Where the elderly are concerned, the primary role of healthcare professionals is management of chronic diseases. This means keeping the disease under control by limiting the chronic nature and preventing or minimizing the impact of acute exacerbations of the disease/s. This is what disease management is all about.
Seniors often have multiple chronic diseases requiring a number of different medications. Because of the healthcare system, specialty care is common. That means a different healthcare provider for each body system. Often there is not one physician at the helm and the senior gets lost. The specialty physicians do not speak to each other and prescribe medications which may be adverse to the overall wellbeing of the senior. To make the situation more complex, the senior may also take over the counter medications and natural medications which may inhibit or exacerbate the effects of the prescription medications. This is all part of the challenge of disease management.
Seniors may purchase medications on line. They may use multiple pharmacy providers. When this happens, the oversight by the clinical pharmacist gets lost. The pharmacist is knowledgeable about drug interactions and is that expert in this area. If the pharmacist does not know the entire medication picture, they cannot provide input on medication alternatives or prevent adverse reactions.
The first rule, is to take all medication, including over the counter and natural or herbal remedies used, to each doctor visit. Do not leave anything home. This may mean that there is a sack of medication bottles, but better that that being hospitalized from an unknown interaction.
Little is known about the metabolism and excretion of drugs in the elderly. In addition to changes in our bodies’ ability to handle medications, the number of medications a senior takes worsens the problem. When a drug is tested prior to approval for use by the general public, the drug is tested in younger, healthier adults. The human test subject is not on multiple medications at the time of testing because the drug manufacture wants to see the side effect profile and action of the drug being tested. Because of this bias, little is known about the effect of multiple drugs with multiple actions in seniors.
Often seniors go to their healthcare providers with complaints and are given medication to manage or control the complaint. Each medication is a chemical and has unique properties and side effects. The side effects of the medication may cause more side effects leading to other complaints and more medication to deal with the new side effects. The senior and their advocate must have discussion with the healthcare provider about the necessity of medications and safer alternatives.
Most of the chronic diseases of the senior are not reversible. The only option is treatment to minimize the long term consequences of the condition. Some of these diseases had their onset in middle age and the side effects are now seen in older age. Other conditions first manifest in the senior. Both types of conditions need treatment to prevent further deterioration.
Diseases that may occur earlier in life and manifest symptoms after years or decades of disease. Some of the more common conditions include high blood pressure, diabetes, heart disease and lung disease. All of these conditions have long term consequences. The necessity of complying with medications and treatments can minimize effects, but not totally eliminate them. The cost of medications and treatment may not be affordable. The young adult may not have symptoms or chose to ignore symptoms leading the life altering consequences.
As the body ages it is less able to fight off or tolerate new conditions due to its loss of reserves. The immune system is not as effective and diseases like the common flu can be deadly for seniors. Shingles does not kill, but can be very painful during and after an episode. Long standing smoking can lead to the need for oxygen when the lungs are so unhealthy that they con not function adequately. Seniors should take advantage of immunizations for shingles, flu and pneumonia. If your healthcare provider does not speak to you about them, ask. Be your own best advocate.
Some diseases like high blood pressure or hypertension do not have their onset until later in life. That does not mean that it should not be treated. The long term outcome is still heart disease and stroke even when untreated as a senior. The medications used may be different than the younger individual, but there are effective medications for seniors.
Exercise is one of the best wellness strategies for any age. Senior exercise programs should not be started until approved by the healthcare provider. But once the senior gets the go ahead, exercise is good medicine. Water exercise limits the stress on joints. Joints that are experience moderate exercise hurt less. Exercise is good for the heart, circulation, bones, muscles and gait. High impact exercise is not good for seniors, but there are many other options available.
Take your medications as prescribed. More is not better. Saving medication because of expense will not prevent the side effects of disease. The drug manufacturers may be able to assist you with the cost of your medication. The pharmacist may be able to provide you with less expensive options that you can speak to your physician about.
Disease management requires that you understand the basics of the disease process. Once you understand that, you can have a meaningful discussion with your healthcare provider about treatment options. If the healthcare provider does not seem to be interested in speaking to you, make an appointment to specifically speak to him/her or find a provider who will work with you.