By Timothy Riddell, MD
As we age, we come to a point where we need to make choices about our lifestyle, healthcare and personal pursuits. In today’s world, we frequently see that aging and the challenges of aging are rarely addressed in our society. Life expectancy is increasing for Americans, with the 85-and-older age group as the fastest growing segment of the population.
However, despite advances in healthcare, many elderly people have chronic, incurable progressive diseases and need assistance with daily living activities. One of the greatest challenges facing us as we age is the prevention of physical disability and the extension of “active life expectancy.” Fortunately, recent studies suggest that healthy aging is achievable, with sound planning for old age.
We have many outlets in popular culture to learn about the problems with each stage of life—except the problems associated with aging, death and dying. For this reason, it is important to have forums to discuss these processes. These discussions are valuable for both the elderly AND their caregivers. They include multiple topics, ranging from changes in independence to the need for hospice care and services.
The first concern lies in identifying the need for activities of daily living. These activities include outside the home activities such as shopping, driving and way-finding. As aging and disease processes progress, they include bathing, dressing, housekeeping, feeding and walking. There are multiple solutions to this issue such as physical therapy or home health. Many require further evaluation by one’s physician.
If interventions in the home are not effective, then advanced therapies such as nursing home care may become necessary. Understanding the steps needed to determine appropriate levels of care: independent living, assisted living, or nursing home, are necessary skills for any patient or caregiver. Next, understanding the steps needed to pay for, institute or establish these interventions are equally as important.
Finally, we are all subject to our own mortality. Many people ignore this important part of our lives. It is necessary to prepare and discuss our personal wishes regarding this important event for our families and ourselves.
Through two decades of caring for patients, “womb to tomb,” I have developed personal knowledge to help guide patients and their families through these conversations. Although they are sometimes difficult, and our natural instinct is to avoid them, I strongly encourage patients and their families or caregivers to openly engage in these important conversations.
Timothy Riddell, MD
Associate Medical Director, Family Medicine
Ochsner Health System – North Shore Region