The most important consideration specific to the care of an older adult is taking a whole-person approach that addresses their unique physical, mental, and social needs. This means looking at more than just their illness. It means understanding how aging affects their body, mind, and daily life in ways that are different from younger people.
Caring for older adults is not the same as caring for younger people. Each individual ages in their own way, and the physical, psychosocial, and cognitive health of older individuals varies widely. As people age, their bodies change in ways that affect how they respond to treatments, medications, and daily activities. This article will explore the key things to consider when caring for older adults to help them stay healthy, safe, and independent.
Understanding How Aging Changes Everything
Physical Changes That Matter
As people get older, their bodies work differently. According to the FDA, the older we get, the more likely we are to use more prescription and nonprescription (or over-the-counter, OTC) medicines. That can increase the chance of harmful side effects and drug interactions. The liver and kidneys may not work as well as they once did. This affects how medicines break down in the body.
The circulation system may slow down, which affects how fast drugs get to the liver and kidneys. The liver and kidneys also may work more slowly. This could affect the way a drug breaks down and is removed from the body. When medicines stay in the body longer, they can cause more side effects.
Mental and Social Changes
Older adults may also face changes in thinking, memory, and social connections. They might feel lonely or worried about losing their independence. Many older adults are burdened by sensory and/or cognitive limitation that limit their ability to hear, see, understand their medical circumstances, or access of health care services.
These changes don’t happen to everyone the same way. Some older adults stay sharp and active well into their 90s. Others may need more help earlier. The key is to treat each person as an individual.
Medication Safety Is Critical
Why Medicine Management Matters More
One of the biggest concerns in older adult care is medication safety. Older adults have narrow therapeutic windows and require close monitoring, especially when on multiple medications. This means there’s a smaller difference between a helpful dose and a harmful dose.
Most older Americans (48%) take at least one medication and many older adults take three or more medications each day. When people take many medicines, the risk of problems goes up. Medicines can interact with each other in ways that cause harm.
Common Medication Problems
Here are the main medication issues that affect older adults:
- Drug interactions: When medicines don’t work well together
- Side effects: Problems that happen more easily in older bodies
- Confusion: Taking the wrong medicine or wrong dose
- Cost: Not being able to afford needed medicines
A study of older adult outpatients who took five or more medications found that 35 percent experienced adverse drug events. This shows how important it is to watch medicine use carefully.
What Caregivers Can Do
Family members and caregivers play a big role in medication safety. Make a list of all the medications you take. This list should include prescriptions, over-the-counter (OTC) medications, herbal remedies, vitamins, and other supplements.
It’s also important to:
- Ask questions about each medicine
- Understand what each medicine does
- Know what side effects to watch for
- Keep medicines stored safely
- Never share medicines with others
Fall Prevention Comes First
Falls Are a Major Danger
Falls are one of the biggest risks for older adults. According to the Centers for Disease Control and Prevention (CDC, 2020), in 2018, falls were the 11th leading cause of death and the first cause of fatal or non-fatal injury in people aged 65+ in the United States of America.
Over half of all falls take place at home. This means making the home environment safer is very important for preventing falls.
Simple Home Changes That Help
Making small changes to the home can prevent many falls:
In the Bathroom:
- Add grab bars near the toilet and in the shower
- Use a shower seat for safety
- Put in bright, non-glare light bulbs
- Use non-slip mats
Throughout the House:
- Remove throw rugs that can cause tripping
- Add handrails on stairs
- Keep walkways clear of clutter
- Improve lighting, especially at night
A community-based program that helps older adults make modifications to their homes such as adding grab bars, shower seating and slip-resistant surfaces in the bathroom, as well as lighting and handrails on staircases can reduce falls by nearly 40%, according to research from Washington University.
Beyond Home Safety
Fall prevention isn’t just about the home. It also includes:
- Regular exercise to stay strong and balanced
- Eye exams to see clearly
- Medicine reviews to avoid drugs that cause dizziness
- Wearing proper shoes with good support
Communication Is Key
Talking With Older Adults
Good communication is essential for quality care. Effective communication can help build satisfying relationships with older patients to best manage their care. It can strengthen the patient-provider relationship, lead to improved health outcomes, help prevent medical errors, and make the most of limited interaction time.
Many older adults have hearing or vision problems that make communication harder. The National Institute on Aging notes that about one-third of older adults have hearing loss, and the chance of developing hearing loss increases with age. Healthcare providers and family members need to adjust how they communicate.
Better Communication Tips
Here are ways to communicate better with older adults:
- Speak clearly and at a normal pace
- Face the person when talking
- Make sure there’s good lighting
- Use simple words instead of medical terms
- Give written instructions they can review later
- Be patient and allow time for responses
Write down or print out takeaway points. It can often be difficult for patients to remember everything discussed during an appointment. This is especially helpful for older adults who may have multiple health concerns.
Cultural Sensitivity Matters
Respecting Different Backgrounds
The population will also become increasingly diverse. According to Georgetown University’s Health Policy Institute, by 2050, racial and ethnic minorities will comprise 35 percent of the over 65 population. This means healthcare providers need to understand and respect different cultural backgrounds.
