Addressing the unique health requirements of the older adult Population

Abstract

The number of people at least 65 years of age in the U.S. is at a record high.1 As outlined in this month's lead feature article, the number of Americans in this age group is projected to reach 95 million by 2060, almost double the number in 2018.1 This population increase can be attributed to an increased life expectancy resulting from a shift in the leading cause of death: from infection to chronic conditions.2 The older adult population has specific health requirements that health care teams will need to understand to provide optimal care.3 It is important to recognize that each older patient has a distinct health history and that the conventional features of age do not apply to the entire older adult population. A patient could be 80 years of age, but have a biological age of 65 years from living a healthy lifestyle and having a high level of physical activity. A comprehensive evaluation can help the health care team identify each patient's biological age, physiological response to aging, and functional status.4 It is expected that by 2030, 60 percent of the baby-boom generation will have at least two chronic health conditions that will increase the complexity of their care.2 Health care teams will need to anticipate the presence of such comorbidities and implement appropriate management strategies. This will require an interdisciplinary approach; a focus on preventive rather than reactive care; and knowledge of potential behavior changes, medication interactions and adverse effects, and options for addressing pain and other symptoms.2, 3 In addition, these patients may benefit from receiving a more comprehensive care plan before discharge, additional monitoring after discharge, and notification when follow-up care is required.2 Adding to the complexity of caring for older adults are possible end-of-life issues. For patients whose general health and function are deteriorating, quality of life should become the focus of care; each patient's circumstances, culture, values, beliefs, and preferences should be taken into consideration. Helping these patients work through care decisions to determine the most effective and appropriate interventions will require sensitivity and understanding from each member of the health care team.4, 5 With the older adult population expected to continue to increase in numbers, health care teams need to be prepared to address the unique concerns associated with these patients. This can include managing frailty, as outlined in this month's lead feature article; assessing for biological age; managing comorbidities; and considering end-of-life concerns and quality of life when making treatment decisions.