It's important that older adults, their families and friends understand four key principles to ensure that older adults or recipients of elderly care receive timely & appropriate health care services. Older people should not just be treated as if they are only dealing with old age.

A patient I treated several years ago, Ms. Vi Tality, was 95 years old. She complained of pain in her right knee. Shrugging her shoulders, she said to me, "What do you expect at my age?" I asked her about her left knee. It was fine. Puzzled, I said, "Isn't that knee just as old as the other?" She smiled and understood what I meant.

When assisting older people, consider these four factors:

1)  Confusion or Disorientation - Check for Sudden Problems 

If an 80-year-old person appears confused or disoriented--and was alert and oriented the day or week before--he or she is almost certainly having or has had an acute problem such as an adverse reaction to a new medication, urinary tract infection, pneumonia, heart attack or stroke. However, confusion or disorientation may be the only symptom of these acute problems, and once cleared, the person might very well return to the clarity they had last week. Sudden change comes from sudden problems. Senility does not appear suddenly, so give the person the benefit of the doubt and have them checked for an acute problem.

2)  Gradual Decline may be Chronic Metabolic Disease or Depression

Chronic metabolic illnesses--thyroid gland disease, vitamin B12 deficiency, Parkinson's disease and medication side effects (see next section), for example--may develop over months to years, causing an elderly patient to "slow down," become "confused" or feel tired and weak.

Mood problems such as depression are often mistaken for dementia. What can you do? Loneliness and social isolation are very common, and can often be helped simply through kind words of reassurance, improved transportation, hearing aids or glasses, senior center involvement or volunteer work. A big hug can have a profound therapeutic effect, too.

Alzheimer's disease is a chronic, progressive dementia developing over months to years. The disease impairs thinking ability and in its final stages, it impairs physical functioning. A decline in physical and mental functioning, however, is not always indicative of Alzheimer's disease.

3)  Medication Use

Many older adults see several doctors, each of whom may prescribe one or more medications. These same patients may buy their own over-the-counter medication on a regular basis. Even one drug that's not right for older adults can impair their ability to function and decrease the quality of life they enjoy. Imagine what five can do. Older adults should avoid prescribing medications for themselves and question doctors about prescribed drugs: Are these medications necessary? What are the side effects of these drugs? Do they interact with other drugs?

4)  Ageist attitudes can be harmful
"What do you expect at your age? You're not getting any younger!" Do these statements sound familiar? These are unjust generalizations and prejudicial statements that assume all older adults naturally become weak, sick and forgetful. Older adults become sick from diseases; they don't become sick just because they're old.

In Summary...

Think about your assumptions. I do. It helps me keep my care of older patients on the right track.

Updated 6/30/08
by Marlene M. Maheu, Ph.D.

Robert S. Stall, M.D.,
14 Heritage Road West, Williamsville, NY 14221
Phone: (716) 636-7531 FAX: (716) 636-7532