Cultural competence refers to the ability of healthcare providers to understand and respect the cultural backgrounds, beliefs, values, and practices of their patients. Different cultures have different views about aging, family roles, and healthcare decisions.
Understanding Cultural Differences
Some important cultural considerations include:
Family Involvement: Some cultures expect family members to be very involved in healthcare decisions. Others value individual choice more.
Communication Styles: In some Asian cultures, there may be a more indirect communication style that values politeness and avoiding conflict. This might affect how people express concerns or ask questions.
Health Beliefs: In traditional Chinese culture, there is a strong emphasis on the harmony of mind, body, and spirit. This may lead to seeking out alternative or complementary therapies in addition to Western medicine.
Language Needs: Over half of Vietnamese elderly individuals in the U.S. had limited English proficiency, highlighting the need for language assistance in healthcare settings.
Managing Multiple Health Conditions
The Challenge of Multiple Illnesses
Most older adults have more than one health condition. The National Council on Aging reports that it is estimated that 9 out of 10 Americans have at least one chronic condition by age 80. This makes caring for older adults more complex.
When someone has multiple health problems, treatments for one condition might affect another condition. For example, medicine for heart disease might interact with medicine for diabetes.
Coordinated Care Approach
The best care for older adults involves a team of healthcare providers working together. Due to the multitude of comorbidities, geriatric assessment and care require coordination between all members of the interprofessional healthcare team.
This team might include:
- Primary care doctors
- Specialists for specific conditions
- Pharmacists to manage medicines
- Physical therapists for movement and strength
- Social workers for support services
- Mental health professionals
Supporting Independence and Quality of Life
What Matters Most to Older Adults
While treating illness is important, the ultimate goal is helping older adults maintain their independence and quality of life. Care of older adults should be designed to better respond to a broader perspective of patient-centered concerns, and target not only improved longevity, but improved function, independence, and quality of life.
Many older adults who are able to perform ADLs without assistance consider themselves healthy. Activities of Daily Living (ADLs) include basic tasks like bathing, dressing, eating, and moving around safely.
Supporting Daily Activities
Healthcare providers and families should focus on helping older adults:
- Stay as independent as possible
- Continue activities they enjoy
- Maintain social connections
- Feel safe and comfortable at home
- Make their own healthcare decisions when possible
The Role of Family and Caregivers
Family Support Is Essential
Family members and other informal caregivers play a significant role in the lives of their loved ones. They may provide transportation and accompany an older adult to medical appointments.
Family caregivers often help with:
- Managing medicines
- Transportation to appointments
- Home safety improvements
- Daily care activities
- Emotional support
Preventing Caregiver Stress
Caring for an older adult can be stressful for family members. Key risk factors for caregiver stress include: (1) a caregiver who is also frail; (2) a patient with cognitive impairment, emotional disturbance, substance abuse, sleep disruption, or behavioral problems; (3) low income or financial strain; and (4) acute illness or hospitalization.
It’s important for caregivers to:
- Take care of their own health
- Ask for help when needed
- Use community resources
- Take breaks from caregiving duties
Special Considerations for Healthcare Visits
Making the Most of Appointments
Healthcare visits are especially important for older adults. When performing a comprehensive assessment on an older adult, the findings are used to establish their baseline status of physical, cognitive, psychosocial, and spiritual well-being.
To make visits more effective:
- Bring a list of all medicines
- Write down questions before the visit
- Bring a family member if helpful
- Ask for written instructions
- Don’t be afraid to ask questions
Regular Health Monitoring
Older adults benefit from regular check-ups that include:
- Blood pressure and heart rate checks
- Medicine reviews
- Vision and hearing tests
- Balance and fall risk assessments
- Mental health screening
- Cancer screenings appropriate for age
Technology and Modern Care
Using Technology Wisely
Technology can help improve care for older adults, but it needs to be used thoughtfully. Some older adults readily engage in using electronic technology, but others have low digital literacy or experience difficulty when accessing electronic health resources.
Healthcare providers should:
- Offer both digital and paper options
- Provide training on health technology
- Make sure technology is easy to use
- Have backup plans for those who don’t use technology
Final Thoughts
The most important consideration in caring for older adults is recognizing that they are unique individuals with complex needs. Good care requires looking at the whole person – their physical health, mental well-being, social connections, and personal values.
Success in older adult care comes from:
- Safe medication management
- Fall prevention strategies
- Clear, respectful communication
- Cultural sensitivity
- Coordinated healthcare teams
- Support for independence
- Family involvement
At Yorktown Health, we understand these special considerations. Our team provides comprehensive care that honors each person’s individual needs and helps older adults maintain their health and independence.
Remember, aging is not a disease – it’s a natural process. With the right care and support, older adults can continue to live full, meaningful lives. The key is making sure that care is thoughtful, coordinated, and focused on what matters most to each individual person.
If you’re caring for an older adult or are an older adult yourself, don’t hesitate to ask questions and seek support. Good care is a team effort that includes healthcare providers, family members, and the older adult themselves working together toward the common goal of health, safety, and quality of life.
