Introduction to the Special Issue on the Workforce for Seriously Ill Older Adults in the Community


Joanne Spetz and Vyjeyanthi S. Periyakoil

May 10, 2019

In May 2018, 40 leaders and scholars from universities, delivery organizations, professional associations, advocacy groups, government agencies, and private insurance companies convened in Napa, California, for a Workforce Summit organized by the University of California, San Francisco, and sponsored by the Gordon and Betty Moore Foundation. Attendees were charged with a mission: Identify and prioritize recommendations to ensure an adequate workforce to support the care of people with serious illness in the community . The goal was to focus on recommendations that could overcome barriers and accelerate health workforce development activities in the near term defined as approximately 3 years.

This effort built on prior work by the National Academy of Medicine and other consensus‐based recommendations from organizations such as the Office of the US Assistant Secretary for Planning and Evaluation and the Center to Advance Palliative Care. To launch discussions of concrete recommendations, seven papers were commissioned. This special issue of the Journal of the American Geriatrics Society presents these papers, along with a summary of the recommendation developed at the summit. The articles address a range of pertinent topics: advance care planning and integration of care planning into primary care, clinician communications regarding prognosis and patient preferences, strategies for building a culturally competent workforce, a vision for the palliative care workforce, supporting family caregivers and direct care workers, and linking patients with social services.

After 3 days of consensus‐building efforts, the summit attendees proposed 16 overarching recommendations, spanning the workforce from home care aides through geriatricians, and including topics such as entry‐level education, continuing education, payment reforms, health information technology improvements, expansions of innovative federal programs, enhanced data collection, and focused research. The recommendations highlight the urgency of the issue and charge policymakers, foundations, healthcare payers, delivery organizations, and clinicians to act now. We hope the contents of this special issue spur readers to engage as change agents to meet the great and growing needs of seriously ill patients living in the community and their families.