"As we're living longer, we're seeing a lot more chronic problems in our people who receive home care," said Joanne Sweisz, director of the county's Home Health Care Unit.

"The people that we're seeing now (in that "older senior" group) lived through the Great Depression and two world wars. Health care was not as good when they were young, and we're seeing a lot of those chronic problems, like heart disease, now."

Programs like the Health Department's Home Care Program are designed to help people stay at home in a safe environment for as long as possible.

Health-care providers know that 24-hour nursing care will still play an important role in long-term care, but shortages of health-care providers everywhere have the industry concerned.

"Recruiting is tough," Sweisz said. "I would say that 40 percent of my nurses are below 45 (years of age), and 10 percent are below 35. As the average age of nurses continues to go up, it will become increasing difficult to replace those who retire."

The same future faces physician coverage. A physician shortage already exists in many regions of New York state, and those numbers may continue to decline as more and more doctors reach retirement age.

"We continue to entice more physicians into practice," said Dr. Wouter Rietsema, medical director at CVPH Medical Center. "Hospitals continue to employ more physicians than ever before. But we need to continue to be creative to keep up with the needs of the elderly as health-care providers age as well."

THE BIG PICTURE

Hospitals need to recognize a shift from patients admitted for medical care to more patients being treated on an outpatient level at clinics and doctors' offices.

"As the aging population increases and we face more serious chronic disease, we need to address what health care will look like in the Emergency Department, in the Cardiac Unit and Oncology Unit," Donahue said. "We need to continually analyze the population's future needs."

Communities are also taking that future role seriously.

"The State Office for the Aging and State Health Department are collaboratively looking at long-term care," said Crystal Carter, executive director for the Clinton County Office for the Aging, who heads the county's Long Term Care Council, an organization of experts from many regional areas involved in health care.

"The Long Term Care Council's charge is to look at the gaps in services in an area and to better understand what is happening at the local level so the state can be prepared for long-term-care needs," she explained.

Carter works closely with the Department of Health, Department of Social Services and the local hospital to analyze current trends in health-care needs for the aging population and what the future will bring for those seniors.

"With the changing demographics, it's important that we recognize the needs of people when they reach that age when health-care needs become more important. That 85-plus demographic is growing rapidly. As a community, we have to be prepared for that."