What You Need to Know about Taking Care of Aging Parents
The Ultimate Role Reversal: Taking care of one's aging parents
Dr. Alicia Arbaje has made a career of helping older adults manage their health so they can continue to live full lives, travel, and even work well into their seventh and eighth decades. As a geriatric medicine physician at Johns Hopkins Medicine, she is a specialist in the unique issues associated with older adults, including managing chronic disease, nutrition, cognitive and memory issues, maintaining balance, and the side effects of overlapping medications. “People are living longer with more burden of disease, so they need more help managing their health to live fully,” she says. Even so, older adults can use this time to learn new skills, leave a legacy, and live independently if they receive the proper support, and Dr. Arbaje stresses that their children should play an active role in providing the right environment.
Of course, helping older parents live well as they age can bring challenges. She cites her own father, who was on multiple medications for managing his blood pressure; primary side effects included fatigue and an extremely dry mouth, which made it difficult for him to speak for several hours after taking his pills. “My father is very active at 80, and he needs to talk to people and schedule meetings. For a few hours every day, he sounded like he was drunk,” says Dr. Arbaje. So she worked with his geriatric medicine specialist to see which of his medications could be streamlined or reduced. “We mentioned to his doctor that we were willing to put up with slightly higher blood pressure as a trade-off. That would not have happened if we had just looked at blood pressure alone, but when considering his life goals, there is an enormous upside for him to not have this side effect that affected his quality of life.”
Because reducing medication is something most doctors are not trained to do, getting an aging parent to a board-certified geriatrician—available at many teaching hospitals—is a good first step in taking control of health issues associated with aging. These doctors take a team-based approach, meaning the patient is not required to visit multiple specialists who might prescribe different medications and give varied recommendations. This prevents the patient from having to see a different doctor three out of five days a week; instead, a single team may consist of a geriatric medicine physician, a nurse practitioner, a social worker, and other specialists who provide coordinated care. “Make sure the care is focused on [the patient’s] goals,” advises Dr. Arbaje. “Medication is just one way to care for chronic conditions, and there are many other approaches that do not involve medication.” In her father’s case, doctors helped him improve his diet and exercise regimen, two factors that not only helped mitigate the reduction in his blood pressure medication but also keep him mobile and independent.
Enhanced fitness and nutrition can also decrease the effects of many chronic illnesses such as heart disease, high blood pressure, and diabetes. And since nobody wants every parent-child conversation to revolve around health issues—potentially creating a dynamic that turns the adult child into a constantly nagging parent—a geriatric specialist or dietitian can make recommendations about exercise and diet so they do not have to come from the family. When considering mobility issues, children of older adults often focus too much on safety, when a better and more holistic approach would be to focus on their life goals. “Mobility is part of staying independent,” she says. “That does not mean patients do not have a disability, but that they are able to cope with disability.” An adult child could consult a physical therapist or personal trainer to improve a parent’s mobility, or hire a driver to take a parent to regular exercise classes where there is also interaction with others.
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