Helping Senior Loved Ones Manage Multiple Health Conditions

Senior couple figuring out their medications

Mom's doctor recently prescribed a new medication for her blood pressure — but it's making her dizzy. With her osteoporosis, anything that raises the risk of falls is not good! Meanwhile, Dad has mild memory loss, which makes it hard for him to remember his diabetes care routine.

Health education materials often focus on managing one particular chronic health condition, such as diabetes, heart or lung disease, arthritis, depression, hypertension, incontinence, osteoporosis or substance abuse. It might seem as if one disease operates in a vacuum!

Yet as the American Geriatrics Society (AGS) recently noted, more than 80 percent of seniors in the U.S. are living with multiple health conditions. These seniors and their families face a number of challenges:

Many healthcare appointments. Patients with multiple chronic conditions may see a primary care doctor, along with routine checkups, tests and emergency care provided by a variety of specialists. It's hard to keep track of all these appointments. And when care coordination is fragmented among multiple providers, seniors may undergo unnecessary duplicate tests and treatments.

Complex medication management. A senior might be taking 10 or more prescription and over-the-counter drugs — each at a different time and in a different way. Sometimes more than one doctor prescribes a similar drug, which can lead to an overdose. Certain drugs may interact negatively with others. One drug may cause another to be less effective. A drug prescribed for one health problem even might make another condition worse.

Some health conditions cause changes in other ones. Arthritis pain might tempt a heart patient to neglect their exercise routine. A stroke patient might have trouble eating and fail to follow their diabetes food plan. Almost half of people with dementia also have depression, and the two conditions can worsen each other.

Alzheimer's disease and related conditions complicate matters. It's harder for people with memory loss to follow a care regimen. This is a serious problem, because almost 90 percent of seniors with dementia have two or more other chronic conditions, and 35 percent have more than five.

A challenge for patients and families alike

The AGS reports that the majority of seniors with multiple chronic conditions are helped by family members and friends. It's often a difficult job. Family caregivers report they must perform skilled medical tasks that they don't feel prepared for. They struggle to keep track of their loved one's appointments and care. Meanwhile, these family caregivers are likely to be juggling jobs, other family responsibilities and — if they can find the time — their own healthcare. To top it off, the AGS says caregivers often experience conflict with their loved one over care-related matters. Almost half of the respondents to a recent poll in the Caring Right at Home online newsletter listed emotional issues as the most difficult aspect of serving as a family caregiver!

A change of focus

Historically, when medical researchers study a particular disease, they have recruited test subjects who have only that disease, and no others. The AGS calls for more research on the interplay of multiple conditions — few health problems exist in a vacuum as we age!

There's also a widespread recognition that today's "silo" approach — with specialists each focusing on one health problem or body part — leads to ineffective care coordination. Progress is being made, with improved electronic health records (EHRs) getting primary care doctors and specialists on the same page. Pharmacists can keep track of medications and sound the alarm if one drug might interact dangerously with another. Patient-centered self-management programs train seniors to manage their care routines. And Yale University experts are calling for a more family-centered approach.

And of course, there's the bottom line to consider: Seniors with multiple conditions account for 71 percent of healthcare spending in the U.S. and 93 percent of Medicare costs, according to the Centers for Disease Control and Prevention.

Who can help?

If managing multiple health conditions is a challenge for you or an older loved one, ask the doctor for some suggestions. There are disease management programs for patients of every age. Many families today take advantage of the services of an aging life care professional (also known as a geriatric care manager). These professionals interact effectively and frequently with the healthcare system, and can attend doctor appointments with clients and communicate with families and among doctors.

Home care services also help patients and families juggle multiple conditions. Skilled nursing services can be provided at home. And at a more modest cost, nonmedical in-home care services can be provided by a trained, professional in-home caregiver, who can:

Home care worker helps client down the stairs

  • Work with family and healthcare providers to keep track of and coordinate healthcare appointments.
  • Provide transportation and accompany clients to appointments.
  • Pick up prescriptions at the pharmacy and provide medication reminders.
  • Keep clients, family and healthcare providers on the same page with effective communication.
  • Provide grooming, housekeeping and meal preparation when the effects of health conditions make this hard for the client.
  • Supervise and encourage clients as they follow their doctors' recommendations for diet and exercise.
  • Provide companionship, which is a real mood boost for clients who are suffering from depression — so common when a senior struggles with debilitating health problems.
  • Support the health and safety of clients who have Alzheimer's disease or other dementia.

Managing multiple chronic health conditions is a team effort. Patients, families and professionals working together can help create the best possible quality of care — and quality of life — for these seniors.

For information on topics related to home care and healthcare, visit our Home Care and Healthcare Advocacy group on LinkedIn

Right at Home, Inc. is a national organization dedicated to improving the quality of life for those we serve. We fulfill that mission through a dedicated network of locally owned providers of in home care services.