The best news about staying in good physical health as you age is not the breakthroughs in medical technology, but in the way good doctors now treat their older patients.
Changed goals: For years, patients would go to a doctor to get treated for a specific problem. But if you visit an experienced physician today, he/she is much more likely to check on a full range of physical and mental functions, with the idea of preventing disease or illness from taking hold by nipping any health problem in the bud as soon as it’s spotted.
Successful aging strategy
- It’s now recommended that doctors see their older patients (generally 59 years old and above) at least three times a year and once a year make a full assessment of the patient’s physical and mental status.
- This assessment employs a multidisciplinary approach the doctor quickly refers the patient to an appropriate specialist if any preliminary test suggests a problem.
- Preventive medicine is stressed, including vaccinations and diagnostic tests.
- The doctor is an active adviser on diet and exercise.
- If any medical problem does occur even a seemingly minor one doctors will now treat it much more aggressively than in the past, when older patients were “expected” to become ill.
Finding a good doctor
Many primary care physicians now have the equipment to make a full assessment right in their offices.
If you’re looking for a doctor, seek out someone who treats a large number of older patients. For those who are age 70 or older and have several ongoing medical problems, I recommend seeing a geriatrician (a primary care doctor who specializes in age-related health issues).
Full annual assessment
Studies have shown that older people are significantly healthier from year to year if they have annual comprehensive assessments. This can be done by a doctor or a geriatric nurse practitioner. The health assessment should include
- An evaluation of your daily living activities. How easy is it for you to dress, cook and shop for yourself? Are there any mobility or balance problems that need to be addressed?
- Cognitive and psychological exam that checks for any hint of early dementia, alcoholism (which may affect as many as one out of three people age 75 and older), side effects of medication or infection (both of which can cause delirium) and signs of depression, a common and often undiagnosed problem among seniors, and one that can be treated very effectively.
- Nutritional risk evaluation. This is very important. Many seniors don’t eat the way they should, for a variety of reasons. Money can be an issue, or good shopping facilities might not be easily accessible. A physical disability such as arthritis could also make the act of cooking difficult. The same is true of depression, or some other underlying medical problem. If there is a nutritional deficiency, nutritional supplements and more careful menu planning can help correct the problem.
- Vision evaluation. If a problem is diagnosed, the doctor should refer you to an ophthalmologist.
- Hearing test, using an audiometer. If any deficiency is spotted, you should be referred to an audiologist.
- Urinary and bowel continence evaluation. If there’s even a slight problem, it’s good to know about it. There are many things that can be done, either by your doctor or an urologist, to treat incontinence.
- Basic dental evaluation.
- Full social evaluation including a look at how your support system of family and friends is holding up, what your general financial situation is, as well as key life decisions you’ll be making such as drafting a living will.
Aggressive screening and preventive care
“Prevent it or catch it early” is now the motto of doctors who cater to older patients. Your doctor should be making sure you are up to date on all important diagnostic tests and vaccinations, including
- Pneumovax vaccine. Pneumonia can be fatal in older people, particularly those who live in cities. This vaccine is good protection against pneumoccocal pneumonia.
- Tetanus vaccine. This should be renewed every 10 years something many adults forget.
- A regular tuberculosis test.
- Annual mammogram, to test for signs of breast cancer in women.
- Annual prostate-specific antigen (PSA) blood test to check for the signs of prostate cancer in men.
- Flexible sigmoidoscopy. This procedure checks for polyps in the colon, and should be done every three years.
- Annual pelvic exam, to check for signs of cervical or ovarian cancer in women.
- Test for thyroid function.
- Annual evaluation of cholesterol and triglyceride levels in the bloodstream.
- Vitamin B-12 and foliate evaluation for deficiencies that can lead to a decline in mental functioning.
- Influenza vaccine shot every autumn. This is important for all adults. Studies show that the flu vaccine curbs serious illness in all adult age groups.
Aggressive treatment
While the tests listed above may seem expensive in the short term, they actually cost much, much less than the price of treating a serious illness further down the line.
This is why more and more HMOs and insurance companies are beginning to embrace the “whole-person” preventive philosophy it saves them money.
Another part of this approach is to treat any illness, even a minor one, in an aggressive fashion.
Chronic problems like high blood pressure, diabetes, osteoporosis or mobility problems now get close attention from informed doctors. A wider range of treatments is now being used as well, including physical therapy and exercise and nutrition programs.
In the same way, swift aggressive treatment is now the rule for acute problems like respiratory infections or muscle or bone ailments. The view is that anything that takes away from your overall ability to live your daily life is a threat.
Finally, if you have any questionable health test results, expect your doctor to refer you to a specialist immediately. The older we get, the more important it is to get a qualified specialist’s opinion quickly.
