Get healthy 100 years old – Geriatric Medicine – healthy aging
In Munich I recently attended a 2 day seminar about integrative geriatric medicine. Title: Get healthy 100 years old.
The referent was Dr. Michael Teut, a specialist for geriatric medicine, working at the well known Berlin Charite hospital. The concept there is to combine conventional medicine with alternative methods, in regular and intensive care units as well as in ambulant services. His statement is that all the different disciplines of medicine have to work together to provide optimal care for optimal result. In geriatric medicine that means: To keep the elderly person as long as possible active and independent with quality of life. Especially in the combination of conventional with natural medicine and openness to teamwork of all care participants he sees the chance for the future to deal with the challenges of having more and more older people. As a summary he said, the results of the treatments, since they follow that integrative concept, are much better and are less expensive.
One of the problems today is, that a patient – and especially somebody with multiple health problems is seeing several doctors: the general physician, the cardiologist, the endocrinologist, the ophthalmologist, the nose throat and ear specialist, the physiotherapist, the orthopedist, the neurologist, the urologist, the dermatologist, the dentist and the pharmacist. Each of them is seeing the patient, coming to a conclusion separate from the result of the other doctors and prescribing its own favorite medications. Finally the patient has to take a whole bunch of medicaments: for pain, digestion, nerves, eyes, heart, bladder, prostrate and maybe even for sleep, depression or anxiety.
Very often people feel overwhelmed by that amount of drugs and complicated directions how and when to take them. Sometimes instinctively it comes to an aversion against taking so many medicine. And right! Because each of them has its own chemical reaction, reverse and side effects. As a result, too often people have to take medication just to treat the negative side effect of another drug. Who can keep the overview, who can keep control over the whole case?
Even a general physician would have enough time to check all of them in its summary , it is actually impossible to have control over these many effects.
These multi prescriptions are one of the big problems in geriatric medicine today, Dr. Teut said. Therefore they recommend to give no more than 3 different chemical drug substances. If more are necessary than only for a short time by a reduced amount of daily administrations, for example instead of 3 times a day only twice a day etc. or they cut the tablets in half. It is very interesting, that a lot of patients immediately improve. The motto is: Start slow and go slow.
Our life expectancy extended over the last 200 years dramatically. In some of our western countries the aging pyramid gets drastically reversed. More and more older people contra less and less young people. This situation is challenging us. We have to develop new models for increasing life quality of elderly people, for effective prevention and – most important – to create support systems that helps to keep the autonomy and independency of a person as long as possible. But this is only possible when everybody who is involved in the care taking system is willing to work as a team. The goal has to be providing the best care and not making the most money.
To reach that goal there has to be some change in our medical care and social system. Required is more teamwork, more efficiency, more holistic, integrative medicine and it has to be less expensive.
Optimal would be to have a person who is able to do a good “case management”: to organize and to check living conditions, which includes physical and social activity and good nutrition. It has to be someone who can accompany the person in a healthy aging process. If there is no relative who can do it, then it should be a professional person. The money for that person is a good investment and will save in other areas a lot of expenses, for example early required care in nursing homes. But most of all it will help to keep independency as long as possible.
Prevention should begin early in life, but it is never too late – not for prevention and not for goods treatments.
When we look at the most frequent heath problems of elderly people, we see on top of the list physical problems. Pain, stiffness, inflexibility, which is often caused by a fall or accident or an already long existing laziness to do some exercise or sufficient walking. Therefore we can say: Most important in geriatric medicine care is to keep the person mobile and active.
Helpful is usually a plan or regimen to build up strength and energy. Improvement of mood and energy comes along almost automatically with more mobility. If the person is younger and still in good shape 10.000 steps a day – or 30 to 45 minutes of exercise or physical activity is a must for somebody who is still able to be active. This is the best approach to prevent the most dangerous problem of old age: Immobility, inflexibility and stiffness what leads to accidents like falls, strains, fractures etc.
The result is long lasting pain, more immobility and most of all: fear of another accident and more sitting or laying down. It is a vicious circle, because inactivity also leads to depression and loosing meaning of life. Contrary to that activity also helps to prevent cancer, depression, high blood pressure, diabetes, high blood sugar, arteriosclerosis, osteoporosis, dementia. Another beneficial result of exercise and activity is more stability and flexibility of the body and therefore less likely accidents with fractures etc.
It sounds wired: But the most important geriatric treatment rule is therefore to activate the person!!! Recommended to senior citizens are walking, dancing, swimming, qi gong, yoga (chair-yoga), stand bike etc.
Malnutrition is another underestimated fact: Investigations showed that up to 70 % of alone living elderly people are having a nutritional deficiency. What are the causes? Lack of consciousness about the importance of a healthy diet comes together with other negative factors like eating alone, dental problems, inhibited eye sight or problems to get groceries en general. Therefore a diet rich on fresh fruit and vegetables, less meat and protein, instead more fish, vegetal protein and unsaturated fatty acids is important. It is scientifically proven that people who eat less, but with a high qualification of food live longer.
Therapeutically Dr.Teut highly recommends to be open to complementary, integrative medicine. Homeopathy, acupuncture and herbal remedies are very effective and can be used complementary to chemical drugs .Pain, dizziness, digestive and neurological problems, low energy or emotional downs etc. are treatable with alternative methods.
Of incredible importance are all “touching- therapies” like massages, reflexology, reiki etc. We all need being touched and the older we get, usually less of touching we become. All these therapies are also “soul – therapies”, they help to improve the overall well being and help to sustain the meaning of life. In that way the amount of strong chemical drugs with negative side effects can be reduced.
In the late 60ies young people were living in so called living communities. Do we have to find similar living concepts now for our new older generation? Living forms were everybody can have privacy but not to the cost of loneliness. In many of our countries architects, social workers and interested people are working on such new concepts.
Fortunately here in our wonderful area in Mexico, with the healthy climate and the loving and caring Mexican people, together with social events, concerts, theater, literature etc. provide best circumstances and an ideal environment to reach that goal.