“I’ve been on my gout medication since the 1990s. No one
ever suggested I stop taking it, doc.” Jerry was a new patient, in for a
general health checkup. He had a variety of health conditions and was taking at
least 6 different medicines. When I asked him how long it’d been since his last
gout flare, he proudly replied, “I haven’t had one in 20 years.” Now, maybe he
hasn’t had a recurrence in two decades because he’s been on the medicine, or
rather, maybe he just doesn’t need to be on the drug anymore.
Jerry’s experience isn’t unusual: Many older patients are
still taking medication that had been prescribed to them when they were much
younger, without anyone questioning whether they should still be taking it.
Think about it – has your doctor ever comprehensively reviewed all your
medicines with you – and discontinued one or lowered a dose? It’s critical that
you review your medications with your doctors and see if there should be any
changes. Every drug has risks and benefits, and that balance can sometimes
shift as we age.
In fact, certain drugs should be outright avoided as you
get older. Yet, most older patients are unaware of this.
This is one of many findings surfaced by a recent survey
on age-friendly health systems conducted by WebMD and The John A. Hartford
Foundation. We surveyed nearly 3,000 patients and caregivers, age 65 and older,
and the results were a bit sobering. We learned that the care of older adults
is mired in misinformation, especially among minority populations, with older
patients and caregivers mistakenly believing that sharp declines in the quality
of life are inevitable.
You can learn more about our survey results here, but here are a few of the findings that
I found most concerning:
·
Forty percent of those surveyed were
unaware that certain prescription medications affect the quality of their
thinking.
·
More than two-thirds of caregivers said
that the person in their care has difficulty walking around, and half said that
they had fallen within the past year. And very few are doing any activities to
improve mobility.
·
Only a very small percentage talk to their
doctors about their concerns and fears or share their future health goals.
·
Forty percent of respondents incorrectly
think that depression is an inevitable part of aging.
So why are older patients not getting the care and the
information that they need?
I think part of the reason is that patients and
caregivers often aren’t sure what to expect – and what they should demand –
from doctors and the health care system. They just accept the status quo, but
we need to change that. Patients and caregivers need to know that they can and
should ask for care that meets their specific needs.
Advances in medicine have allowed us to live longer, and
that’s great. But now we need medical care that will help to optimize our
health as we age. We need age-friendly care that is evidence-based, causes no
harm, and is always consistent with what matters to the older person. But that
kind of change will only happen if patients and caregivers ask for it and start
to expect it. So, if you’re an older patient, or caregiver, I hope you’ll take
a few minutes and read the results of the survey – it may open your eyes to
some things that you didn’t know you could be asking of your doctors.
And, in case you are wondering, Jerry did decide to stop
his gout medicine and he has been doing very well!
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