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Successful Aging: Why do some medical practitioners make assumptions based on age?


Q. I recently called my internist to make an appointment for a routine EKG. The receptionist asked the important initial questions: date of birth, then name. After I gave my date of birth which is 1942, she immediately transferred me to the nurse practitioner (NP). I left a message with her and did not get a call back. I called back the receptionist and asked if I were 35, would she have referred me to the NP. She indicated the referral was for those who had chronic conditions. I said I had none. With that, she put me on hold; after a long pause, she came back on the line and indicated I was off the NP list and gave me an appointment for the next day. I felt she was making an assumption about me based solely on my age, assuming I had a chronic disease. Is feeling annoyed and offended reasonable? S.N.

Dear S.N.

If someone has an opinion or makes a decision about us exclusively because of our age, that’s a good reason to be annoyed. That is, unless it relates to pensions, Medicare or Social Security which typically are benefits based in part on our contributions.

My guess is that the office policy is made for efficiency. We know older adults take more time with medical professionals. Having someone available who specializes in treating older adults understands the time required and problems often presented. There is an argument for the receptionist to have forwarded your call.

Here is what we know: About 80 percent of older adults have one chronic disease. Over two-thirds of Medicare beneficiaries have two or more chronic disease and over one-third have four or more. The assumption that at your age of 76 you are likely to have at least one chronic disease is not unreasonable. However, it’s important to note that 20 percent of older adults don’t.

Such diseases are pricey. They consume 95 percent of health care costs for older Americans. And less than 1 percent of health care dollars are spent on prevention to improve overall health. The traditional model of caring for people with chronic disease focuses more on the illness than the patient which is considered expensive and often ineffective, according to the National Council on Aging.

Although you have been fortunate so far, age, family genetics and gender leave most older adults in a vulnerable position. Let’s look at the three most prevalent chronic diseases among those 65 and older and what can be done to prevent their onset or make managing an existing condition easier, as recommended by National Institute on Aging and the National Council on Aging.

Hypertension: We know that 58 percent of older adults are treated for high blood pressure. You can have it for years and not know it which is dangerous since it can cause other serious health conditions such as stroke and heart attacks. Here are some ways to try and prevent or reduce high blood pressure:

Keep a healthy weight.

Reduce your stress level.

Cut down on salt and drink less alcohol.

Exercise every day to include moderate to vigorous-intensity aerobic activities, flexibility and stretching, and muscle strengthening.

Don’t smoke.

Get a good night’s sleep.

Manage your stress.

High cholesterol: About 47 percent of older adults are treated for high cholesterol, a condition when your body has excess bad fats (lipids) that can result in clogged arteries that can lead to heart disease. To prevent or manage this condition, lifestyle counts.

Don’t smoke and avoid excessive alcohol consumption.

Be active each day.

Manage your weight.

Minimize saturated fats and trans fats in your diet.

Arthritis: We know 31 percent of older adults are treated for arthritis, an inflammation of the joints that causes pain and stiffness. There are steps to take that can delay or manage the condition.

Exercise at least 5 times per week to improve function and decrease pain. Try to include a mixture of aerobic, strength-building and stretching movements.Stay within the recommended weight for your height.

Take precautions to avoid joint injuries.

Get enough rest.

Eat a healthy well-balanced diet.

Wear shoes that fit. A cane can help with pain in one’s feet, knees, and hips.

To your question, Should you be annoyed? Despite one’s understanding of the need to be efficient, the receptionist could have asked the nature of your call and whether you have any chronic conditions. Yes, that takes a bit more time. Yet, such an answer acknowledges that each one of us ages differently, at different rates and with varying health conditions.

Most importantly, each of us wants to be treated as an individual rather than a number in a statistical report.

Thank you, S.N., for your good question. Best wishes for continued good health and successful aging.

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