Intro to Aging Issues: Part 1 - Healthy IU · Breast cancer, cervical cancer ... Doctors want to...
Transcript of Intro to Aging Issues: Part 1 - Healthy IU · Breast cancer, cervical cancer ... Doctors want to...
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Intro to Aging Issues:
Part 1JENNIFER CARNAHAN, MD, MPH, MA
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Disclaimer
This talk contains general medical
information and is intended for
educational purposes only. It is not
intended or implied to be a substitute
for your own medical doctor’s advice.
Please consult your medical provider
before seeking any new treatment.
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Outline
Part 1
Healthy aging
Common ailments
The D word
Part 2
The D word continued
Living arrangements
Advanced care planning
Tips for talking with your doctor
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The key to healthy aging
Risks versus benefits
Ask about your options
Weigh your options
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Healthy Aging
Risk vs benefits:
Ageism vs treatment options/outcomes
Values and beliefs
Physicians can help with risk profile
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Healthy Aging
Genetics plus environment
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Healthy Aging
Medicare: (65 and older)
“Welcome to Medicare” in first year
Annual Wellness exam after that
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Medicare
Part A-Inpatient/Hospital/Skilled Nursing Facility (100 days)
Part B-Outpatient/Observation Stay
Part C-Medicare Advantage (HMO/PPO)
Part D-Prescription Drug Coverage
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Medicaid
Varies by state
Income requirements
CHIP, HIP
Approx 65% nursing home residents rely on Medicaid
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Healthy Aging
Diet and Exercise
Fresh fruits and vegetables
Complex carbohydrates
Both cardio and weight or strength training
Unless rec by doctor supplements not necessary
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Healthy Aging
Screening tests:
Colon cancer
Lung cancer
Bone density
Prostate cancer
Breast cancer, cervical cancer
Other: mood, obesity, alcohol, aortic aneurysm etc
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Healthy Aging-Vaccines
Pneumonia-two:
PCV-13 (Prevnar®)
PPSV-23 (Pneumovax®)
Tdap (tetanus-diptheria-pertussis)
Shingles:
Zoster Vaccine Live (Zostavax®)
Recombinant Zoster Vaccine Adjuvanated (Shingrix®)
Yearly influenza
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BREAK/QUESTIONS
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Clinic Visit Tips
Written list of maximum of 3 things to talk about
Doctors want to hear the truth
Brown bag your medicines
Take your medicines before your appointment
Weigh your options: risks vs. benefits
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Common Ailments
Cardiovascular
Hypertension
Heart failure/CHF
Coronary artery disease (heart attack)
Stroke
Peripheral vascular disease
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Endocrine
HypOthyroid
Diabetes (Type 2)
Low bone density or osteoporosis
Diet/food is the best way to increase
calcium and vitamin D
Weight bearing exercises
Stop smoking
Common Ailments
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Polypharmacy
Common Ailments
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Common Ailments: polypharmacy
THE PRESCRIBING CASCADE
NSAID = non-steroidal anti-inflammatory drugs = ibuprofen, naproxyn
CCB = calcium channel blocker = blood pressure medicine
Diuretic = “water pill” = increases urination
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Musculoskeletal
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Musculoskeletal
“Arthur” or arthritis:
Osteoarthritis
Rheumatoid arthritis
Broken bones (osteoporosis)
Joint replacement (obesity, arthritis)
Common Ailments
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Hematology/oncology
Increased risk of cancer
Increased risk of anemia
Increasing specialization in geriatric
oncology
Common Ailments
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Common Ailments
Neuropsychiatric
Depression & Anxiety
Delirium
Dementia
MUST distinguish the first two from the
third
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Common Ailments
The C word is now “the D word”
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The D word
Dementia
Alzheimer’s disease
“Old Timer’s Disease”
Vascular dementia
Lewy body dementia
Frontotemporal Dementia
(Parkinson’s disease)
(Mild) Cognitive Impairment
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BREAK/QUESTIONS