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From our collaborators at Johns Hopkins Medicine | What is your advice for living well as we age?

Four tips from a medical expert in the care of older adults

Man floating in a tub on the lake

As a geriatrician, an expert in the care of older adults, people often ask me about strategies for living well, remaining independent, and obtaining the best healthcare possible. Here are four tips:

  • Know what self-care activities make a difference
  • Avoid the care you do not need
  • Do not avoid important conversations
  • Be a savvy navigator of the healthcare system

Know what self-care activities make a difference

Check to see if you need to adjust your attitude about aging. We often think about aging as a time of decline, but it does not have to be that way. We all know people who have a positive and serene attitude regardless of what is going on around them. Attitude is the most important thing you can adjust to stay well.

Do not smoke. Smoking is the number one thing you can do that will accelerate aging.

Stay socially engaged. Engage in activities that keep you around other people, such as a hobby or a past time that you enjoy. Fourth, find authenticity and live with purpose. Engage in activities that align with your goals and values, such as volunteering in your faith community or being a mentor to others. It is not only good for your soul, but it changes the shape and functioning of your brain in healthy ways.

Adopt a whole-food, plant-based diet. While nutrition advice can seem confusing, there is little disagreement regarding the benefits of a whole-food, plant-based diet for improving the bacteria living in our gut, reducing the risk of chronic illness and extending our life span. This means focusing on foods in their natural form, not in their processed form. Examples: whole fruit instead of fruit juice; whole grains instead of bread and pasta; brown rice over white rice. As a general guideline, fill up half of your plate at every meal with fruit and vegetables. The rest of the plate can have a portion of a good source of protein, preferably from plants, such as beans, tofu, tempeh, or quinoa. Include other vegetables as starches for the rest of your plate, including sweet potatoes. Focus on eating these six foods every day: greens, beans, onions, mushrooms, berries, seeds. Significantly limit your consumption of animal products to less than 10% of your diet. Animal products include meat, fish, eggs, and dairy.

Manage your stress. Yoga, meditation, tai chi, walking, and dancing can all make a difference in helping to manage stress. So can prayer, contemplation and journaling.

Avoid the care you do not need

Avoid social isolation, taking too many medications, and receiving too much healthcare. We know that medical errors are now the third leading cause of death in the U.S., and many of these occur while in the hospital. While not all hospitalizations are unavoidable, it is best to prevent the need to go to the hospital by taking good care of oneself, following a good diet, exercising, and seeing your doctor regularly for preventive checkups.

I recommend a medication review at least twice a year. Medications can be causing symptoms that you may be attributing to aging. Choose your birthday and one other day throughout the year to make an appointment with your doctor and review all of your medications. Ask three questions: “Do I still need this medication? Do I still need it at the same dose? Are there alternatives to this medication, such as changes to my life style?” The medications to scrutinize the most are: blood thinners, sleep medications, allergy medications, water pills, blood pressure medications, pain medications, and antidepressants.

Do not avoid important conversations

Ask yourself, “what if I get sick, what if my partner gets sick, who is going to take care of them, who is going to take care of me, and most importantly, who’s going to make decisions for me if I can’t make them for myself?” These are important conversations to have with your family before a crisis occurs.

Be a savvy navigator of the health care system

Make sure you know who will make decisions for you if you are unable to make them yourself. Work with one doctor, such as a geriatrician, to coordinate your care. Schedule periodic medication checkups.  Do not go to health care appointments alone and instead bring someone to help understand the care plan. Keep your own personal health records. Finally, create emergency plans for if you or a member of your household gets sick.

Finally, consider seeing a geriatrician. A geriatrician is a doctor with advanced training in the care of older adults. Our goal is to evaluate the four M’s: memory, mood, medicines, and mobility. We treat existing health care conditions and we keep track of medications. Our goal is to help older adults stay independent at home. We coordinate care with other specialists and work as a team.

Who needs to see a geriatrician? It is based more on your needs rather than on your age. You might need to see a geriatrician if: you have a disability, your health impairs daily activities, you have several chronic conditions, you take a lot of medications, you have several healthcare providers, you go to the hospital often, your family and friends feel stressed as caregivers, or you have a condition that is common in older adults. These conditions can be difficulty swallowing, malnutrition, sleep problems, delirium, dementia, vision or hearing problems, depression, dizziness, fainting, difficulty walking, falls, pressure ulcers, incontinence, or being on too many medications.

In conclusion, respect and honor the journey across your lifespan and adjust your attitude about aging. Engage in activities that bring you joy and health. Make sure the health care you receive matches your goals of what you want out of life. And find a geriatrician to help you live your best life.

Content courtesy of Alicia I. Arbaje, M.D., M.P.H., assistant professor of medicine at the Johns Hopkins University School of Medicine and Director of Transitional Care Research at Johns Hopkins Medicine. The content was reproduced with permission of the office of Marketing and Communications for Johns Hopkins Medicine International. Additional reuse and reprinting is not allowed. The information aims to educate readers and is not a substitute for consultation with a physician.

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