water House Study, the connotations of this shortage are stronger in the trillion dollar U.S. healthcare sector. Actually, hospital managers express concern about the perceived shortcoming. The Pricewaterhouse study (Roberson, 2007) indicates that even though scarcity can create difficulties, there will be an even greater challenge from the uneven allocations of doctors by specialisation and geography.
Boomers and the Cost Crisis
The projected price tag of supplying older Americans with health insurance still adds up to a shadow state of affairs. At the present period, about 16 percent of the Gross Domestic Product (GDP) is consumed by U.S. health care expenditures (Poisal, et al. 2007). It would bring more strain to an ageing population. Aged people currently incur three or five times the expense of health coverage than those less than 65 years of age, and the likely cost of Medicare itself is estimated to exceed $862 billion by the year 2016 (CMS, Office of the Actuary, 2007). That’s about 4% of GDP in general. And if ailment prevention and preventive support are not effective for older people, owing to population trends, the nation’s health care budget is projected to rise by 25 percent.
Boomers and the Quality Crisis
Undoubtedly, receiving the best treatment is a trait of excellence; nevertheless the goal has become elusive. The leading psychological theory on what happens and what is not always followed. A new Population Standard Index report undertaken by Elizabeth McGlyn and colleagues at RAND Health courageously reveals that all adults in the United States are at risk of accessing inadequate health care, regardless of where they reside; whether from whom they obtain care; or what their ethnicity, gender, or economic status is (Rand Health, 2004).
But boomers will confront the pharmacy dilemma with an additional consistency catastrophe. False medications are on the increase for elderly people. The complexity is threefold. Patients are given drugs they don’t require, they don’t administer medicines they really need, and they prescribe the incorrect medicines for a particular illness (Spinewine, et al. 2007). The prospect is to expect increasing production, labour force shortages, volatile efficiency, and rising costs. Not that good is this outlook. The Baby Boom Generation itself, however was disregarded, underestimated, and not exploited as a fundamental resource. In health care delivery networks, this generation of Baby Boomers will be a transformative force.
In order to secure health insurance, the Baby Boomers have every incentive. In United States past, they lead to the single big population increase. And they have huge jurisdiction. This is the age demographic that has characterised the civilization of America, from embraced civilization to human rights, faith and politics in many respects. This community is currently ready to redefine the truth of growing old. The age group of the Baby Boom has the capital, college education, computer skills, and the potential to revamp the health care system.
According to the Department of Labor’s Consumer Spending Report, America’s Baby Boomers lavishly invest an extra $400 billion per year on consumer products and services relative to other age classes. The group of Boomers is the most educated in America’s history. Around 90 percent of Boomers have diplomas from high school and 57 percent have graduate education (U.S. Census Bureau, 2006). In 2004, 76% of Americans between the ages of 50 and 58 were in their office, at college, at home, or somewhere else studying or using a computer. The overwhelming majority of Baby Boomers are expert at making buying decisions using online knowledge, and that includes medical decision-making.
The Capacity for a Culture Shift
Baby Boomers are now witnessing two awareness-raising phenomena that appear to be a contrasting combination of both an expansion of time and an end of time perception. The bulk of people live over 30 years or more than their ancestors did. The 30-year duration is a struggle for ageing Americans to brace themselves for this prolonged life span. Set the drift in the path of internet usage and wellness literacy, it would be necessary to devote a great deal of this bonus period dreaming about and addressing health care. Such care-giving and administrative responsibilities offer Baby Boomers an opportunity to hear about the inadequacies of the new U.S. health care framework. Boomers provide the whole portion needed to transform the health care sector, along with figures, faith, experience, and motivation.
Tools for Health Care Transformation
At times, it acquires a few basic guidelines and tools to get away from the old ones in the context of a multifaceted framework. The rules and instruments of the Ix Approach will produce the chaotic enhancement needed in a more positive and cost-effective way to rethink health care. In the modern society they build, the clinics, hospitals, and insurance plans that operate for the first time will have the greatest potential to succeed.
The Self-Care Rule
The majority of Boomer patients, including those with several belongings, are not aware of what they are capable of, how they can do it and what their own health care function must perform. While new technologies and developments carry improvement, Personal Preventive Strategies are meant to be generated through Ix Solution Self-Service Software. Each Boomer will extend a personal fitness, nutritional support, and disease prevention plan by online resources to lead them in the direction of healthier behaviours, healthy environments, and recommended immunisation and assessment services. And you may get a debilitating illness as well,
Each Boomer with one or more chronic illnesses may access a full self-help plan customised to individual needs, likings, and degree of value and motivation for management plans with online resources. In order to understand the costs, dangers, and advantages of treatment options, patients can take decisions with online help on ‘aids’ and each Boomer can engage enthusiastically in medical decisions along with his or her physicians. Boomers may treat mild problems on their own and assess better whether they need help from healthcare providers with printed self-care handbooks.
