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Learn from active, aging patients
People older than 60 will do things they never imagined possible at that age.
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When I was struggling to complete medical school and residency, those around me frequently said that life begins at age 40. Now patients tell me their life has really become more enjoyable after age 60. Those who have their health are finding and enjoying more freedom, and they have the resources to continue pursuing new and old interests.
In the future, active older people will comprise a greater portion of the people with whom medical professionals will interact. Our population is living longer and expects to be physically active much longer than previous generations. As a result, society is redefining middle age and old age.
Age no longer implies less opportunity, nor does it suggest one is not working, expressing talents or pursuing physical challenges. And because we have healthier older people, fewer people retire because of their health. Instead, older people retire because they choose to do so or they may even change careers by choice.
Planning for health
A unique aspect to planning one’s health is that it cannot be bought with money. Although we can control many factors contributing to our health after age 60, there are still many we cannot control. If we look critically at our patients older than 65, most have significant health limitations that are related to obesity, years of unhealthful eating habits, chemical abuse (eg, alcohol, cigarettes and drugs), stress and genetic factors.
Just look at the lists of medications your patients are taking. These include drugs for inflammation, pain, acid reflux, cardiac arrhythmias, sexual enhancement, cholesterol control, blood pressure, nutrition supplements and more. Why do they need these medications and why do they need them at the doses they are receiving? What does this tell us and what can we learn?
A World Health Organization report in 2003 reported on “the healthy life expectancy” in the United States as 69.3 years compared with Japan’s 75 years. They define healthy life expectancy as the time when the effects of aging and disease do not limit a person’s choices.
This measure underscores the concept that we medical professionals should continue to expand our role in contributing to the healthy life years of our patients, those around us and ourselves — in the areas where we can all exercise some control.
Pacing and proportion
Although we strive for healthy life years, we will all see our physical, mental and sensory abilities, and prowess start to decline at some age. As Robert Larson, MD, an orthopedic surgeon from Eugene, Ore., used to tell me, “If I was doing at 60 what I was doing at 40, I was not doing enough at 40.”
He was right. There are things I cannot do as well as when I was 40, but I enjoy the physical things I am doing today just as much. Yet I find many of us will be doing things past age 60 that we never imagined we would be able to do. Just like many of you, I am thankful every day for my health and fitness level as I get older and try to live life to the fullest.
We need to continue to teach our patients that achieving good health and fitness when you are older is not a short-term strategy. It should begin earlier in life. After you lose your health, it may be too late to retrieve it. We will all get weaker, become less flexible and have the wear-and-tear changes, such as arthritis, associated with aging. In addition, we will experience differing degrees of preservation when it comes to mental status, vision, dexterity, balance, hearing and blood supply.
The onset of chronic disease, as well as the unexpected occurrence of various cancers, will also take their toll on the aging population. These are the realities of aging. But how we manage these issues can make a difference — and that is worth our efforts.
So, this year, think about how, as physicians, we can really help our patients, families, society and ourselves. This includes paying attention to body weight, fitness level and healthy eating habits as well as relieving pain and suffering. Successfully leading an active lifestyle well into old age requires a long-term strategy. We should all work even harder with our patients to help them delay the effects of aging and disease from limiting their choices.
For more information:
- Douglas W. Jackson, MD, is an orthopedic surgeon in Long Beach, Calif., and serves as chief medical editor of Orthopedics Today, a SLACK Incorporated publication.