Medical Care for the Elderly

In many cultures in the world, elderly people are revered and their advice is sought and respected. In our culture, the wisdom, the knowledge and the social skills of the elderly are often overlooked and instead we focus on the mental and physical deficits of our older generation. Because of this prevailing attitude, older people are generally regarded as less valuable than younger people. The younger person has responsibilities of raising a family, maintaining a career and supporting the economy. The older person generally has no responsibilities and in addition is a drag on the economy since a great part of the tax base must go towards the support of older Americans.

It is inevitable that medical care providers will unconsciously have this same attitude towards their older patients. As a result, if an older person has a medical complaint and the cause is not readily apparent, a medical practitioner is more likely to accept the condition as a consequence of old age and treat the symptoms with medication as opposed to aggressively trying to identify the problem. In younger people, if the medical complaint is interfering with normal daily function, typically a more concerted effort will be made to identify and correct the problem.

Another problem with treating the elderly is that many medical care providers regard old age, itself, as a disease and medical conditions that are just as common with younger people often go untreated in the elderly. As an example, many practitioners are unwilling to treat hypertension in the very old or to aggressively manage depression.

A third problem with medical treatment for the elderly is the large number of prescription medications the average older person is taking. On average a person over age 75 has five prescription drug medications and is using at least two over-the-counter medications as well is taking herbal supplements. Due to impaired ability to "clear" medications from the body, recommended dosages of prescription drugs are generally too much for older people. This can result in over-dosage and drug reaction and in some cases even death. The medical community is well aware of this problem, but finding the right dosage is often a problem because drug reactions are often masked by symptoms of the many chronic medical problems most elderly endure. In addition older people often don't recognize or they fail to report drug reactions. Another huge problem is that the primary care provider may not be aware of all of the prescriptions being taken and some of these drugs may be causing interaction with each other. Finally, many elderly either over-dose or under-dose or fail to take medications.

Some practitioners are trained in geriatric care and many others have extensive experience in this area and they are capable of dealing with the issues above. Caregivers should be aware of the medical care issues with their loved ones and should seek out those care providers who are most knowledgeable in providing medical care for the elderly. We also discuss the growing phenomenon of home visiting doctors and medical adviser services.

We also include an eight-page discussion of the exciting and promising new area of "ehealth". Topics discussed are: use of the Internet, efforts to change paper medical records to electronic record databases, advances in telemedicine, home telehealth and telehospice and the exciting new National Health Informaton Network initiative.

Finally, we invite you to examine the work of Dr. Rob stall. Dr. Stall is passionate about the area of geriatric health care. Rob is a board certified geriatrician and he maintains a private practice as well as being medical director for a number of health care facilities. He has a popular web site that provides pertinent information on health care for the elderly. He is very interested in empowering older persons and their family caregivers to advocate their own needs to the medical community. Towards this end Dr. stall provides articles, advice, instructions and a self-assessment worksheet for the patient to complete before visiting his or her doctor. In addition to his practice, he has a popular monthly radio program and he speaks frequently to local groups about care for the aged.

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