Managing Multiple Health Problems

More than half of all older Americans have “multimorbidity,” a medical term that means having multiple chronic health problems like heart disease, arthritis, and diabetes. It can be challenging for healthcare professionals, older adults and their friends and family to manage multiple health problems.  There are many more factors to think about.  For example, treating one health problem may make another health problem worse.  And having multiple health problems often requires taking more than one medication, which can result in unwanted drug interactions and side effects.

To help healthcare providers and patients better manage multiple health problems, the American Geriatrics Society (AGS) recently asked leading experts in the field to develop “guiding principles” for the care of older adults with multiple medical conditions.

The principles don’t specify what kind of care clinicians should provide a given patient. Instead, they outline steps to care that is tailored to each patient’s unique needs. You can read more about these principles and living with multiple health problems here.

Here is a very short summary of ways patients and their caregivers can work with healthcare providers to enhance care when dealing with multiple health problems:

Get informed - Learn as much as you can about your healthcare problems and treatment options. Ask your healthcare providers for information and advice, and get family and friends to help you with research.

Make sure your healthcare professionals understand what’s most important to you - For many older adults, for example, remaining as independent as possible is a top priority. Find out how different treatment options will affect your priorities.

Ask bout “trade-offs” – Ask your healthcare provider how the benefits of different care options compare with their risks.

Call if there are problems – Because there isn’t a lot of research examining how older adults with multimorbidity respond to different treatments, clinicians may not be able to predict exactly how a treatment will affect you. So let your healthcare provider know if you’re having unwanted side effects or aren’t getting the desired results from a certain treatment.

Ask for something simpler if you need to – The more complicated treatments are, the more likely patients are to stop following them. Ask for a simpler treatment plan if necessary.

Make sure your care plan does three things - Your healthcare providers should:

  • Make sure that treatments that are most important to you get the highest priority.
  • Maximize the benefits of your treatment.
  • Minimize risks by, for example, using non-drug medications when possible to lower risks of drug-drug side effects.

 

 

Getting Your Flu Shot

With autumn just around the corner, now’s the ideal time to get your flu shot.  Influenza season can start as early as October, and it takes your body about two weeks to respond to the vaccine by creating the flu-fighting antibodies you need to fight off the virus. That’s why healthcare professionals recommend getting the shot as soon as it becomes available in your community— usually early September. I’m planning to get my shot when I see my healthcare provider this month.

If you’re 65 or older, it’s particularly important to get vaccinated. Older adults run an increased risk of potentially serious complications of the flu, such as pneumonia. Some people, however, should talk with their healthcare provider before getting a flu shot, especially if you’ve experienced any of the following:

  • severe allergic reaction to chicken eggs
  • have had a serious reaction to the flu shot in the past
  • have been diagnosed with Guillain-Barre Syndrome

And if you have a fever, hold off until it’s gone before getting your shot .

Though some vaccines protect you for years, the flu shot is only effective for one year.  Why? The flu virus is constantly changing, so the vaccine that worked against last year’s virus won’t take care of this year’s. Don’t skip a year!

Good news: Medicare covers annual flu shots, and there’s no copay. You can get the flu vaccine from your healthcare professional, or at senior centers, urgent care clinics, and health departments.   Many retail pharmacies also offer the flu shot for a small fee.  As of late August, the vaccine was available in many communities throughout the U.S. To find where you can get a shot near you, visit the frequently updated Flu Vaccine Locator on the Center for Disease Control and Prevention’s website.

And for more information about the flu and other essential immunizations for older people, take a look at these tipsheets: “Flu Prevention and Treatment Tips” and “Essential Vaccination Information for Older Adults.”

Staying Safe in the Heat

When the weather starts warming up—as it is in much of the United States right now—the body uses a variety of clever strategies to cool down. Sweat glands work overtime, sending more sweat to the surface of the skin where it evaporates and cools the body. Muscles relax so more heat-carrying blood flows to the skin where that heat can escape into the air. Even tiny body hairs get involved. They flatten themselves so surrounding air can more easily circulate over the skin and allow more heat to escape.

However, as we get older, age-related changes in our bodies lessen our ability to use these important cooling strategies. And this increases our risks of dangerous heat-related health problems such as heat stroke—a potentially life-threatening increase in the body’s internal temperature. Age-related changes also makes it harder for the body to tell when it’s getting dangerously dehydrated—or “dried out”—and needs water right away. In addition to age, medical conditions such as heart disease and diabetes can boost older people’s risks of heat-related medical problems. Some medications can also affect how you feel in the heat.  Heat-related medical problems can be very serious. An estimated 200 older Americans die of heat-related health complications each year.

And that simply shouldn’t happen. With some simple precautions, older adults can avoid heat- related dangers. There are several tips from the experts in this new, easy-to-understand “tip sheet” for staying safe when it’s just too darn hot.  You can find the new tip sheet, Hot Weather Safety Tips for Older Adultshere.

Older adults and their caregivers need to be especially careful when the temperature reaches 90°F and keep an eye out for signs of heat-related problems.  The Health in Aging team hope you’ll share these tips with older friends and neighbors as well, and that this important information will make the livin’ easier, even as the mercury rises this summer.

How do you plan to stay cool this summer?

Beers Criteria

A century ago, the average American could expect to live 50 years or so.  Today, we can expect to live nearly 80. That’s a big jump. What contributed to that big jump in longevity? A lot of things — including the development of medications that prevent and treat serious illnesses like diabetes and heart disease. In addition to all the good they can do, though, drugs can also cause serious side effects and interact with one another in potentially harmful ways. That’s why weighing a medication’s benefits against the risks it poses is so important. It’s particularly important in later life, because age-related physical changes put older adults at particularly high  risk of  drug side effects and other “adverse drug events.”

To help healthcare providers safely prescribe medications for older adults, the American Geriatrics Society (AGS) recently revised, updated and expanded the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. The criteria were first published by the late geriatrician Mark Beers, MD, and other experts in 1991, and were revised in 1997 and 2003. They have long been the leading source of information about safe prescribing for adults 65 and older.

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