Multiple Health Issues
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.