senior health care
Successful Aging Takes a Team!
Successful Aging Takes A Team!
Let’s talk about why it’s critical to their quality of life to have a strong support team around seniors who are growing older.
Why?
Because I see so many older people in my private practice who face, for example, situations where they are grappling with:
- family members or loved ones with very strong opinions about what is best for them – opinions danabol that may or may not be informed and wise
- *no* family members or close friends at all to advocate for them
- a primary care physician who is prescribing medications but not following them in after-care. What is known as the “diagnose and adios” routine.
- a specialist or two who is also prescribing – say for instance a cardiologist or endocrinologist – but who is not tracking the interaction of *all* of the medications involved
- a psychiatrist who may be also be treating and prescribing psychiatric medications
- possibly a nutritionist, alternative health practitioner or two prescribing supplements, vitamins and minerals which may all be fine but which also carry side effects that can contribute to mood problems.
Way more often than not, there is very little, if any, communication and coordination amongst the health professionals. This coordinator function may have been done in the past by the primary care doc who managed the broad perspective overview of how each of his patients were doing. But nowadays primary docs are under so much time pressure in their practices that they just do not have time take on this role.
In order to build that coordinated team which will support an individual’s successful aging, it takes someone stepping into the role of being a skilled ADVOCATE. A person who knows how to coordinate effective communication amongst team members and who is in charge of reaching out on behalf of the patient to represent their concerns. Someone who can help the patient communicate their concerns and questions to other team members, and who also helps the patient remember the answers and instructions of doctors. Team members need to work in concert with each other, supporting the various lens through which each patient is viewed.
All of this process needs to be done with the utmost RESPECT for each patient where the patient has TRUST in the advocate that he or she is representing the wishes of the patient towards the goal of the best possible quality of life at any stage.
Gerontologists and mental health professionals who understand the importance of building good communication and coordination amongst care teams can be invaluable to the patient and family. Sometimes, it is care managers who provide this role, sometimes it’s an adult child, and sometimes it’s gerontological counselor.
Whoever it is that takes the lead in this role, a support team that is identified, built, coordinated and in good communication, will result in a patient who is much more likely to thrive and much less likely to fall through the cracks.
This is the health care situation for older people in our country today. Just the facts. And totally doable to navigate through it successfully. With help. With a solid, caring team.
Solutions to The Problem That Has No Name
Here are, as promised, some tools that boomers are using to help keep their spirits afloat as they navigate the transition from their 60’s into their 70’s. They are simple and we mostly know about them. Putting them into regular practice is the key towards feeling better.
- Mindfulness, contemplation and loving kindness practices
Sitting still and paying attention. Daily. That is the gist of mindfulness practice. It doesn’t have to be for a set length of time. One minute is fine. What tends to happen is that if you can stop the momentum treadmill of everyday life even for a moment by stopping, sitting up with good posture and paying attention to your breath for one minute, you might find yourself sitting for more than one minute. The hardest thing is simply to make the effort to stop. This can be pulling over on the side of the road, in a parking lot, in your office, at your home, wherever. The word for mindfulness in an Japanese is also the word for heartfulness. This is where loving kindness practice comes in. Sitting quietly with awake presence includes paying attention to our feelings and not judging them. Letting them be, and pass by. This is a big long topic but keeping it simple, it’s about being kind towards yourself before you can begin to be truly kind to others. Repeating the simple Metta Loving Kindness mantras can be a place to start: “May I be safe, May I be happy, May I be healthy, May my heart be filled with loving kindess.”
- Exercise – aerobic; Yoga
Exercise is key, we all know that. Again, even a few minutes can make a big difference both in physical health and in mental health too. A short walk around the block. A few minutes on a stationary bike. Dancing to some music on the radio. A Youtube gentle yoga video to help build muscle but also to stretch your muscles out. Most people find the most challenging part of this is getting started. So, starting by just committing to 5 or 10 minutes a day is a great way to get yourself going. Don’t start with too much of a commitment so that you give up!
