When we think of aging gracefully, we imagine entering into a season of life when meaning and purpose coalesce with comfort and quietude. Though it is the final chapter, it can be filled with ample opportunities to suck the marrow out of life. Pursuing physical and mental stimulation and taking a more proactive approach to health care are imperative to prolonging and fully enjoying this season.
Establishing an ongoing patient-provider conversation is fundamental to living well at any age. According to Dr. Jerome Aya-Ay, primary care physician at Palmetto Proactive Healthcare, “Many Americans live in the reactive phase when it comes to their approach to health care.”
While this practice is not beneficial for any patient, he stresses that it is even more critical for seniors to adopt a proactive mind-set and schedule regular visits with their primary care physician. As the body matures, the risk for disease increases, as does the impact of physical and psychological stressors.
The following are five aspects of aging of which every senior should be aware and that can be addressed with a primary care provider:
- Simply put, age is a risk factor for cardiovascular disease, hypertension, high cholesterol and diabetes. Regular appointments allow primary care physicians to conduct screenings and counsel patients on preventive measures. Dr. Aya-Ay recalled a 68-year-old patient who suffered a ministroke. Prior to the stroke, he “thought he was invincible” because he was seemingly in good health. Dr. Aya-Ay was able to guide the patient to a full recovery, and the man has no residual effects. But, he stresses, prevention is preferable to any reactive treatment. “You might look and feel great, but, with age, your risk for heart attack and stroke increases.”
- Polypharmacy is a growing problem among the elderly population. According to Dr. Aya-Ay, most people start engaging in their health care in their 30s and 40s. From that point on, medications may be prescribed by other physician specialists. Polypharmacy can easily become counterproductive and even detrimental to a person’s health. Having a primary care physician who keeps track of and adjusts medications can help seniors avoid common side effects such as cognitive impairment and imbalance. Additionally, the AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, or the AGS Beers Criteria, contains nearly 100 medications or medication classes that elderly patients should avoid. “As a primary doctor, I quarterback everything,” Dr. Aya-Ay explained. “I look specifically at medications that do not benefit seniors, and I can alter or even eliminate them.”
- Malnutrition and undernutrition pose unique challenges to an aging body. Elderly people are more prone to osteoporosis and, therefore, need a diet that is rich in calcium and vitamin D. Whether it is not eating enough of the proper nutrients or consuming an excess of unhealthy food, the failure to practice good dietary habits is detrimental to a person’s health. Dr. Aya-Ay pointed out that some families live in food deserts, and, as a primary care provider, he can assess dietary needs and prescribe proper supplements.
- In addition to proper nutrition, seniors need to engage in regular activity to improve balance and prevent falling. Bones are not a static structure. Appropriately stressing the bones with weight resistance and activities such as water aerobics will improve bone density. Dr. Aya-Ay counsels patients to find structured programs designed for geriatric patients. Additionally, part of the patient-provider conversation includes discussing home conditions such as carpets, rugs, stairs and showers. He also ensures that patients have a trusted and capable person nearby and an established plan if they do fall.
- Preparation for the final stage of life is one of the most important conversations that seniors should proactively pursue with their physicians. Primary care providers can help patients decide between requesting a full code or do-not-resuscitate. Some providers, like Dr. Aya-Ay, will go so far as to help patients establish a living will and power of attorney and can facilitate conversations with loved ones so that everyone understands a patient’s wishes.
Having an ongoing conversation about the unique aspects of aging is crucial to living proactively. Dr. Aya-Ay recommended that elderly patients see their physician every three months or more frequently if there are specific health concerns that need to be addressed. Establishing a working relationship with a primary care provider is one of the most important ways to ensure that the final years are truly the golden years.
By Jill Harper