Health Challenges for Aging Citizens

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It's often described an "an art" or something to be done "gracefully." But aging can be frightening and confusing. The number of seniors in Pennsylvania is growing -rapidly. Today, roughly 15 percent of the state's residents are over age 65. In fact, Pennsylvania has the third oldest population in the nation (U.S. Census Bureau 2004 American Community Survey). According to the Geriatric Education Center of Pennsylvania, the Commonwealth's elderly population is expected to double to 4 million by 2020.

With increased life expectancies come increased illnesses, injuries, and disabilities. That's why the Pennsylvania Medical Society is tackling health challenges for senior citizens as it launches a new public outreach program called Family Health and Wellness.

Aging is the Family Health and Wellness campaign's first featured topic with information for Pennsylvania's elderly, their caregivers, and the medical community that serves them. Overall, the campaign is designed to help Pennsylvanians make better health care decisions with guidance from the organization's 18,500 member physicians.

The Commonwealth's older residents have plenty of company. Luzerne, Westmoreland, Allegheny, Delaware, Montgomery, Erie, Berks, Lancaster, Philadelphia, and Bucks counties have some of the highest concentrations of senior citizens in the nation. At the same time, Pennsylvania is the only state to exclusively earmark proceeds for programs benefiting the elderly. That's good, because almost 40 percent of residents over age 65 have self-care or mobility limitations.

In Pittsburgh, which has the country's third largest percentage of residents over the age of 65, Pennsylvania Medical Society member Neil M. Resnick, M.D., explains the phenomenon as "an unprecedented graying of the planet." He estimates that Pennsylvania is home to more than 1,000 people over the age of 100 and notes that the number of centenarians is rapidly increasing.

Dr. Resnick is professor of medicine, chief of the Division of Geriatrics at the University of Pittsburgh, and director of the university's newly established Institute on Aging. He says that, for many older Pennsylvanians, the stage was set years ago for chronic illnesses such as heart and lung disease.

"Unfortunately, today's information and regulations weren't available to help this generation make healthful decisions, and now they are paying the price," Dr. Resnick says. "Years of pollution and unhealthy lifestyles - like smoking and fatty diets - make getting older even more difficult."

Overall, Dr. Resnick sees a need for medical system improvements as our senior ranks expand. "The elderly are our most vulnerable population, and their growing numbers are presenting a challenge for the system. We need to concentrate more on prevention and on proactive management of chronic illness. If doctors spend more time with patients up front, they'll be able to diagnose and treat illnesses earlier and more effectively. The result would be improved quality of life for patients and likely a lower cost to the system."

Medical Society member geriatrician, Daniel Haimowitz, M.D., of Levittown, agrees that the medical community needs to work hard to meet the needs of elderly patients. "More time should be spent to properly assess the health needs of senior citizens. An older person typically doesn't hear and comprehend as well and usually has more medical problems requiring more medications - many of which may interact with each other. Therefore, taking proper time to identify and explore a patient's complaints, and then screen for common problems - such as early memory loss, depression, and urinary incontinence - becomes even more important with an elderly patient."

The Medical Society suggests that family members and caregivers take an active role in the health of senior patients. Doctors agree that one of the best things caregivers can do for the elderly is to accompany them to medical appointments. A knowledgeable companion can help a physician get a clearer picture of the patient's health status and other social, safety and psychological issues that could affect the diagnosis. The more involved family members are in the early stages of a problem, the better the outcome for both patient and caregiver.

But involvement of family members can be a delicate matter and must be treated with care, cautions Dr. Resnick. Pennsylvania's population is diverse, and families from various cultural and socioeconomic backgrounds deal with sharing personal information in different ways. Asking a family member to describe or translate intimate physical details could be uncomfortable or even taboo for some elderly patients.

"It can be embarrassing for an older person to ask a grandchild to translate personal medical information," says Resnick. "So, often, the senior doesn't bring a translator and the doctor-patient communication is jeopardized."

To help elderly patients communicate well with different doctors, the Pennsylvania Medical Society offers a free medical history card. The wallet-sized card has space to enter vital health information, including a history of allergies or chronic diseases and the names and dosages of current medications. Elderly patients can keep the cards in their wallets and ask their doctors to update them at each visit. Simple actions like this, combined with proactive family involvement and good doctor-patient communication, can improve health outcomes and quality of life for senior citizens.

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