Holistic Healthcare for an Aging Population with Dr. Lina Shihabuddin

For the sixth episode of the Moving Healthcare Forward Podcast, I was honored to speak with Dr. Lina Shihabuddin. Dr. Shihabuddin is the Chief Population Health Officer with RWJ Barnabas Health, and she has an extensive and wide-ranging background in healthcare: she has trained in internal medicine, psychiatry and geriatric psychiatry, hospice and palliative medicine, and more. On today’s episode, we dove into elderly mental health, holistic healthcare and the incredible role that geriatric psychiatrists play in taking care of our aging population.

The Demand for Geriatric Psychiatry

Holistic healthcare can’t be achieved without taking both mental and physical health into account as linked and inextricable factors. The brain is the center of the body’s ability to function, something which Dr. Shihabuddin says has always fascinated her — and yet, she notes that mental health is often treated as separate from the health of the rest of the body. “The reality is, it’s taking care of one individual,” she explains.

As our population ages, living longer than ever before, caregivers are faced with a new question: How do we take care of people who are living longer lives? 

The risk for age-related cognitive diseases increases with age. In fact, aging is the number one risk factor for Alzheimer’s disease, and as the number of people surpassing the age of 70 or 80 gets higher, so does the demand for geriatric psychiatrists who can help prevent and address cognitive deterioration. 

Unfortunately, that significant demand for geriatric psychiatrists is not being met. Primary care physicians tend to bear the brunt of caring for aging patients with cognitive diseases, but they do not have the extensive training and expertise that geriatric psychiatrists do when it comes to handling elderly patients, especially when they are agitated. 

Furthermore, patient access to these psychiatrists and the healthcare they need can be even more elusive. Psychiatry is under-compensated by insurance, and older patients tend to have a hard time paying out of pocket as they are most likely retired. Telemedicine and telepsychiatry have helped improve access by making it easier for patients to physically access care, but cost and provider availability remain barriers to accessing care in many cases. 

Care Beyond Prescriptions

Beyond psychiatric care, there are several other factors that can help prevent or mitigate the effects of cognitive diseases — social engagement, faith, hope, creativity and activities like yoga and Tai Chi can all have remarkably effective impacts on improving the physical and mental health of aging patients with cognitive diseases. These activities can even reduce a patient’s need for sleep and agitation medicines. However, they all cost time, money and resources that are simply unavailable. “No one’s paying for it,” Dr. Shihabuddin says succinctly. “You fall, you break a hip, you go to rehabilitate the hip. [But] there is nothing called cognitive rehab paid for simply because you are developing early stages of Alzheimer’s disease.”

Dr. Shihabuddin hopes that government-funded programs will begin to see how important it is to focus on prevention when it comes to the elderly and cognitive impairment. While entitlement programs tend to be perceived as politically risky for politicians to support, in part due to the tough questions about who to finance them and who (or what age groups) would be eligible, Dr. Shihabuddin points out that “we’re all going to age. The population is aging. All these individuals have worked all their lives — it’s not really a handout from the government.” In reality, it’s an important part of caring for our loved ones and our communities.

Listen to our episode with Dr. Lina Shihabuddin, Chief Population Health Officer with RWJ Barnabas Health, on Apple Podcasts here, or on Spotify here.