Best Practices for Improving Patient Outcomes in Older Patient Population - Episode 9
Stephanie Chow, MD, MPH: This country is a very creative country. We are built on innovation and the acceptance of persons of all different backgrounds. This is what we say that we do, but as a geriatrician, I feel that ageism is something that is very real. And the discrimination and the negative feelings and attitudes toward it are felt very strongly in the older patients who walk through my door. If I were to say that I wanted something to be fixed in society, we really have to come together as leaders of geriatrics in promoting healthy aging, to come up with better models of care that really support individuals who are living longer with more chronic conditions—who may be more increasingly isolated because they’re no longer in the workforce but perhaps they should be. They can no longer independently manage their medications, but there probably should be better medication organization structures. They can’t leave their home easily to go grocery shopping, so perhaps they need better meals. But currently geriatric psychiatrists and psychotherapists are lacking. Perhaps individuals need more physical therapy, but currently there are not enough physical therapists who are helping, trained in the care of the older individual.
We also need to help with other aspects of aging: maintaining health insurance and Medicare— understanding how to navigate that process and the payment for some of these medical needs. These are things that are very important, and families and patients may not know how to navigate this as well. So having society help with some of these aspects, and allowing physicians and geriatricians to have that longer visit to discuss the complexities of our older patients—that is very necessary in order to maintain them as full contributors and happy individuals in our society.
It’s really important for us to give back that meaning to their lives and help our older individuals feel that they are still part of our society because very much they are. And as our population is growing, we really need to harness this and move forward together rather than have us versus them. This is all part of us. We are all aging, so it’s something that we always need to be thinking about. This is part of our own advance care planning for this country.
To maintain our older patients we are given and provide them with healthier lives, we really need to approach it from a multidisciplinary angle. We need to use our unique models of care, not the current structures as they are but new programs that incorporate the psychosocial dynamics, the nursing piece, the physical therapy, the pharmacy—all of these things—caregivers. Bring everybody to the table and discuss what can we do to achieve the highest quality of life for our aging population in a way that matters the most to them.
Transcript edited for clarity.