The health of older Americans will become a critical national policy issue during this century. As the population of older adults increases dramatically, there are few signs that adequate resources are available to meet the challenge of providing health care and good quality of life for older adults and their families. A fundamental change in the values emphasized in the American culture, and in other cultures, will be required to change the present health care system from one which focuses on diagnosis and treatment of disease to a system that attends to the major issues that affect quality of life of older adults and their families. This article discusses four critical areas influencing the quality of life of older Americans: providing resources to individuals to help manage chronic medical conditions, assuring a sufficient number of primary health care providers educated in geriatrics and gerontology, removing financial barriers to accessing health care and medications, and changing the American cultural value system that emphasizes disease treatment over providing emotional, educational, and support resources. To make these profound changes in the formal health care system, health care providers, health care organizations, and policy makers must commit to embracing the importance of quality of life as an integral component of health care for older citizens.

aged --- aged --- 80 and over --- health services for the aged --- chronic disease --- family caregivers --- quality of life

The aging of the baby boomers comes at a time of a growing nursing workforce shortage: registered nurses, nurse aides, and nursing faculty. Older adults have multiple physical, social, and psychological conditions, making the assessment, planning, and delivery of health care more complex than that of younger adults. Not surprisingly, this age group also utilizes the majority of health services in the country. Thus, most nurses will provide care to older adults in a variety of settings. However, the majority of nurses have little to no background in geriatric nursing. These multiple forces: aging population with complex needs, nursing work force shortage, and lack of geriatric knowledge, along with fewer resources, will have a grave impact on health care in this country in the near future. This article reviews issues related to an aging population, the projected nursing workforce shortage, and the lack of geriatric nursing education; it concludes with suggestions for future health care delivery to the geriatric population in the US

nursing workforce --- geriatric nursing --- aging population