Managing Multiple Health Problems

Many older adults have more than one health problem. In fact, more than half of all adults 65 and older have three or more ongoing health problems. Heart disease, diabetes, arthritis, and high blood pressure are some examples of common health problems older adults experience.

Taking care of older adults with multiple (many) health problems can be tricky, even for healthcare professionals who specialize in caring for older adults. Having multiple health problems can mean you take several medications that may interact with one another in potentially harmful ways. Also, most clinical guidelines for healthcare providers focus on how to manage a single disease or condition, instead of how to manage multiple health problems. In addition, older adults with multiple health problems are often not included in research studies to test new drugs and other treatments. This means that there is less information (often called evidence) about how medications and other treatments affect people with multiple health problems.

To help healthcare providers better care for older adults with multiple health problems, the American Geriatrics Society has identified five essential elements of good quality of care that should help your healthcare provider keep the focus on the best alternatives for you.

• Considering older adult preferences.  Share your preferences and values. Your healthcare provider should help you understand your care options and choices. They should also include your caregivers or other people you have asked to help you make healthcare decisions in these discussions.  Given the available options, your provider should work with you to make decisions that are in line with your preference and values, focusing on the outcomes that are most important to you, such as being able to be as independent as possible.

• Considering available medical research.  Expect your healthcare provider to look at the available research to see whether a given treatment approach is suitable for you. Your provider should understand – and explain to you—the uncertainty about whether a specific approach is likely to work for you.

• Making treatment decisions based on possible risks, benefits, and prognosis.  Keep in mind the possible risks and benefits of treatment, and the overall prognosis (the likely outcome of a health condition). Your healthcare provider should discuss with you what is likely to happen—both with and without each available treatment—and how long it will likely take to experience any benefit from the treatment.

• Assessing treatment options. Consider what each treatment involves. Adults with multiple health problems are more likely to stick to their treatment if the plans are not too complicated, confusing, burdensome, or difficult.

• Optimizing treatments and care plans.  Your healthcare provider should try to maximize benefits and minimize risks from the treatment approach within the overall care plan. For example, your provider should prescribe lifestyle changes and other non-drug treatments whenever appropriate to reduce potentially harmful medication interactions and other side effects.

Each of the principles above is meant to help improve the health care of older adults with multiple health problems. They keep in mind that each person is unique. Older adults may have different preferences, and all of these preferences are important.