Home Health Nurse Practitioners and an aging population: why we need them more than ever

Nurse Practitioners and an aging population: why we need them more than ever

by Radhe Gupta

It is safe to say that nurse practitioners, or NPs, are some of the hardest-working medical professionals employed across the US today. The demand for NPs is likely to grow by around 46% by the start of the next decade. But why are we so much more dependent upon our NPs now than ever, and why does it tie into a “graying” population?

In this guide, we will take a look at why NPs are so vital in helping to support elderly care in the US and why that dependency is only going to grow from here on out. As it happens, there are multiple different routes for NPs to take when studying and progressing – and the way the population is evolving, specializing in elderly care may be one of the most rewarding routes to travel.

Why do we need nurse practitioners so much?

It is not just doctors and specialists who care for us. In many cases, a nurse will help assess, diagnose, and provide ongoing care to patients of all ages and at all support stages. In fact, there are many different reasons why NPs are in such high demand, and we will come to the elderly link shortly.

The first and perhaps most obvious reason for NPs becoming more sought-after is that we are running short on doctors. It is thought that physicians are, regrettably, in short supply. That is felt immensely in rural and off-grid territories.

However, this is where NPs can head out and share their knowledge and care with wider communities. In many cases, a talented and qualified NP can diagnose and treat people without needing doctors to get involved.

From a healthcare provider’s perspective, NPs are paid less, on average, than general physicians. This is largely because they help to complement the care and guidance doctors provide. That said, if NPs continue to receive so much dependence over the years to come, there may likely be growing demand for wages to match those of their contemporaries.

NPs are multi-talented, multi-faceted and offer a wide range of care essentials for people of all ages. As our population ages, we need their on-call support more and more than ever.

The population is “graying”

While this is true of several countries worldwide, statistics clearly show that the US is getting “older.” That is, in the sense that there will be more older people than younger people across our country by the start of the 2030s.

Research undertaken by the US Census Bureau states that, by 2034, people over 65 will outnumber children in the US for the first time. This has even scaled back a year, with 2035 previously projected as when the milestone would be hit.

We are already living in a nation of predominantly middle-aged people. But, within the next ten years, older and older adults will become the majority of our population. That means it is more than likely NPs will need to support more elderly patients than ever before as the years go by. 

The growth of our elderly population appears to result from the Baby Boomers generation generating more births than the Silent Generation before them. We are heading towards a quarter of the population being 65 years or older, and there may even be half a million of us over the age of 100. It is incredible to think about!

However, as you may imagine, the older we all get, the more support we need. This is where the elderly population is creating more of a culture of dependency on NPs as we approach the mid-decade.

Elderly people demand more care, more often

The most obvious reason for older people increasing NPs demand is that they simply need more care. As we age, our bodies weaken, from our muscles to our immune systems. While we all age at different rates and are individually disposed to handle various conditions and diseases differently, you are more likely to head to the hospital in your 80s than in your 20s.

In addition, older people are more likely to be proactive in seeking health assessments. Even if they have no specific complaints or conditions to contend with, many older people book regular checkups to ensure they are ahead of any potential underlying problems.

It is a conscientious move that is always recommended – however, it is placing additional pressure on our NPs.

Therefore, with older people making more regular visits to health centers and hospitals, NPs are encouraged to consider specializing in elderly care as the years go by. Some people studying to become nurse practitioners consider the difference between AGACNP vs. FNP routes, such as through Rockhurst University. Their programs offer clinical placements to ensure their students graduate ready for their roles.

But what do all those letters mean?


FNPs are family nurse practitioners. They care for the whole family, from children to grandparents, from birth to old age. As mentioned, these FNPs are often relied upon to provide care to rural and marginalized communities where doctor support is not available.

While FNPs care for older people as part of their daily routines, some specialists solely work with gerontology. AGACNPs, or adult gerontology acute care nurse practitioners, specialize in supporting adults approaching middle age and later in life.

As you may imagine, these nurses often need to handle more complex conditions and sometimes take greater care in helping support their charges. We will cover the complexities of elderly care in a little more detail shortly.

However, let’s also break down a curious statistic. Although the US population is undeniably growing older, heading toward the 2030s, there is a disparate gap between FNPs and AGACNPs. Only 2.9% of NPs who graduate specialize in acute care for elderly people.

Comparatively, 7% are specialized in adult gerontology care to a primary extent, while the vast majority– 69.7% of graduates – are FNPs. In years gone by, focusing on the family has made perfect sense. However, the statistics from the US Census discussed above prove that there needs to be a significant shift in who our NPs treat and care for.

Could this mean that universities and medical colleges promote AGACNP disciplines as a priority? It is perhaps too early to say. But, with doctor shortages continuing to ravage the wider medical system, it certainly would not be beyond question.

Elderly people require complex care

Returning to the care needs of older people, let’s also consider how much dedicated support our elderly population needs with complex conditions and diseases. As they are more susceptible to illness and immune deficiency, our older patients not only need to head to the hospital more frequently but also need more conscientious support.

The older people get, the more at risk they are of complications from illnesses and even inadequate treatments. Dedicated NPs need to be exceptionally careful in their decisions and precise in the medication and support they provide.

That means we need valuable, genuinely talented NPs to take care of our parents and grandparents more than ever. If physicians are not available to help our family members in their advanced years, we need NPs to be laser-precise in their decision-making.

