Chronic Concerns What to Know About Living with Multiple Health Problems

More than half of all adults 65 and older have three or more chronic (ongoing) medical problems, such as heart disease, diabetes, cancer, or arthritis. Caring for older patients with multiple health problems can be tricky, even for healthcare professionals who specialize in caring for older people. Take prescribing medications, for example; a drug may be useful in treating one of the patient’s health problems, but it might make another worse.

Here are some tips for older adults with several chronic health problems when working with their healthcare provider to manage their care.

• Get as much information about treatment options as possible. You should work with your healthcare professional to understand all of your options for care and take an active role in deciding what kind of care you would like. For example, you should ask your provider to tell you how long each treatment option may take to work, because some treatments may take longer than others to show benefits.

• You should also decide if you want to make all of your care decisions on your own, or include others — such as spouses, family members, or friends — in the decision-making process. And you should always let your healthcare providers know right away if you have questions or concerns, want to stop treatment, or want try something new.

• Make sure your healthcare provider understands your priorities for care. Decide what treatment outcomes are important to you. For example, you may want to remain as independent as you can for as long as possible. Because of this, you may prefer a treatment with fewer side effects, even if this treatment may not prolong your life as long as other treatments. This is just one example; you should ask your healthcare professional how different treatment options will affect the aspects of your life that are most important to you, such as your level of independence, stamina, or pain.

• Ask questions about tradeoffs between benefits and risks of treatments. Most medications and other treatments have both benefits and risks. Talk with your healthcare provider about possible benefits of each treatment, and also possible drawbacks, such as increased risks of disability, new health problems, and poorer quality of life. Understanding all of the pros and cons of each treatment will help you decide which option is best for you.

• Let your healthcare professional know immediately if a treatment doesn’t seem to be working or is causing problems. Since there isn’t a lot of research examining how older adults with complex health problems respond to treatments, your healthcare provider may not be able to predict exactly how a treatment will affect you. Because of this, it’s very important for you or your caregiver to tell your healthcare provider — right away — if a treatment doesn’t seem to be working or is causing side effects.

• Speak up if your treatment plan is too complicated to manage. Studies have found that, the more complicated treatment instructions are, the more likely patients are to stop following them. Let your healthcare provider know if your treatment becomes too complicated or difficult for you to follow. And make sure you understand all instructions before you leave your provider’s office. Ask him or her to work with you to make instructions as simple and easy to follow as possible.

• Make the most of treatments that cause few or no side effects. Your healthcare providers should make the most important and effective treatments the highest priority. Your treatment plan should fit your needs and preferences, while getting you the most benefits and least amount of risks. Among other things, your healthcare professional should be able to tell you about non-medication treatment options — and to recommend those when possible — to avoid potentially dangerous interactions between medications and other side effects. Ask your healthcare professional if there are non-medication options for at least some of your symptoms.

This article was prepared by the Foundation for Health in Aging, a program of the American Geriatrics Society.