By Judith Graham
Kaiser Health News
Large numbers of seniors aren’t receiving recommended interventions that could help forestall medical problems and improve their health, according to a new survey from the John A. Hartford Foundation.
Notably, one-third of older adults said doctors didn’t review all their medications, even though problems with prescription and over-the-counter drugs are common among the elderly, leading to over 177,000 emergency room visits every year.
Falls cause over 2 million injuries in people age 65 and older annually, but more than two-thirds of the time doctors and nurses didn’t ask older patients whether they’d taken a tumble or provide advice about how to avoid tripping on carpets or slipping on the stairs, the Hartford poll found.
Similarly, depression can cause people to become socially isolated, suicidal, or stop taking care of themselves, but 62 percent of seniors said doctors and nurses hadn’t inquired about whether they were sad, depressed or anxious.
The results, which cover a period of 12 months, speak to doctors’ and nurses’ lack of training in geriatric medicine. Providers need to recognize that “care of an 80 year old differs from that of a 50 year old,” said Dr. Rosanne Leipzig, professor of geriatrics at the Mount Sinai School of Medicine in New York. But too often, this doesn’t happen.
Seven interventions examined in the Hartford study are part of Medicare’s annual wellness visit, which became a no-cost benefit available to all seniors in the government health program in January 2011. Yet 54 percent of older people surveyed by the foundation had never heard of the Medicare wellness visit while another 14 percent weren’t sure if they had.
Only 2.3 million seniors out of a total 35 million with traditional Medicare coverage took advantage of wellness visits last year, according to government data. Medicare pays doctors about three times their ordinary office visit rate for asking about older adults’ ability to function, evaluating their mood, recommending preventive services, and connecting them with community resources during wellness visits.
“These are low tech, low cost interventions that are easy to do and that can have a huge impact on an older person’s medical care and their quality of life and function. But too many providers and older adults don’t realize they’re important,” said Dr. Sharon Brangman, chairwoman of the board of directors of the American Geriatrics Society and professor of medicine at SUNY Upstate Medical University.
Christopher Langston, program director at the Hartford Foundation, said older adults should schedule a Medicare wellness visit and talk to their doctors about recommended preventive care. The Rand Corp. has found that only 30 percent of older adults get care supported by medical evidence, compared to 55 percent of the general population, he noted.
Still, despite gaps in care uncovered, 97 percent of respondents reported being satisfied with their primary care providers.
The mission of the Hartford Foundation is to improve the health of older adults. Its survey, released Tuesday, asked 1,028 people age 65 and older between February 29 and March 3 about their experiences with care. The study was conducted online by Lake Research Partners and had a margin of error of +/- 3.1 percentage points.