This, of course, can create a lot of pressure for many nurses. That said, this is still a career path with immensely rewarding opportunities. Healthcare providers must ensure that NPs receive thorough guidance and post-school education to ensure older patients receive adequate medication and care regardless of age and status.

COVID-19 created huge bottlenecks

There was already a growing need for AGACNPs ahead of 2020’s COVID-19 lockdowns. The emergence of a new respiratory disease – that put elderly people at particular risk – only helped to heap more pressure on NPs across the country.

COVID-19 resulted in a mass shortage of medical personnel for various reasons. Nurses and doctors were required to care for more patients than ever, with staff also contracting the virus, resulting in care bottlenecks and rising mortality rates.

In the early days of the pandemic, there was no vaccine. The elderly among us were encouraged to shield themselves from the emergent disease and to “bubble” with limited numbers of family members wherever possible.

Pre-vaccine, the world became an even more unpredictable place for older people. While many more people survived the first year of COVID than passed away, the pressure on NPs to treat older people and stem the spread of the virus became difficult to bear.

The pandemic proved to millions that we need NPs more than ever. Thankfully, this situation led to NPs gaining more experience and taking more responsibility in their workplaces. This was compounded in many high-stress situations, but the landscape is still changing post-2020.

Above all, 2020 proved that our elderly population needs specialist NPs more than ever – and in dire circumstances where family members could not help on their own, there were specialists available to support them.

Again, this pressurized year has put additional strain on healthcare bodies to employ more NPs who specialize in gerontology. As mentioned, this balance will likely tip by the end of the decade – but when?

Elderly patients need our compassion

Again, we are all different in our backgrounds, physical and mental health. That said, older people heading to hospital for simple healthcare checkups may need more compassion and empathy as they age.

Going into hospital with a potentially threatening condition is always likely to be frightening. For older people, who are at higher risk of mortality, it can be a very scary experience indeed. That is why our older population depends on NPs who are not only highly skilled in diagnosing and treating patients but also in supporting their charges with a healthy “bedside manner.”

Once again, the pandemic has proven that we need talented NPs to help guide us through some truly scary moments. The height of COVID-19 was as mysterious as it was frightening, which meant NPs and physicians needed to rely on their compassion and empathy to help people get through the pre-vaccine period.

This is especially true of older people, who, having read and seen varying media reports on elderly mortality in line with the novel coronavirus, were heavily dependent on the carers assigned to them.

Post-vaccines, this need for compassion has not gone away. The period has helped many older people realize how much they depend on their nurses to help support their mental health as well as their physical recovery. As such, the landscape is, yet again, changing to push NPs to the forefront.

Elderly people cannot always get to a hospital

Earlier in this guide, we mentioned that one of the biggest supports an NP can provide is remote care. As we are already experiencing a physician drought in hospitals across the country, it stands to reason that we are also lacking traveling doctors who can attend communities and areas far from town and city centers.

Let’s consider, too, that mobility problems and lack of transport may also restrict older people from heading to surgeries and hospitals to receive the care they need. Given NPs’ flexibility in movement and cases, our older populace has grown accustomed to nurses visiting them at home.

This may be within their own properties or even within residential homes, where pressure was similarly high on care home staff during the height of the pandemic.

Elderly people need NPs and care specialists who can visit them for checkups and even in emergency situations. Those older people who are especially frail and who cannot get access to the care they need right away will continue to need mobile assistance for the years ahead.

With the population of older people only set to increase, it is likely this dependency is going to become all the more commonplace. Therefore, the demand for flexible NPs who can work out in the field will only increase from state to state.

Why the growing dependency is mutually beneficial

It is clear that older people require more support from NPs – and, thus far, receiving it – is positive. While there are still gaps in our national healthcare that require swift attention, NPs are working harder than ever to ensure that elderly patients get the empathy, compassion, treatment, and aftercare they deserve.

However, before we assume that all this pressure is unfair upon NPs, consider the potential job market. With elderly people demanding more and more medical attention from specialist NPs, this is likely a job role with multiple openings from area to area.

A vast shortage of physicians and a growing need for NPs to replace them means that anyone graduating from a leading university will find hundreds of opportunities across a similar number of miles. Right now, this industry is likely to give back to graduates with little risk of waiting around.

It is also worth considering that this need is not likely to go away any time soon. For pure job security, with our aging population, NPs will find that they are always in demand. There will always be opportunities to pick up care and even to progress in some circumstances.

For all that technology is helping to advance society and convenience in myriad ways, there will always be a need for human nursing, especially when it comes to gerontology.

That said, it is clear healthcare bodies need to start promoting gerontological care and specialist NP requirements far and wide. As the proportion of elderly people across the US increases, there will be less and less need for basic FNP care. While FNPs can and do care for older people, more specialist care will ensure that our elderly live for longer and receive the best care possible.


The US is getting older, and NPs’ workloads are increasing alongside. That is only going to continue heading in such directions.

NPs in training need to consider what they would like to specialize in – family care, which, while still crucial, is becoming less relevant – or acute geriatric care, which is growing in relevancy all the time. 

Of course, the specialisms nurses choose will depend on personal choice as much as the desire to progress and develop on a specific career path. That said, there are few nursing specialisms out there that are just as rewarding and in demand.

Whether you’d like to specialize in aftercare, the choice of adequate medication, or the support of patients through oncology, treating the elderly offers a variety of career paths.

Thankfully, universities and colleges are making it easier for people to get into gerontology as well as family nursing. If you are a budding NP, think carefully about who you would like to help, and take solace in knowing that your talents will always be required, no matter where you go!

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