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Tom Spear, age 102, plays 18 holes of golf weekly. (He shoots 15 under his age.)

Tom Spear, age 102, plays 18 holes of golf weekly. (He shoots 15 under his age.). (www.med.harvard.edu). Secrets to a long healthy life?. Arnold slide. Senior citizens often do NOT receive the same treatment as younger adults. Heart Attack

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Tom Spear, age 102, plays 18 holes of golf weekly. (He shoots 15 under his age.)

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  1. Tom Spear, age 102, plays 18 holes of golf weekly. (He shoots 15 under his age.) (www.med.harvard.edu)

  2. Secrets to a long healthy life?

  3. Arnold slide

  4. Senior citizens often do NOT receive the same treatment as younger adults • Heart Attack Seniors are less likely to receive life saving drugs • Cancer Seniors are less likely to be offered chemotherapy • Intensive Care Seniors are less likely to be treated with state-of-the-art therapies Source: www.agingresearch.org/brochures/ageism/ageism_booklet_final.pdf

  5. Health concerns in younger & older adults Greatest health concern under age 55 years: • Cancer Greatest health concern over age 55 years: • Memory loss • (Alzheimer’s Disease) Source: Metlife survey: www.metlife.com/

  6. New Medical Problems Occur as We Age, Many Are Not Treated (or Even Diagnosed) Treatments exists for ALL of these conditions

  7. Multiple Medical Conditions Diabetes High Blood Pressure High Cholesterol Heart Disease Arthritis Osteoporosis Emphysema

  8. Marketing!

  9. Too Many Drugs!!!

  10. Falls Source: aging.slu.edu/ newsletters/winter2002.pdf

  11. Immobility and Weakness Source: guide.stanford.edu/96reports/96clin1.html

  12. Alzheimer’s

  13. Urine Incontinence Black River Harbor on Lake Superior (paddleguides.com)

  14. Isolation Scource: news.bbc.co.uk/

  15. Weight loss & Malnutrition Source: aging.slu.edu/newsletters/winter_2004.pdf

  16. Sometimes families need a hand…

  17. Alternatives to Nursing Homes Adult Daycare Facilities Senior Community Centers “Lifeline” Retirement Communities Senior Apartments Assisted Living Communities

  18. Common Reasons to See Geriatrics Multiple Medical Problems Numerous Medications Falls & Walking Problems Alzheimer’s disease & Memory Problems Urinary incontinence Depression Social isolation Poor appetite/ weight loss

  19. Goals change in Older Patients: Quality is more important than Quantity • Improve: activity level, living situation • Reduce polypharmacy, prescribe appropriate medications • Decrease hospitalizations/nursing home use • Increase home-based health care • Reduce medical costs

  20. How can non-geriatricians deliver good “geriatric” medical care? • Recognize FUNCTION as an outcome. • Learn how to assess FUNCTION. • Activities of Daily Living (ADLs, IADLs) • Mobility, Cognition, Affect • Nutritional Assessment

  21. Documentation First rule of geriatrics (similar to first rule of real estate sales) “Function, Function, Function” Patients don’t care about their diagnoses, they care about their function

  22. Barriers to Geriatric Care • Age Denial • Americans generally want to be younger • Do not plan (or think about) getting older • Ageism • Medicine aims to extend life (Quantity not quality) • Lack of public awareness of Geriatric Focused care • Most people think “a doctor is a doctor” Alliance for Aging Research, 2002

  23. Too few “academic” geriatricians & Lack of Support at Medical Schools • Lack of funding for training in geriatrics • 450/9800 fellowships (<0.5%) are in geriatrics • Poor re-imbursement • Decreased payment has led to physicians seeing more patients in smaller time period Alliance for Aging Research, 2002

  24. Medical care exists in “Silos” • Research trials usually exclude older patients • Most NIH research dollars pay for specific diseases. <1% dollars address the changes that occur with aging. For example: Why does cancer usually affect older patients? Alliance for Aging Research, 2002

  25. Questions?

  26. Baby

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