According to the U.S. Census Bureau, one in five people in the United States is over the age of 65. As of 2020, this brings her to 56.4 million. The hypothesis is that older patients are less afraid of dying than they are of losing independence, but a single fall that leads to a trip to the ER portends a higher risk (up to 21 percent) of dying within a year. It is erected.
Elderly patients often do not have the luxury of making changes to their delicate daily routines. Proper nutrition and regular exercise can be a challenge for people with chronic health conditions. Isolation, depression, and lack of social cohesion can also contribute to rapid decline. Expensive drugs and their undesirable side effects also contribute to the challenges faced by older adults.
With people 65 and older expected to reach 20% of the U.S. population by 2030, our nation wants to find better ways to help our aging population stay healthy for as long as possible. Our efforts should be directed toward maintaining health and independence while aging at home. There are Medicare-approved platforms, such as Embrace Prevention Care, that reward health care providers for their efforts to track seniors' health issues at home while reducing unnecessary trips to hospital emergency departments (EDs). It provides compensation.
Prevention is the key to healthy aging, but is it “too late” to focus on prevention for patients over 65?
Is it ever too late to change?
Peter Attia, M.D., author of Outlive, says education, awareness, and preventive health habits need to start years before symptoms appear, whereas Medicine 3.0, a proactive curriculum, helps prevent symptoms starting at age 40. It suggests that you are teaching strategy. This approach covers more ground as you get older. It will prevent the physical and economic damage caused by what he calls the “four horsemen” of health decline: diabetes, heart disease, cancer, and dementia (p. 10 and p. 41).
Unfortunately, medical schools often still teach traditional medicine 2.0, a “find and cure” model where symptoms are present, a diagnosis is made, and a treatment is prescribed, often involving expensive tests, medications, Surgery will be required. Early in most medical careers, most doctors try to correctly diagnose an illness or injury. Then learn how to choose the most appropriate treatment plan. Then, as expertise and experience shape our judgment, our mission becomes prevention.
It is estimated that the United States spends more on health care than any other country. Approximately $35,300 is spent in the last 12 months of life alone, and more than 60% of elderly patients in the United States die in acute care hospitals. Can we reduce these numbers through preventive strategies? I think so, but it requires behavioral changes on the part of both doctors and patients.
prevention
In Younger Years for Women, authors Chris Crowley and Henry S. Lodge, M.D., write that although many patients live well past age 65, there are significant differences in their health levels. They claim that it is the amount of activity.
Just like contributing money to a retirement account, starting at age 65 is way behind the curve. However, while most doctors encourage their patients to start exercising and staying active at a young age, it's never too late to start getting/staying active. Even after age 65, you can prevent or delay health problems and keep your muscles strong, which means you're less likely to break a bone in a fall and reduce injuries.
Moving your body for 30 minutes a day, five days a week, improves your strength, balance, and stamina. Doing so promotes emotional well-being, strengthens cognitive function, and reduces heart disease, diabetes, and some cancers. As always, restful sleep and a proper, balanced diet with an emphasis on water and protein contribute to these benefits.
It is imperative that we as physicians innovate our approach to providing health care and encourage our patients to individually focus on areas where they need more help.
Strategies that connect people to their GP, promote healthy behaviors, and create a safe environment are key to reducing hospital visits and subsequent hospitalizations. Medication adherence, fall prevention exercises, and cognitive activities have all been shown to help with this.
take care of the elderly
Today, many caregivers of elderly patients are in a crowded room, some with a variety of medical professionals in their circle, all of whom have established beliefs about the quality of health and quantity of life expectancy. Have an opinion on whether it fits your goals or not. In many cases, there is little practicality when coordinating care team input from different sources, especially when dealing with an aging demographic of older adults. In her “Geriatric Age” by Louise Aronson, MD, articulate and committed young family members are also encouraged as essential members of the care team.
Osteopathic physicians are uniquely positioned to promote preventive health strategies. As one of the fastest growing fields in the medical field, DOs account for more than 11% of practicing physicians, and that number is rapidly increasing. Through the increase in our numbers, we can adopt new philosophies in health care promotion and disease prevention using the principle that AT Still, DO, MD: the person is a unit of body, mind, and spirit. Masu.
Where to seek support for older patients
One example of innovation in geriatric care is Embrace Prevention Care (EPC). It is a scalable prevention platform that amplifies physician voice for older patients with frequent calls for nurses to help implement care plans to change behavior and reduce emergency department visits and first hospitalizations. . . Elderly patients with chronic conditions will be contacted monthly by a nurse to provide virtual preventive care reminders and strive to make ongoing behavioral changes such as exercise, nutrition, medication adherence, and social cohesion. Masu. Geriatric pharmacists, medical social workers, and psychologists are also available as needed.
As another example, chronic care management, a Medicare offering, allows patients to utilize monthly virtual health reminders to encourage feedback, reducing the need for unnecessary hospital visits. Monthly reviews by nurses, pharmacists, and social cohesion experts are also helpful. The new Medicare code allows for reimbursement for overworked medical teams, including primary care physicians.
Traditional mechanisms for health care for older adults are often inadequate, too expensive, and too slow. Many team members don't know what they don't know. Early prevention can reduce pain, suffering, and financial burden. Tailored prevention strategies for older adults with chronic health conditions can be achieved by changing the behaviors of both patients and caregivers.
It's better to start late than never. Small changes that older patients can make are more likely to have a positive effect.
Editor's note: The views expressed in this article are the author's own and do not necessarily represent the views of the DO or AOA.
Related books:
DO Book Club, January 2024: “Outlive: The Science and Art of Longevity”
Hearing the patient's voice: Emergency room sounds