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Interactions:
the problems snowball
As you have probably already begun to realize
as you read preceeding information, many of these health issues have serious
potential to interact with each other. Since older patients have a much
greater chance of having multiple health issues going on concurrently,
the potential for interaction between those health issues becomes a serious
issue in itself.
In addition, the changes in how the liver
and kidneys of older people metabolize medicines means the potential for
these medicines to have unintended side-effects increases as well, especially
when doctors inexperienced in adjusting dosages to older metabolisms treat
the multiple health issues of older patients by prescribing multiple medications.
All too often, seniors are thrown into over-medicated states because of
this accumulation of medications that their body can't clear out efficiently
enough, resulting in mental confusion, lethargy, and other negative reactions.
This in turn exposes seniors to a heightened risk of falls, automobile
accidents, and other mishaps attributable to the mental fog of overdose.
Worse still, this mental fog can often be misinterpreted by family and
friends as the beginnings of senility, and thus go uncorrected for some
time.
Seniors and larger issues of public health
Finally, many health conditions have social,
psychological, and cultural ramifications, but aging is especially prominent
in this regard. Any discussion of health concerns of the aging has to
take into account such public health issues as patients' social support
networks and access to caregivers; their economic situation and ability
to afford care and/or health insurance; and psychological as well as physical
ability to comply with necessary treatment. Even basic research into medical
treatments for conditions common among seniors benefits from keeping this
point in mind, because a newly-discovered treatment won't do seniors any
good if they don't have the resources to either access it or maintain
it. Specific public health issues of older patients include:
- The rising
cost of health care, in particular medicines—more and more, health
care has been shifting to cost-containment practices, outpatient care,
and an emphasis on prescription medicines. Since seniors typically take
multiple prescription medications for their multiple health conditions,
these shifting and rising healthcare costs directly affect them.
- The growing
proportion of people in general and older people in particular without
adequate health insurance, or any insurance at all—older Americans
tend to lose their employee-provided insurance upon retirement, and
find Medicare covers less and less, and doesn't cover prescriptions
at all, which again is a major burden given the number of prescription
medicines they take.
- Disparities
in health, longevity, etc. based on socioeconomic group—studies
continue to find these inequalities based on level of income and membership
in economically disadvantaged racial/ethnic groups, inequities which
deepen as these population groups age.
- Demographics—the
proportion of older people in the American population continues to grow,
partly because of the baby-boom bulge continuing to move through the
population, partly because this past century of improvements in health
means the average life span continues its upward increase.
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