April 3rd, 2013 at 10:00 am
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Personalized preventive care plans for elders

by Dorian Martin

I’ve seen first-hand how quickly an elder’s condition can deteriorate when they don’t take proper care of themselves.

My mother, who struggled with chronic obstructive pulmonary disease, began experiencing memory issues in 2003. As those issues progressed, Mom started mis-medicating herself, sometimes forgetting to take her medication and other times taking too much because she had forgotten she had already taken it. Her memory issues led her to avoid doctor’s visits because of her fear of receiving a dementia diagnosis. She didn’t exercise and ate primarily prepackaged foods. Her health decreased rapidly between 2003 and 2005 when she was indeed diagnosed with Alzheimer’s disease and placed in a nursing home for care.

In comparison, my father doesn’t miss too many doctor appointments. He suffers from a bad back and is pre-diabetic and hypertensive (he has high blood pressure). Dad was diagnosed with prostate cancer, but is not receiving treatment: “This is a disease you die with, not die from,” the doctor told him. Dad always takes his medications and vitamins. He’s not good about exercising, but I’ve made sure he eats a healthy diet.

Dad serves as the classic example of maintaining a regimen of preventive care, whereas Mom is the poster child for what can happen when a preventive care regimen is not followed.

Strategies for healthy aging

An article in the Journal of American Medical Association recommends tailoring preventive care based on age and individual factors. Deciding on preventive care should depend on the likelihood that the person would benefit, according to Dr. Huan Chang, Alison Burke and Dr. Richard Glass. For example, some types of cancer screening may only be beneficial if a patient has a life expectancy of more than 5 years.

The 2009 JAMA article recommends preventive care for adults who are 65 years old and above, including procedures such as the following.

Vaccinations:

  1. Annual influenza vaccination
  2. One-time pneumococcal vaccine
  3. Tetanus vaccine every 10 years
  4. One-time Zoster vaccine for shingles

Screenings:

  • Alcohol use (and counseling, if needed)
  • Breast cancer (every 1-2 years)
  • Blood pressure
  • Colon cancer (up to the age of 75)
  • Depression
  • Diabetes (in individuals with blood pressure over 135/80 mm Hg)
  • Lipid disorder (in men and in women who have an increased risk of heart disease)
  • Obesity (with counseling intervention for those who are obese)
  • Osteoporosis (for women who are at risk)
  • Ultrasound for abdominal aortic aneurysms (one-time screening for men aged 65-75 who have smoked during their lifetime)

Preventive actions:

  1. Aspirin as preventive measure against cardiovascular disease (to the age of 79, if the benefit is greater than potential harm)
  2. Exercise (three times weekly for 30 minutes as well as strength training two times a week)
  3. A healthy diet (with specific dietary counseling in cases of high cholesterol or risk factors for other diseases related to diet)
  4. Limited alcohol consumption (no more than one drink per day for women and two drinks per day for men)
  5. Smoking cessation counseling for seniors who smoke

An ounce of prevention is worth it

As the JAMA study notes, different individuals may need customized care plans. My last blog post on the danger of falls mentioned the importance of osteoporosis testing for anyone over 50 (not just women) who has had a bone fracture. Other potentially beneficial screenings might include glaucoma testing, as I described in another blog post.

What can caregivers do to help? You can encourage elders to talk to medical professionals and also follow the recommendations for preventive care. These strategies could help improve your elder’s chances at a longer and healthier life while aging.

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