Preventative Care Key To Health In Older Patients

By Nancy K. Crevier

Focusing primarily on the fragmentation of medical care, Newtown physician Dr Robert Ruxin was at the Newtown Senior Center on Tuesday, April 11, to share his ideas on the medical system and how seniors can get more personal care from their doctors and medical aides.

What senior citizens need to understand, he said, is that because of the way the modern medical practices are set up, patients in a hospital or nursing home are likely to see a physician other than their own primary care doctor. The danger in this is that new caretakers do not know the patient. “A new caretaker does not know how the patient was before he or she got sick.”

“Be your own advocate,” he urged, when care does not meet expectations. That includes dissatisfaction with office scheduling. One of the most common complaints he hears is that of overly long waits followed by hurried visits with the primary care doctor. “You’re the patient. You have rights. It is not good medical care to be rushed and pressured [at an office visit],” he said.

He cautioned those present to be persistent in preventative care. “As we get older, we don’t want to take medicines or get mammograms. But as we get older, we really do need to continue to do so,” he said. As a matter of fact, he said, the benefits of medications used to prevent heart attacks and strokes are more visible the older a patient gets. Mammograms have saved lives of women between 50 and 70, he told the women present, and can prolong life when cancer is detected.

Because doctors and nurses in large practices can be rushed, they do not have the time in detail to review preventative things seniors can do to keep themselves healthy. He said, “I hear in my practice from elderly patients, ‘Oh, I’m ready to die. That’s okay.’ But with some of these diseases, you don’t just die; you suffer a long time.” Preventative care and having a good communication with a health care provider is essential as people grow older, he said.

Dr Ruxin also advised the audience to pursue a prescription plan, such as Medicare Part D, if they have not already done so. He suggested that because insurance companies have the luxury of being able to change the formularies (drugs) they carry once every two months, while plan participants can only change plans once a year, that rather than choose a plan based on what drugs the plan now carries, ask how many drugs are needed each month and what will the premiums and co-pays add up to at the end of the year?

He said that people are unnecessarily afraid to switch from more expensive name-brand drugs to generic brands. “Insurance doesn’t always pay for the name brand. Data shows generic [drugs] work as well as name brands,” he said. A scare tactic used to keep people paying more for a particular drug is the rumor that four times the amount of a generic drug is needed to provide the same protection as a name-brand drug. Even when that is true, he said, it is all in one pill, so it does not make a difference in how it is taken.

With some drugs, Dr Ruxin said, the prescription can be written for a larger dose and the patient can break it in half. This is a safe and effective way for senior citizens to save money on the many expensive drugs they often must take.

In closing, Dr Ruxin reiterated the importance of finding a health care provider willing to spend time with his or her patient. “The elderly need more time,” he said. “Every decade of age, the number of medications increases and physical disabilities increase.”