By Mary Parish Gavinski, MD
Chief Medical Officer
Community Care

Healthy aging is the goal of geriatric care. In my practice, I have discovered three key areas that have significant impact on the wellness of older patients: maintaining function, managing medications and awareness of change.

One of the single most important things providers can do is to help patients maintain function. If a person is able to transfer from a wheelchair to a bed and back to the bed, caregivers should aim to have that ability continue. If someone can walk down the hall of his apartment building once a day, encourage him to slowly increase the amount he walks. Even at very old ages, patients should continue to exercise, no matter how minimally. Even very minimal improvement in functioning leads to improved health. Without your encouragement, older adults tend to become progressively more sedentary. Helping them exercise will enhance their quality of life.

The second key is to effectively manage a patient’s medications. Older adults are often taking multiple medications and research shows that with more medications, the risk of side effects increases. When a specialist prescribes a new medication, it is important that it be considered in context. Likewise, medications affect older adults differently from younger ones. Something as simple as eye drops may cause an older person’s blood pressure to fall, or worse congestive heart failure or other unintended side effects. At Community Care, our clinical pharmacist works with the primary care provider to carefully evaluate the risks and benefits of any new prescribed medication for that individual patient. We also work to educate family members about the risks of additional medications. Every six months, our pharmacist and primary care provider will review the medications of each patient. This may mean stopping medications no longer needed to changing the medication regimen to a better one.

Thirdly, pay attention to small changes. One of the incredible things about Community Care’s programs is that an individual’s team members communicate with each other regularly. If a driver, family member or home care worker notices a subtle change in a patient, the patient can be seen by their nurse, nurse practitioner or physician right away. In the fee-for-service world, you would have to call your doctor for an appointment while critical time passes. Through this early intervention we are able to start treatment sooner, prevent the need for some hospitalizations and get our participants well much more quickly.

These three keys are interconnected and can spiral in either direction. If an illness goes unnoticed or a new medication is introduced without careful consideration and knowledge of geriatrics, a patient’s health may worsen. What happens then? They’ll quit moving and lose functionality. On the other hand, if we help them keep moving, manage medications and pay attention to subtle changes, our patients will feel better, have better health and be able to do more.