Three years ago, the county of San Diego adopted an Aging Roadmap, a comprehensive plan to support the region’s growing aging population.
Last month, it hired its first chief geriatric officer to advance that vision.
Dr. Lindsey Yourman will be responsible for building strong ties with social service agencies, the local medical community and continuing education providers. The goal is to provide services supporting healthy aging, safety and independence for the older adult population, which is expected to reach nearly 1 million over the next decade.
Chief Medical Officer Dr. Eric McDonald, who leads the county’s Health and Human Services Agency’s Medical Care Services department, said that by hiring Yourman the county will be able to expand engagement with the local medical community to improve standards of care for older adults through continuing education.
“There is just an increasing amount of evidence-based practice that has been developed just recently in geriatrics in general,” he said “I think just bringing that to each of the different provider communities is going to be an exciting thing.”
Yourman’s passion to serve older adults
Long before entering the medical field, Yourman said she gravitated toward seniors.
Growing up, she had a very close relationship with her grandparents and frequently visited her grandmother in a skilled nursing facility. During her visits, she’d interact with the other residents.
“I always felt so useful and I kind of felt alive when I was there, like this is where I’m supposed to be connecting with people that I feel are really under-appreciated sometimes,” Yourman said. “They’d have so much to share with me, so much wisdom, so much resilience just in their daily lives.”
Yourman graduated with her bachelor’s degree in psychology from Harvard College in 2005, and from there, worked as a Medicare Rights Center health advocacy fellow for a year until starting medical school.
In 2006, she started pursuing her doctorate of medicine from UC San Francisco Medical School, specializing in a track supporting populations often under-served by the health care system. It was there — at an activities fair during her first week of school — that geriatrics became her primary educational focus.
“There were all these different booths of really inspiring causes like children with cancer — things that really tug at your heartstrings and that really matter a lot — but I was just so surprised that there was no one at the geriatrics booth,” Yourman recalled.
“It was this room full of all of these idealistic people who want to help the underdog, and no one was at that booth. So I decided at that point that was for sure what I was going to do.”
After graduating in 2011, she did her residency at Scripps Mercy Internal Medicine, followed by a UC San Diego Geriatrics Fellowship and a West Health-UCSD Geriatrics Quality Improvement Fellowship.
In addition to her studies, Yourman has spent her professional career providing health care to seniors. After working as a primary care physician at St. Paul’s PACE, a nonprofit supporting seniors as they age in place, she transitioned to UCSD, where she served as an associate clinical professor, leader of Age-Friendly Health Systems and medical director of Geriatrics Quality Improvement.
Yourman is still affiliated with the university as an associate professor, but is currently taking an unpaid leave of absence. The 39-year-old said she would most likely continue teaching and will also continue to practice medicine at a county-run facility, most likely at Edgemoor Hospital, a skilled nursing facility in Santee.
Why it’s needed
As the Baby Boomer generation ages, San Diego’s older adult population is one of the most rapidly growing demographics in the county. The San Diego Association of Governments projects that by 2035, the population of people age 60 and older will grow from the 626,683 people estimated in 2020 to nearly 1 million people.
Along with an increasing number of people living with chronic health conditions such as Alzheimer’s disease, the region is also an expensive one, especially for seniors who may have limited income or depend solely on Social Security.
In a California Health Interview Survey prepared by the county, 41.8 percent of San Diego residents age 65 and older had an income of $50,000 or less in 2021. The U.S. Census Bureau reports that in 2020, 24.2 percent of San Diegans age 65 and older lived on less than $25,520 a year.
To support the increasing senior demographic, the county and local advocates have long pushed to increase older adult programs and infrastructure.
HHSA Director Nick Macchione said he created the chief geriatric officer position after seeing his parents on the East Coast deal with substandard senior health care. He watched as doctors only reacted to the complaints of his father — who has some severe chronic health conditions — instead of seeing him as a whole person, and he wanted to do more to improve local senior care.
“I felt like he wasn’t alone,” Macchione said. “This is not something we can allow to happen, so the wish, the vision, was to create not just a person, but a whole movement.”
While she doesn’t have any of her own direct reports, Macchione said Yourman will essentially have the nearly 8,000 employees within the Health and Human Services Agency at her disposal.
A county spokesperson said in an email that Yourman’s salary is approximately $275,000.
Local nonprofits thrilled by new hire
Representatives from some senior care nonprofits in San Diego County expressed excitement that the county has hired its first chief geriatric officer.
Janet Hamada Kelley, Alzheimer’s Association San Diego and Imperial Counties Chapter executive director, said that given Yourman’s knowledge of geriatric medicine, she’s thrilled there’s now someone dedicated to elevating the needs of older adults in the region.
“Dr. Yourman’s focus on this population will allow organizations like us to better serve those with Alzheimer’s and dementia by identifying new ways to collaborate, reach and support the community,” she said.
San Diego Oasis president and CEO Simona Valanciute said that having someone dedicated to senior care issues may be a major factor when it comes to increasing the local support infrastructure.
“Work gets done when we have someone who’s driving the strategy and execution,” she said. “Her job will be to envision and assess where we are and drive a strategy where senior causes, needs and wants are acknowledged, and we create perhaps more systems to find the best centers of excellence to keep our older adults thriving.”
Going forward, Yourman said she’s excited to collaborate with older adult San Diegans about what programs they need or want. Part of her focus will be on making the overall community more age-friendly.
That includes making it easier for people of all mobility levels to travel outside the home by updating sidewalks to minimize the risk of falling or improving transit systems. It can also include increasing access to medical care, and ensuring that doctors assess older patients wholesomely, giving them the proper treatment for their ailments.
“It’s not necessarily that everyone wants to be out and about and always so far from home, but for a lot of people that is really important, that independence of mobility,” Yourman said.
The public can provide comments or feedback on the ongoing efforts to improve care for seniors by emailing [email protected] or calling (858) 514-3260.