The Law of Guidance makes boomers inquire about the health services they need. The Boomers are less reflexive than their parents in the doctor’s patient partnership. They are inclined to pursue various therapies, and are most willing to look for information regarding their wellbeing on their own. The strongest and most trustworthy companion of a health care customer will be medical practitioners. If boomers want high health treatment, though, they need to help their doctors do their work. About 45% of persons who have experienced a heart attack receive the proposed path of beta-blockers to minimise their chance of death. And as suggested, only 61 per cent get aspirin. Increased patient awareness of the recommendations will decrease risk. Just one out of four individuals with diabetes tests their daily monitored blood sugar levels.
Less regulation of blood sugar in patients with diabetes may cause kidney disease, blindness, and loss of limbs. Many boomers have initiated routinely scheduled blood checks to close the distance. Medicine awareness that allows the public to understand the difference will guide better treatment and reduce prices. And in both situations, a Boomer who understands the law is best able to inquire for the optional and needed treatment and get it. Having the patient’s instructions increases the potential of the patient side of the doctor professional team as a consequence of which the patient may help in making choices on his or her treatment.
Each Boomer would be best prepared to ask for the treatment they need with evidence-based recommendations in hand. There is less work for the clinician as patient orders are integrated into the clinic’s electronic medical records system. The doctor also saves time, since the orders from the patient make patients realise what they can do. Patient records supported electronically may be prescribed at the time of a doctor’s appointment or immediately via the electronic medical record system. Links to additional Web-based decision support resources are embedded inside certain directions. Routine claims data, test data, or PBM data will cause prescriptions for health plan-delivered data.
They will also provide users with targeted updates about their existing health conditions and more immersive and informative material with site links. The biggest advantage to these programmes is that patients who may not actually be searching for knowledge on their own should be activated. By making it easy for them to locate good knowledge without narrowing their quest, they often bring value to the more proactive health seekers. In the data prescription, the site links that point to additional widespread and more interactive resources often provide additional benefit.
In the Ix Approach, the third level toolset involves ongoing and immersive crusades to help each person master his or her chronic conditions. The campaign helps patients acquire the knowledge and develop the motivation to manage their situations. These crusades are part of the traumatic modernization that will fuel the Boomer’s health care movement. The Veto Rule lets Boomers say “No and make sure the Boomers are the original generation to enter retirement with a well-learned capacity to say “No thank you” to their healthcare providers. One of self-rule is the essential issue. Via true autonomy, the treatment and comfort they need may be determined by patients (Mettler, Kemper, 2007).
Boomers Remain Optimistic About Retirement
The new financial crisis, the shame of mutual funds, and the resurgence of unemployment are obvious to have had a slight effect on the retirement point of view of Baby Boomers. On par with the 70 percent recorded in 1998, 69 percent of Baby Boomers are equally optimistic regarding their retirement years. 46% claim that in the preceding five years their retirement point of view has improved for the healthier. Many with the superior outlook are more likely to attribute that to diligent work to put up more for retirement and perfections in their monetary situation that come from lifestyle adjustments such as paying off a debt or making their last child move out of the home. Unlike other communities, African Americans have a far superior and substantially more positive retirement attitude.
- CMS, Office of the Actuary (2007), National Health Expenditure Accounts. Retrieved on 18 April 2009 from: www.openminds.com/indres/031207cmsnathealthprj.htm
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- The U.S. Times, (2006). The world’s biggest and most expensive health-care system is beginning to fall apart. Can it be fixed? America’s Health Care Crisis. Retrieved on 18 April 2009 from: http://www.ustimes5.com/america’s_health_care_crisis.htm
- The National Academies, (2008) Health Care Work Force Too Small, Unprepared For Aging Baby Boomers; Higher Pay, More Training, And Changes In Care Delivery Needed To Avert Crisis. Retrieved on 18 April 2009 from: http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=12089
- U.S. Census Bureau, (2006) Current Population Survey, Annual Social and Economic Supplement Retrieved on 18 April 2009 from: www.census.gov/population/socdemo/education/cps2006/tab01-01.xls