With 10,000 Americans turning 65 every day, the demand for geriatricians continues to grow. And despite a shortage of certified geriatricians as the demand increases, many geriatricians will see a patient on a one-time or as-needed basis and then make recommendations to the patient’s primary care physician. (BPT) - Are you 65 or older? While your primary care doctor may be an internist or general practitioner, have you thought about adding a geriatrician to your health care team? A geriatrician can act as your health care “quarterback,” helping to ensure you get the specific care you need, as well as coordinating care with specialists. “Our health needs often change dramatically in our later years,” said Dr. Efrem Castillo, chief medical officer for UnitedHealthcare Medicare & Retirement. “The kind of care you deliver to an older adult is not the same as for a middle-aged person. The physiology of older people is very different from people in other stages of life.” Those differences are significant enough that the medical community developed a specialty — geriatrics — to address the needs of older adults. Geriatricians are licensed physicians who have completed additional training in managing the care of older people. That training makes geriatricians uniquely suited to help older adults manage the complex demands of their health care needs. One source of that complexity is chronic conditions. Older adults are significantly more likely than their younger counterparts to have a chronic condition such as hypertension, diabetes and heart disease. In fact, about 80 percent have at least one chronic condition, and 68 percent have two or more. Given the prevalence of chronic conditions in older adults, they’re also heavier users of prescription medications than younger adults. About 90 percent of adults 65 and older take at least one prescription medication, and 40 percent take five or more prescription drugs. Juggling multiple chronic conditions can introduce challenges for doctors and patients, with one condition sometimes exacerbating the effects of another. Moreover, treatments for illnesses can sometimes interfere with each other. That means the recommended course of treatment could look different in a patient with one chronic condition when compared to a patient with several. Establishing the ideal treatment regimen for older adults with multiple chronic conditions can be further complicated by side effects unique to older adults. Some medications can be ineffective or even dangerous for older patients. Common over-the-counter drugs such as the allergy medication Benadryl, for example, have been linked to serious confusion in the elderly. Digoxin, a medication used to treat irregular heartbeat, can be toxic to older people when used at doses sometimes prescribed to younger adults. Geriatricians are trained to understand how drugs uniquely impact older adults so they can appropriately customize their drug regimen to mitigate the risk of complications. Decisions about how to customize a patient’s treatment aren’t necessarily black and white, requiring a doctor and patient to carefully balance risks and benefits. For example, some diabetes medicines can cause dizziness, meaning the doctor needs to focus not just on regulating the patient’s blood sugar but also on minimizing the risk of a fall, which is the most common cause of injury for seniors. “A lot of what geriatricians do is determining which medications are more likely to cause harm than help,” said Castillo. “And the concept of shared decision-making is integral here — asking patients, ‘What trade-offs are you willing to take?’” Sometimes, the trade-offs are purely medical in nature — weighing the pros and cons of taking a certain medication or undergoing a specific screening, for example. But more often than not, they also involve a person’s overall life goals. How important is it to maximize longevity? Comfort? How about independence? Each person answers those questions differently, and geriatricians are trained to use the answers to guide their treatment recommendations and care plan. When should you seek out a geriatrician for yourself or a loved one? A significant change in health status could be a trigger for a visit with a geriatrician. But any time an older adult feels his or her care is becoming too complex or needs better coordination, a visit with a geriatrician could help. Finding a geriatrician With 10,000 Americans turning 65 every day, the demand for geriatricians continues to grow. And despite a shortage of certified geriatricians as the demand increases, many geriatricians will see a patient on a one-time or as-needed basis and then make recommendations to the patient’s primary care physician. The American Geriatrics Society offers information about how to find a geriatrician on its website, and many larger hospitals and university medical centers have geriatricians on staff that will see new patients. If you’re enrolled in a Medicare Advantage plan, be sure to confirm whether a geriatrician you want to see is in your plan’s network and if your plan requires you to first get a referral from your primary care physician before a visit with a geriatrician will be covered. UnitedHealthcare members can get help with those questions. From scheduling your next checkup appointment to helping you find a specialist to getting the treatment you need, it’s easier to get the right care at the right time. * Check with your health insurance provider or Medicare about whether the cost of this new vaccine is covered under your plan. Whether it’s helping to schedule routine care appointments or checkups, UnitedHealthcare can help you navigate the health care system to get the care you need as soon as you need it. Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies. For Medicare Advantage and Prescription Drug Plans: A Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in these plans depends on the plans contract renewal with Medicare. KEYWORDS
This article addresses the four common barriers to good nutrition, why they happen and some solutions to keep in mind. Arming yourself with knowledge and preparation, while also maintaining a sense of normalcy around food, will allow you to be a huge source of support for your loved one, helping him or her stay on track.(BPT) - When a patient is battling cancer, good nutrition is essential to maintain physical strength and help ensure a better response to treatment. Foods high in protein are an important part of your loved one’s balanced diet, and helping them eat well is a critical investment in their health and well-being. That said, there may be obstacles to good nutrition during cancer treatment such as mouth pain, fatigue, taste sensitivities and nausea. If eating and drinking are painful or unpleasant, it’s easy to see how maintaining good nutrition could be a challenge. This can lead to a chain reaction of complications and a longer recovery time. "Most cancer patients are too tired to make a meal, or even shop for it. Yet the importance of good, consistent nutrition can't be overstated," said Dr. Bruce Moskowitz, physician and chairman of the Cancer Nutrition Consortium (CNC), a nutrition resource to help patients overcome the barriers to eating and get the nutrients they need, including proteins, fats and carbohydrates. Below are four common barriers to good nutrition, why they happen and some solutions to keep in mind. Arming yourself with knowledge and preparation, while also maintaining a sense of normalcy around food, will allow you to be a huge source of support for your loved one, helping him or her stay on track. 1. Fatigue Many cancer patients identified themselves as the main food preparer in their household, in a survey conducted by the CNC. On good days, your loved one may be in the kitchen, preparing and enjoying a tasty bean and vegetable soup from scratch. However, some days they might feel too tired to fix a meal. A lack of food can lead to even more fatigue, and that can trigger a downward spiral. Keep a stock of nutrient- and protein-rich foods on hand for the too-tired days. One option is HORMEL VITAL CUISINE products, a line of power-packed drinks and packaged foods designed by nutritionists, physicians and chefs to fill a void and support the nutritional needs of cancer patients, while battling common barriers to good nutrition. 2. Mouth pain/trouble swallowing Run your tongue along your inner cheek and gums. Those are brand new cells made by the body. Because chemotherapy and radiation damage cells, these mouth cells are often a casualty during treatment, resulting in sores that make it uncomfortable or even painful to eat. Avoid tart and acidic foods that can irritate the mouth, such as citrus fruits and tomato sauces. Steering clear of hard foods with rough edges, such as crackers, is also wise. Soft, easy-to-swallow foods are good options, such as eggs, bean soups or smoothies. 3. Taste sensitivities Again, the disruption to the rapidly dividing cells inside the mouth can alter the flavor of food. Patients often experience a metallic taste, but sometimes, flavor components that are salty or bitter can intensify — unpleasantly so. Radiation can also damage saliva glands. When foods taste bitter, metallic or too salty, try a sweeter approach and marinate meats in a sweet or sour sauce, fruit juice or a honey-lemon vinaigrette. If a food is too sweet, add salt or dilute it in water. Stimulate the taste buds and saliva glands with sour foods: avoid pickles, but try wholesome options such as Greek yogurt, kefir or tart cherries. 4. Nausea and vomiting Besides being a common side effect of chemotherapy and radiation, cancer patients are often plagued with a condition called anticipatory nausea. That is, certain settings or circumstances, such as entering a treatment room, can make your loved one feel ill. Be aware of triggers and respect them, taking advantage of nausea-free days. Encourage fluid intake in between meals rather than with meals, to leave room in the stomach for food. A few hours before radiation or chemotherapy, prepare a light snack or meal to get nutrients and protein into the body. If the doctor prescribes an anti-nausea drug, keep close tabs on how well it’s working, advocating for alternatives if needed.
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