Overview: California’s aging population is growing rapidly, and the state’s capacity to support the care of aging adults is a pressing concern. According to a report by the Public Policy Institute of California, by 2040, 22% of Californians will be 65 or older, and this older population will increase by 59%. The California Department of Aging’s Master Plan for Aging includes five key goals to improve caregiving and health access for aging Californians. Families and caregivers need to know all the care options that exist for aging adults, including episodic care and primary care.
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As California’s aging population continues to grow at a rapid rate, the conversation around the state’s capacity to support the care of aging adults remains a pressing concern. According to a report by the Public Policy Institute of California, by 2040, 22 % of Californians will be 65 or older, and this older population (aged 65+) will increase by 59%, but the working-age population (aged 20–64) will remain mostly unchanged.
Their analysis noted that this imbalance will result in an “old-age dependency ratio of 38 older adults per 100 working-age adults, up from 24 in 2020, and the highest ever recorded.”
The California Department of Aging’s Master Plan for Aging, a 10-year blueprint that reflects California’s future vision of and commitment to an age- and ability-forward state. Among the master plan are five key goals that are designed to improve caregiving and health access for aging Californians.
Geriatric Medicine Division Chair
One of the goals is “Health Reimagined” and one of the initiatives in progress is protecting California’s Medicaid expansion. The initiative is currently focused on the Long Term Services and Supports (LTSS) Financing and Affordability Initiative which is supported through the Budget Act of 2022 AB 179 (Ting). This Initiative includes $5 million for the California Department of Aging (CDA) through June 30, 2026, to support data and research of LTSS financing and services options for older adults and people with disabilities.
As the state works on implementing such initiatives aimed at supporting aging adults, it’s important families and caregivers know all the care options that exist for aging adults such as primary and episodic care.
Riverside University Health System Geriatric Medicine Chief Dr. Wael Hamade, AGSF, shared his expertise on finding the best care for aging adults, especially those who may have chronic conditions that require long-term care. Dr. Hamade is also an associate professor at the University of California, Riverside School of Medicine and the associate director of Elder Abuse Forensic Center for the County of Riverside.
BR: What does episodic care look like with regard to aging adults?
Dr. H: Episodic care focuses on urgent, short-term medical needs rather than long-term disease management. For older adults, this often means treatment for sudden illnesses like infections, falls, confusion, or medication complications. Care might include lab tests, imaging, IV fluids, wound care, or even short-term hospitalization.
BR: How do families decide if episodic care or primary care is the best option?
Dr. H: If a loved one has life-threatening symptoms such as chest pain, stroke signs, severe shortness of breath, or a serious fall, episodic care is urgent. But for ongoing management of chronic illnesses, medication monitoring, preventive checkups, and follow-ups, primary care is safest.
A trusted primary care provider knows your loved one’s medical history, coordinates specialists, and ensures continuity which is critical for those who are medically fragile. When in doubt, ask: can this safely wait for a scheduled visit, or does it require immediate attention?
BR: For aging adults with chronic conditions, what should they consider when looking for care options?
Dr. H: Frail seniors benefit most from integrated healthcare systems like Riverside University Health System. Look for networks that offer primary care, specialty services like cardiology, geriatrics or neurology, labs, imaging, pharmacies, and patient education all in one place. Integrated care reduces travel, avoids duplicate tests, minimizes medication errors, and keeps all providers on the same page.
Accessibility matters too, consider geriatric expertise, transportation options, and support for cognitive or mobility challenges. Convenient, coordinated care is key to keeping vulnerable seniors stable and safe at home.
BR: What episodic care options exist in the county or state?
Dr. H: Emergency rooms (ER), urgent care, telehealth, hospitals, mental health facilities and walk-in clinics all provide episodic care. ERs are best for life-threatening conditions and are open 24/7. Urgent care can handle non-life-threatening but pressing issues, often faster than an ER. Telehealth is ideal for minor illnesses or follow-ups, especially if travel is difficult. Hospitals provide more intensive care, including surgery. Each option serves a different level of urgency, and knowing which to use can save time, stress, and risk for frail seniors.
BR: What are the pros and cons of having a primary care doctor versus using episodic care?
Dr. H: Primary care doctors offer continuity, know your loved one’s history, manage medications, and coordinate specialists. But immediate access may be limited.
Episodic care is quick and often available 24/7, but it focuses on the immediate issue and usually does not provide follow-up care or ongoing management. Families should weigh the urgency of symptoms, the complexity of the senior’s health, transportation challenges, insurance coverage, and the importance of continuity when deciding where to turn.
For frail and vulnerable seniors, timely decisions can mean the difference between a manageable illness and a major health crisis. Knowing when to seek urgent episodic care versus routine primary care helps families act confidently while protecting their loved one’s health, comfort, and overall well-being.
Equally crucial is care from a geriatrician and a specialized older adult team who take a personalized approach, optimizing medications, removing those that are unnecessary or potentially harmful, preventing falls, assessing cognitive and functional abilities, and focusing on safety and long-term prevention. This kind of coordinated, expert care not only treats illness but also enhances quality of life, helping seniors stay as independent, safe, and healthy as possible.