Most older adults have more than one health problem. More than half of older adults have at least three health problems. Heart disease, diabetes, arthritis, and high blood pressure are some examples of common health problems in this group.
Older adults with multiple health problems (also called multiple chronic conditions) sometimes have:
- Severe illness
- Poor ability to carry out daily activities
- Poor prognosis (prediction about the outcome of an illness)
- Unique personal goals for their health
These frail older adults need a flexible approach to their unique health care situation that is consistent with their personal goals. Caring for this group can be hard, even for healthcare professionals who are experts in caring for older adults.
Older adults who have multiple health problems can have increased rates of:
- Side effects of treatment
- Use of health care services and institutions
- Decreased quality of life
- Disability and death
Living with Multiple Health Problems
Three of the reasons that make caring for older adults with multiple health problems complex are:
- A person may take several medications that can interact with one another in harmful ways.
- Clinical guidelines make recommendations on how to handle one disease at a time, not multiple diseases at the same time. The impact of following all the recommendations for each disease could harm the older adult or be impossible for them to follow.
- Older adults with multiple health problems often aren’t in the research studies that test treatments. So, less information exists about how medications and other treatments affect this group.
Basics: Caring for Older Adults with Multiple Health Problems
The American Geriatrics Society recommends five guidelines for quality care. The guidelines help a healthcare provider talk with the older adult about the choices they have to meet their healthcare goals.
- Consider older adults’ choices. Your healthcare provider needs to help you understand your healthcare choices. If you have asked someone to help you make decisions, your healthcare provider needs to include them in discussions.
Your provider needs to work with you to make decisions that are true to your choices and values. For example, if being as independent as possible is your goal, the provider needs to focus on this.
- Consider available medical research. Your healthcare provider needs to look at the research to help decide whether a treatment is best for you. Your provider needs to understand and explain to you the advantages and disadvantage of a treatment.
- Making treatment decisions based on possible risks, benefits, and prognosis (likely healthcare outcome). Your healthcare provider needs to talk with you about:
- What is likely to happen with or without available treatments
- How long it could take to see benefits from the treatment
- Assessing treatment options. Your healthcare provider needs to discuss with you what each treatment involves. Older adults with multiple health problems are more likely to stick to their treatments if the plans are simple and easy to manage.
- Optimizing treatments and care plans. Your healthcare provider needs to maximize benefits and minimize risks in your overall treatment plan. For example, your provider needs to recommend lifestyle changes and other non-drug treatments whenever possible. This reduces harmful medication problems.
Each older adult is different, with varying choices. All of these choices are important and need to be followed to the extent possible.
Discussion with Healthcare Professional
Putting these basics into practice means that the healthcare professional needs to discuss with the older adult:
- The major health care concerns and the reasons for the visit.
- Care plan or the reason for the visit.
- Current medical problems and treatments.
- Ability to follow their treatment plan and their choices for health care.
- Likely healthcare outcomes, while taking into account the person’s goals and choices.
- Treatments and conditions and how they affect each other. This includes the possible benefits and risks of the treatment plan.
- Decisions about treatments.
The healthcare provider and the older adult need to reconsider the healthcare goals and treatment plans regularly.
What You Can Do
- Click here for Tools and Tips to find more information about how to:
- Live with multiple health problems
- Work with your healthcare provider to make choices about your care.
- If you are an older adult with complex health problems and care needs, you may want to consider seeing a specialist in geriatrics (health care for older adults). Click here to learn more about geriatric care.
- Click here to search for a list of geriatrics healthcare professionals in your local area.
Last Updated May 2023