Healthy Aging
[ photo by Vlada Karpovich ]
Healthy aging.
Healthy aging is a term used by the American Geriatrics Society. This term reflects the dedication to improving the health, independence and quality of life in those who are aged 65 and older.(1)
Just the term makes me think how great that sounds. Who doesn’t want to experience healthy aging? I believe as our country’s over 65 population grows, this will become even more of a focus.
The question is, what does “healthy aging” entail? I thought it would be worthwhile to go through some of the aspects involved in helping one undergo aging in the best possible manner. The John A. Hartford Foundation and the Institute for Healthcare Improvement uses a multidisciplinary approach that attempts to foster a better environment for promoting healthy aging. The multidisciplinary approach is used because there are obviously multiple aspects to one’s well-being as aging occurs. I would like to use the next several blog posts to go through several of these aspects.
Monitoring health, the first part of healthy aging.
For this week, let’s dive into the first prong: monitoring health. This seems like a no-brainer, right? Well, I think it is safe to say that many of us are often guilty of thinking “why would I go to a doctor when I am not even sick?” We might likely say the same thing for a loved one we are caring for.
Let me emphasize the importance of utilizing the Medicare Annual Wellness Visit (AWV). According to Medicare.gov, if someone has had Medicare B for at least 12 months, they are entitled to this visit. This visit is not the yearly physical exam. Instead, this is a visit that is used to develop or update a personalized prevention plan to help prevent disease and disability. It is based on an individual’s current health and risk factors. The annual wellness visit assesses an individual’s current health status and discusses behavior change and strategies to reduce risks for certain diseases and injuries.
Components of the Medicare Annual Wellness Visit.
The visit should start with a “Health Risk Assessment” questionnaire your aging parent will fill out. This questionnaire is approximately two pages in length. It covers questions from how much pain one has had in the past week to describing the condition of a person’s mouth/teeth to whether or not one has rugs on the floors of their home. These questions help to direct the primary care physician (PCP) on where a patient might need further counseling and treatment/prevention measures that may need to be taken.
The AWV will also review the medical and family history. During this time, the patient will be asked to provide an updated list of current providers and prescriptions. In my experience, a large number of patients fall into the assumption that the PCP, or any treating doctor for that matter, knows all of the individual’s treating physicians and all of the individual’s medications.
This is far from accurate, unfortunately. The PCP is the point person to oversee one’s overall care, and it is common that the PCP will not always receive communication from treating specialists of mutual patients. The PCP must know who all of the specialists are that might be treating your loved one as well as have an accurate list of medications the patient is currently taking. More often than not, it is the PCP that discovers treatments/medications that might not be compatible with another medication/treatment.
(Related blog post: Options For Medication Management)
The AWV also involves routine measurements such as height, weight, and blood pressure. From these measurements and information, personalized health advice can take place, such as weight loss programs or actions that can help to modify blood pressure. The PCP can also help to provide treatment options available for these risk factors and establish a schedule for screening for certain preventative diseases.
A conversation can be had during this time as well regarding the need for continued screening for certain diseases. As one ages, there are some screenings that may no longer be appropriate or necessary, however, these decisions of stopping certain screenings are best discussed between the patient, the physician, and, possibly, the caregiver.
I have recently discussed the importance of discussing yours and your loved one’s wishes for end of life care. This conversation is also important to be had with one’s PCP. The AWV often covers advance care planning. The PCP can often better explain what to expect in certain end of life situations that might help one make a decision on what sort of care he or she might want.
(Related blog posts: Importance Of Talking About End-Of-Life Decisions, End Of Life Care At Home)
Finally, the primary care physician will also perform cognitive screening to monitor for signs of dementia. This last one, the cognitive screening, will be fairly brief but if there are signs of cognitive impairment, Medicare will then cover an additional visit for more in depth testing.
This is a fairly brief overview of a method for monitoring health, one of the prongs of healthy aging. Again, the Annual Wellness Visit is covered by those with Medicare B. I encourage you to make sure your loved one, and yourself if you are also on Medicare, utilizes this physician visit as a way to help to monitor health, which can then promote healthy aging.
Friedman S, Mulhausen P, Cleveland M, et al. Healthy aging: American Geriatrics Society white paper executive summary. J Am geriatr Soc. 2018;67:17-20. Doi: 10.1111/jgs.15644.
Feeling overwhelmed with the process?
Afraid you may not make the right decision at the right time? This stage of life for you and your aging parent often brings more questions than answers. Reading information from a trusted source like me can help guide you in the process. However, if you still feel overwhelmed, don’t hesitate to reach out to me. I am happy to help with a personalized plan for your unique situation.
© 2021 Jessica Kluetz, DO