The Complexities of geriatric Healthcare

For many older Americans, managing health involves a complex web of medications and healthcare providers. Henri, a 94-year-old resident of a care facility in Brussels, offers a glimpse into this reality, a reality that mirrors challenges faced by seniors across the United States.

Henri’s daily regimen includes a cocktail of drugs to manage a range of conditions: hypertension, type 2 diabetes, thyroid issues, and arrhythmia. “A dozen in the morning, two in the evening at the meal and a sleeping pill in the early evening,” he describes. This polypharmacy, the use of multiple medications, is a common concern in geriatric care. While each medication may address a specific ailment,the combined effect can lead to adverse reactions and complications.

Polypharmacy is a significant issue in the U.S., where older adults often see multiple specialists and receive prescriptions from each. This can result in conflicting medications and a higher risk of side effects, falls, and hospitalizations. According to the Centers for Disease Control and Prevention (CDC), nearly 40% of older adults in the U.S. use five or more prescription drugs.

Henri’s experience in the hospital highlights another potential pitfall. “When I was in the hospital, I was transferred from one service to another and I received a lot of antibiotics. I felt like I was doped at medication. I started to have hallucinations, probably as of all these pills that I took.” This underscores the importance of medication reconciliation, a process of ensuring that a patient’s medication list is accurate and up-to-date, especially during transitions of care.

The Importance of consistent Medical Care

Following his hospitalization, Henri transitioned through a rehabilitation center and eventually into his current rest home. He values the consistent care he receives from his long-time family doctor: “We agreed that he comes to see me once a month. He examines my small sores and adapts medication according to what he see. During his last visit, he did not change anything.” this regular monitoring allows for adjustments to his medication regimen and early detection of potential problems.

However, Henri acknowledges that not all residents of his nursing home have the same level of access to their primary care physicians. Some doctors visit regularly, while others are less frequent or arduous to reach which poses challenges for consistent care. This disparity in access to primary care is a concern, perhaps leading to delayed diagnoses and inadequate management of chronic conditions.

The Alarming Decline in Dental Care for Seniors

Beyond medication management, Henri’s story sheds light on another critical aspect of geriatric health: dental care. While he sees a physiotherapist regularly, he hasn’t visited a dentist in four years. He rationalizes this by saying that for “the three small teeth that he has left”, it’s no longer worth it.

This neglect of dental health is not unique to Henri. The article points to a concerning trend in Belgium, where “4% postpone their appointment for lack of means.” Data suggests this trend is even more pronounced among seniors. In 2023, barely half of Belgian seniors saw a dentist. “”It’s worrying,”” says Elise Derroitte, vice-president of MC, “”Given the importance of good oral hygiene and its link with the general health and the well-being of the elderly.””

This mirrors a significant problem in the United states. According to a 2023 report by the American dental Association (ADA), millions of Americans, particularly seniors, face barriers to accessing dental care. These barriers include:

• Lack of Dental Insurance: Medicare, the primary health insurance program for seniors, does not cover most dental services.
• Fixed Incomes: Many seniors live on fixed incomes, making it difficult to afford dental care, even with insurance.
• Transportation Issues: Limited mobility and lack of transportation can make it challenging for seniors to get to dental appointments.
• Physical Limitations: Conditions like arthritis can make it difficult for seniors to maintain proper oral hygiene.

The consequences of neglecting dental health can be severe. Poor oral hygiene is linked to a range of systemic health problems, including:

• Heart Disease: Bacteria from the mouth can enter the bloodstream and contribute to heart disease.
• diabetes: Gum disease can make it more difficult to control blood sugar levels.
• Pneumonia: Oral bacteria can be aspirated into the lungs, increasing the risk of pneumonia.
• Malnutrition: Dental problems can make it difficult to chew and swallow, leading to dietary deficiencies.

These connections underscore the critical importance of oral health in the overall well-being of older adults.

Seeking Solutions: Improving Access and Prevention

The original article highlights some potential solutions, including better integration of dental hygienists into nursing homes and improved reimbursement for their services. “”In the recommendations it makes, mutuality pleads for a better progress of teams and mobile units in nursing homes and a best nomenclature for dental hygienists whose mission is to ensure better prevention of oral diseases,”” the article states.

In the U.S., various initiatives aim to address the dental care crisis for seniors:

these efforts, along with increased awareness and preventive measures, are crucial to improving the oral health and overall well-being of our aging population.