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Health Maintenance: Staying Healthy at Any Age

Dr. Barney Spivack, medical director for the long-term care consulting company Life­ Care, talks about how to decide what screening tests and preventive measures are important to you or your family member or friend who is a long-term care resident.

Just because a person is elderly and in a long-term care facility doesn’t mean that screenings and preventive care no longer are important. Even if you are older and have several health conditions, early detection and prevention of illness can help you live longer and have a better quality of life. However, the burdens of some screening tests may be greater than their benefits. The physician can help you decide what tests or other preventive care measures are right.

Important preventive care for this population generally includes vaccinations to prevent infectious diseases such as the flu (influenza); screening to detect problems such as high blood pressure, diabetes, or cancer; preventive medications; education on basic health information and how to make informed decisions; and counseling to make sure nursing home residents understand and make healthy lifestyle choices.

Of course, not every preventive or health maintenance option is right for every person. For example, cognitive problems such as dementia or functional problems such as being bedridden may prevent someone from understanding or following directions. Also, some tests aren’t available in the long-term care facility, or they aren’t covered by insurance and a resident isn’t able or willing to pay for them out of pocket. Making sure the physician knows about your medical history (including what tests or preventive measures you have gotten and when) and your care goals (such as being able to walk without assistance or simply feeling well enough to play bingo every week) will help determine what preventive and health-maintenance care might be most useful.

By making sure care goals are designed individually and that your condition, goals, needs, limitations, and other issues are carefully considered, health- maintenance and preventive care efforts are likely to have the best results.

  Questions to Ask the Physician:
• What preventive measures at this time might have the greatest benefit for me? How do I find out if these are covered by insurance and if there is easy access to them?
• Do I have any limitations that might affect what preventive measures to pursue?
• What are the pros and cons of the screening tests that I might pursue?
• How might various preventive and health- maintenance measures affect my treatment plan or condition?

►  What You Can Do:
• Make sure the physician and nursing facility have an updated and accurate record of screening tests that you have had and when.
• Discuss your goals of care and what preventive care you practice. Then make sure the physician knows what you want to achieve in your care.
• Find out which screening tests and other preven- tive measures are covered by insurance and which ones are available in the facility. Discuss options, pros, and cons with your physician.

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