- Understanding the link between nutrition and mental health
More and more research is coming out about the links between good nutrition and good mental health. We are what we eat, it’s true. So many of the neurotransmitters that govern our moods are produced in the “gut”. Paying attention to what we eat – backing down the processed carbs and the white sugar is paramount to good health. Complex carbs, protein, vegetables and fruit. Simple. Fortunately we live in a day and age when good quality organic foods are available. Counting calories is an important thing to watch too. You can eat good quality foods but eat too much of them. Paying attention to your weight and aiming for a strong body are things many of our grandparents and parents knew. We need to pay attention to them too as we get older.
- Giving back to your community; volunteering
It’s not a surprise that helping others makes us feel good. People that survey volunteers at various causes always say that people report that they feel better than the people they help! As we get older and probably are retiring when we can :), people sometimes feel like now what? Traveling and doing hobbies and socializing are great – but so is having purpose and helping out our friends, family and community.
- Consciousness raising support groups
Since we are talking about a “problem that has no name”, being in a supportive peer group where we can compare notes, commiserate, exchange ideas, and yes, laugh!, can be sooo healing. There are meditation groups where people have discussions afterwards, support groups for caregivers, church/temple groups, groups that have to do with aging such as AgeSong in the Bay Area, and more. Many agencies that serve older people offer groups of various kinds, as do community centers. You might have to try one or two before you find one that feels just right.
- Nature – renewing a commitment to spending time outdoors
There is a term in Japanese that translates as “forest bathing”. It turns out that trees release not only oxygen but also chemicals that contribute to the overall health of the forest. And, it turns out, these chemicals are very good for us humans! So, try to get out in nature, in the forest, or on the mountain, or by the ocean or river, or in the park. Anywhere where you can “forest bath” – meaning to simply stop and immerse yourself in the beauty of natural surroundings.
- Counseling
Going to see a therapist who understands the journey of being in middle age and older years can be so healing and supportive. Any therapist might be helpful but particularly someone who understands that the challenges and opportunities and transitions we encounter in this adventure of growing older – can be very helpful in terms of you being able to understand what is common and normal in this part of your life. Understanding that you are not alone – you’re not doing something wrong most of the time – can feel like an unburdening. Yes you still have to figure things out and there are challenges. But the self-criticism, self-blame, and shaming can be *greatly* reduced with the power of a little education about what are called the “developmental tasks” of this age and the common landmarks of this territory. Plus, of course, learning about the many ways people like you are successfully dealing with a variety of issues is a huge help.
- Using the Arts to reconnect with Self
Re-exploring one’s love of the Arts can be so healing at this time in your life. Reading, writing, journaling, reading and writing poetry, playing a beloved instrument, learning how to play an instrument for the first time, taking a 
class, learning to dance, going to art exhibits, singing in a group, going to concerts, enjoying doing crafts, arranging flowers… – all of these feed the soul and, now that you may have more time on your hands, are a good way to relax and keep your mind engaged in beauty rather than on problems. Winston Churchill, for instance, suffered greatly from depression – what he called the Black Dog. Painting, for him, was a tremendously helpful therapy.
Please feel free to email me if you have questions or comment below.
Not Enough Geriatricians or Geriatric Psychotherapists Either
One of our old friends Katie Hafner just wrote an important article for the NY Times entitled “As Population Ages, Where Are the Geriatricians?”. Katie eloquently explains the situation which is that this country is woefully underserved when it comes to doctors who understand the myriad complexity of symptoms that older people encounter. Docs are under-reimbursed by Medicare and so many choose not to go into this field. Others find it too complicated, too difficult, maybe too sad for them. At any rate, treating older people is NOT the same as treating younger people – whether it involves the medical field or the mental health field! Here’s a top-notch quote from Katie’s article that speaks to that fact:
Dr. Eckstrom was a general internist who practiced in primary care for nine years before returning to Oregon Health and Science University to complete a geriatrics fellowship. “I thought I was doing a good job caring for my patients,” she said. “But oral trenbolone for sale I wanted to do more geriatrics teaching and research.” The fellowship opened her eyes. “I had no idea what I didn’t know,” she said.
I hope there will be more articles and education for the public about this critical lack of informed care for the rapidly growing aging population. Someone commented that the government should increase Medicare reimbursement rates for doctors – and I think for mental health professionals too – to encourage more people to go into this field. Someone even suggested the government should pay the student debt for medical students going into geriatrics. We have to do something!