Seniors Benefit From More Preventive Care

Reports says earlier interventions improve quality of life, save money

SUNDAY, March 3, 2002 (HealthDayNews) -- Doctors and insurance companies typically treat seniors after a health problem crops up, but if more time was spent on preventing common medical conditions many of those problems might not happen.

That's the conclusion of a recent report from the American Association of Health Plans (AAHP) Foundation.

The report says that by intervening beforehand, managed-care companies can help with seven common conditions: falls, medication complications, poor nutrition, physical inactivity, depression, dementia and urinary incontinence.

"If you have one of these conditions, don't just accept it as inevitable. Talk it over with your doctor," says Peter Fox, chairman of the AAHP Foundation. "There is every reason to believe that intervention can help."

These interventions are often simple to implement and can greatly improve the quality of life for older Americans. At the same time, it could save insurance companies money, the report says. Here's how:

  • Physical Inactivity: Health-care professionals know a lack of physical activity is a risk factor for many health problems such as heart attack, stroke, osteoarthritis, diabetes and more. The report recommends that managed-care insurance companies should promote physical activity by making members aware of the benefits of exercise and helping them find available community exercise programs. Getting seniors active just one day a week could reduce medical costs by almost 5 percent a year, the report finds.
  • Falls: Thirty percent of older adults fall at least once a year, says the report. After the Lahey Clinic in Massachusetts discovered 45 percent of its emergency room visits in people 65 and older were fall-related, it started a prevention program. The cost of the program averaged $925 per person, but resulted in a $2,000 reduction in health-care costs per member. Interventions to reduce falls include increasing physical strength, checking home safety, correcting sight problems and addressing drug side effects.
  • Medication Problems: Almost a quarter of older Americans take inappropriate medications, and up to a third of all hospitalizations may be due to medication complications, says the report. For patients in the hospital, a bad reaction to medication can cost more than $3,000. Almost two-thirds of seniors visit their doctors each year because of complications with their medications. The report suggests pharmacists should be relied on more often to act as a liaison between patient and doctor, and managed-care organizations should provide more educational materials to doctors to reduce drug complications.
  • Dementia: While little can be done to halt the inevitable progression of dementia, early intervention can improve the quality of life and reduce medical costs for complications such as poor nutrition and fractures. Most important, the report says, is getting an early diagnosis of the problem. The report recommends health-care professionals work closely with a patient's family to make sure the patient is getting the proper medical care, taking prescriptions as directed and receiving needed services.
  • Depression: As many as 10 percent of older adults are clinically depressed, and that number jumps to between 30 percent and 40 percent for those who have recently been hospitalized. Depression can be more disabling than lung problems, diabetes and angina, according to the report. Physicians need to be aware that symptoms of depression are different for older people. They may not necessarily say they are feeling depressed, but will not have any energy or interest in activities. There are many drugs available to treat depression, and prompt treatment reduces the need for in-patient mental health services.
  • Poor Nutrition: Poor nutrition is at the root of many health problems, such as heart disease, diabetes, high blood pressure and osteoporosis. Doctors should regularly check the weight of their older patients and intervene if a patient loses more than 10 pounds in six months, says the report. Oxford Health Plans Inc. enrolled some diabetic members in a high-risk nutrition intervention that resulted in savings of more than $70 a month for each member in medical services, says the report. Sometimes, intervening for people with poor nutrition is as simple as giving them vitamin supplements, says Dr. Michael Freedman, who is the director of the division of geriatrics at New York University Medical Center.
  • Urinary Incontinence: Urinary incontinence affects between 15 percent and 30 percent of older adults, but less than half feel comfortable discussing it with their doctor, says the report. Depending on the reason for the incontinence, treatment may be available for the problem. The report suggests managed-care companies offer incontinence self-management programs and encourage doctors to identify members who need help.

"These kinds of interventions make a huge difference for the population, and will save money," says Freedman. "It's profitable for insurance companies and beneficial to patients."

What To Do: If getting the right nutrition is a problem, read these tips on eating well from the U.S. Food and Drug Administration. The FDA also offers this advice for seniors on taking medications. If you're interested in learning more about the benefits of exercise for older adults, go to the Senior's-Site.

SOURCES: Interviews with Peter Fox, Ph.D., chairman, AAHP Foundation, Washington D.C.; Michael Freedman, M.D., professor, geriatrics, and director, division of geriatrics, New York University Medical Center, New York City; American Association of Health Plans report, Improving the Care of Older Americans with Common Geriatric Conditions
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