‘Dementia Desert’: Virginia faces severe shortage of geriatric care amid aging boom

RICHMOND, Va. (WRIC) -- As Virginia’s population of older adults rapidly grows, the number of medical professionals trained to care for them is falling dangerously short — especially in Central Virginia, which experts now warn has become a “dementia desert.”

A new report from the Alzheimer’s Association reveals a critical shortage of geriatricians and direct care workers across the U.S., with particularly stark gaps in Virginia.

Geriatricians are physicians who specialize in treating older adults, often managing conditions like Alzheimer’s disease and dementia. But in a state where the senior population is ballooning, there are simply not enough of them.

“We’re limited in the number of geriatric training programs we have overall because to have a program, you need geriatricians who can train those coming behind them,” said Dr. Amy Paul, a geriatrician in Virginia. “But if the geriatricians are just trying to see patients, you’re already limited.”

According to the 2025 report, there are currently about 7,000 geriatricians nationwide. The country will need an additional 18,000 by 2050 to keep up with demand.

Virginia alone needs more than 1,000 additional geriatricians by mid-century. And the demand extends beyond doctors — an estimated 900,000 more direct care workers will be needed nationally by 2032.

“If you're diagnosing people later and you have less medical care, everybody automatically becomes more complicated,” Dr. Paul added. “It’s almost like a tsunami of patients who are aging faster, living longer.”

Despite the rising need, geriatric medicine remains an underfunded and underpopulated field. Paul cites difficult working conditions, low pay, and a lack of support staff as key reasons why more medical students aren’t choosing the specialty.

“It’s very complex work,” Dr. Paul said. “They don’t have backup, they don’t have support — and if they do, it’s extremely expensive.”

Jaime Smiley, an occupational therapist who works with seniors, says the shortage is colliding with a demographic shift -- the largest wave of Baby Boomers is turning 65 in 2024, while the overall workforce is shrinking.

That mismatch is pushing more responsibility onto unpaid caregivers — often family members or friends — who may not have the training or resources to provide proper care.

“In the United States, there are over 12 million people serving as unpaid caregivers,” Smiley said. “A lot of these people are going to end up living at home with improper care, and they’re going to become sicker and sicker.”

In response, the Alzheimer’s Association is calling for urgent investment in training programs, financial support for direct care workers and incentives to attract new professionals into geriatric care.

Advocates warn that without immediate action, Virginia — and the nation — won’t be prepared to care for its aging population.