PHYSICIAN’S QUARTERLY BULLETIN - March 2016

Current Topics in Health, Healthcare & Your Practice

The Aging Boom: What Your Practice Needs to Know
 

When the eldest Baby Boomers fill out the patient forms in your waiting room they are well into ‘senior’ territory. But even at 70 these aren’t the seniors that came before.

Physically, emotionally, and intellectually, the Boomers have had inordinate influence on our country in a host of ways, including the attitudes and practices of health care.

Even if you belong to this generation yourself, it’s worthwhile to consider what effects this massive influx of Boomers will bring to your medical practice.

The First Generation of Online Diagnosis

How many times has a patient suggested the diagnosis, the treatment, or prescription to you?  Boomers were the first generation to see computers in the mainstream. With computer, tablets and smart phone at the ready, they are informed and often active in their own health care.

U.S. consumers as a whole each spend about 52 hours online per year -- or one hour per week -- looking for health information, notes a survey by Markovsky Health and research consultancy Fierce Healthcare.

That tendency to self-diagnose may threaten medical authority, says the Journal of Participatory Medicine, but the Journal also associates it with better patient compliance and self-care.

Of course, the information they find might also be inaccurate, exaggerated, or totally wrong for their condition. Busy physicians may find themselves becoming frazzled and impatient with a patient entering into their ‘territory.’ However, Rami Hashish PHD notes that it’s now common so “take your time to correct the [patient] diagnosis without being dismissive or, worse, arrogant. Otherwise you risk of losing your medical authority – or even worse, your patient.”  He suggests acknowledging the patient’s effort. Then explain your own recommendation—all the while avoiding any tone of condescension.

Independence Is Their Mantra

Boomers value an independent lifestyle and they clearly aim to ‘age in place’ in order to maintain their activities and comforts by staying in their homes as long as possible.

An AARP survey showed that nearly 90 percent of those over 55 are planning to stay in their homes as they age. Although approximately 20% will be forced to eventually enter nursing homes or assisted living facilities, up to 70% – 35 million people – are likely to do all they can to age at home.

Thus, the need for more mobility aids. Although Boomers might think of themselves as younger than they are, they recognize the limitations of aging. But unlike their parents’ generation, when Boomers are impatient with their physical limitations, they do something about it.

As a result, mobility and accessibility equipment is going through its own boom. According to a study published in the Journal of the American Medical Association (JAMA), it’s twice as likely for Baby Boomers with mobility issues to use some type of mobility aid to help them walk than the generation before them.
Unlike prior generations with their canes and walkers, Boomers are the beneficiaries of technology that may not have existed for their parents. Comfortable and easy-to-use scooters, power chairs, beach wheelchairs, rollators and more assistive walking devices have been introduced in the past few decades and continue to improve.

Measures of Mobility

The relevant measure of need for a mobility device is whether a person is able to ambulate alone. The CDC’s National Health Disability Survey includes one relevant measure in a two-part question: “Because of a health or physical problem, do you have any difficulty walking?” And “By yourself and without using special equipment, how much difficulty do you have walking, some, a lot, or are you unable to do it?”

Many seniors see a stigma attached to wheeled mobility devices, based on their image of its being a step closer to the nursing home. Many older people struggle with canes and walkers when wheeled mobility devices could be more helpful and efficient. But, as more Boomers—especially those with far-flung families--need to maintain their valued independence at home, the stigma associated with using wheeled mobility devices, is likely to lessen.  As their physician, chances are you’ll be writing a lot more prescriptions for Boomers’ mobility devices to Medicare and Medicaid so it will be advantageous to develop a basic knowledge of the solutions available.

Living Longer with Dementia

Many Boomers are enjoying good health and living longer—and too often that’s a double-edged sword when it comes to dementia. Whatever your specialty, understanding the signs of dementia and Alzheimer’s disease –and knowing how to deal with patients at varying stages of it—will likely be valuable in your practice. You won’t be in the situation alone. Be prepared to expand your network to include mental health providers, health care agencies, social services, and even elder law specialists who you can contact with concerns.

Going Up?  70, 80, 90 and Beyond  

Unless you’re a pediatrician, Boomers will continue to be a growing part of your practice. They’ve reaped the benefits of good health and, discounting dementia, will continue to fight for their independence and actively participate in their care. Certainly, their education and computer literacy make them history’s most savvy group of patients to enter a waiting room so far.

SOURCES

1. Journal of the American Medical Association, March 2013
2. Fierce Healthcare
3. AARP
4. Bureau of Labor Statistics
5. CDC
6. "Demographics of Wheeled Mobility Device Users" by Mitchell P. LaPlante, Ph.D. Associate Adjunct Professor, Dept. of Social and Behavioral Sciences, Disability Statistics Center, University of California
7. Dignity Health - "Managing Patients Who Use Online Medical Information to Self-Diagnose"
8. HealthIT - "How Can Digital Tools Help Me Manage My Health Information?"
9. Home Care Magazine - "Boomers Increase Demand for Mobility Devices"