Older Patients deserve Age-Friendly Care

“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. 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 (www.webmd.com/healthy-aging/age-health-care-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!

~ John Whyte, MD MPH

John Whyte, MD, MPH, is a board-certified internist and the Chief Medical Officer at WebMD, where he leads efforts to develop and expand strategic partnerships that create meaningful change around important and timely public health issues. As a popular health writer, he has been published extensively both in medical and mainstream publications.