WHAT ARE COMMON COMBINATIONS OF CHRONIC HEALTH CONDITIONS?
While older adults can live with with many chronic conditions, there are some combinations of chronic conditions that are more common than others. The five most common conditions are:
High Blood Pressure and Arthritis (14% of older Canadians) |
High Blood Pressure and Cardiovascular Disease (12% of older Canadians) |
High Blood Pressure and Diabetes (11% of older Canadians) |
High Blood Pressure and Cancer (6% of older Canadians) |
Cardiovascular Disease and Arthritis (6% of older Canadians) |
WHAT ARE THE ISSUES WITH MANAGING MULTIPLE HEALTH CONDITIONS?
Managing multiple chronic health conditions can be a challenging task for older adults and their families and caregivers. Some common challenges with managing multiple health conditions are:
HAVING TO TAKE MULTIPLE MEDICATIONS
On average, older adults with three or more chronic conditions take up to six medications. These medications can conflict with one another, as well as with the management of other chronic conditions. For example, medication for one condition can aggravate the symptoms of another condition for which another medication or treatment may be required. These multiple medications can pose significant health, as well as financial challenges.
EXPERIENCING FRAGMENTED CARE
Many doctors are experts in one area, but few are experts in many areas. For older adults with multiple chronic health conditions, this can mean having to see several specialists separately. As a result, they have more frequent medical appointments and have greater self-care needs and can sometimes receive conflicting advice. It is best to work with your primary care provider and possibly a geriatrician to manage your conditions holistically with your personal care goals in mind.
EXPERIENCING GREATER HEALTH CARE USE
Older adults with multiple chronic health conditions tend to use health services more frequently. Those that have at least three chronic health conditions use health care services three times more often than older adults with no chronic health conditions. Have your care plan regularly reviewed, adjusted and better coordinated to avoid having to use services more than is necessary.
EXPERIENCING POORER HEALTH
As older adults deal with more chronic conditions, their self-reported health status declines.
For example, among older adults who have no chronic conditions, 92% report having excellent, very good or good health. Just over half of older Canadians with three or more chronic conditions report feeling the same.
EXPERIENCING A REDUCED QUALITY OF LIFE
As a result of all the challenges that come with having multiple chronic health conditions, older adults can face a reduced quality of life, ability to work and volunteer, and have a poorer self-reported health status. For many older patients, managing their chronic health conditions can bring fatigue, depression and pain. Strategies to manage chronic health conditions ease these burdens.
WHO CAN HELP YOU MANAGE LIVING WITH MULTIPLE CHRONIC HEALTH CONDITIONS?
If you are managing multiple chronic health conditions, you will benefit from the support of an interprofessional team.
This may be comprised of a variety of professionals, but frequently include a doctor or geriatrician, nurse, social worker, pharmacist, physiotherapist or occupational therapist and LHIN care coordinator.
Each of these professionals has unique knowledge and skills that can support you.
PRIMARY CARE PROVIDER
All older adults should try to have a primary care provider, family doctor or nurse practitioner that can see to your overall needs and often provide good management of the common issues that may arise for people who live with multiple chronic health conditions. They can help coordinate referrals to specialist care providers as needed.
NURSE
A nurse can support you by providing education on your health conditions, helping you to manage your symptoms and coordinating follow-up medical and other appointments such as blood work.
SOCIAL WORKER
A social worker can help you understand, link to and coordinate local, social and community supports and services such as social programs, counselling, housing, transportation, meal supports and home care services.
PHARMACIST
A pharmacist is an expert in medications. They can also do medication reviews to ensure your medications are necessary and safe, as well as help you best manage taking multiple medications.
PHYSIOTHERAPIST
A physiotherapist can help you to improve and maintain your physical function to remain as mobile and independent as possible and prevent functional decline.
OCCUPATIONAL THERAPIST
An occupational therapist can assess how well you can complete your daily activities at home or in the community to ensure that your environment is designed to be supportive and appropriate and that you have the right aid to help you complete your tasks as independently as possible.
GERIATRICIAN
A geriatrician is a specialist doctor who is trained to support the health needs of older patients. Not every older adult will need to see a geriatrician.
While all of these professionals can support you, you should also take steps to learn about your health conditions and adopt strategies to manage your symptoms.
WHAT ARE SOME STRATEGIES TO MANAGE MULTIPLE CHRONIC HEALTH CONDITIONS?
Many older patients with multiple chronic health conditions struggle with balancing how best to live their lives with their illnesses. It is important to maintain a healthy perspective. Some older patients find that changing their view of their conditions helps them to manage them better. Prioritizing your conditions, regulating the amount of attention you pay to your situation, and reframing tasks as ways to maintain your independence and a meaningful life are effective ways to manage chronic health conditions.
Not having a strong social network can be a barrier to successfully managing multiple chronic health conditions; by the same token, having a strong social support system is invaluable. Having family, friends and caregivers in your life can empower you to manage your conditions and help motivate and support you to better care for yourself.
There are also steps you can take to ensure your health care providers are helping you to manage your chronic health conditions as best as possible. Use one pharmacy so that it can keep track of all your medications, and engage with your pharmacist to ensure you understand your medications. Additionally, avoid using walk-in clinics and try to work with
one primary care provider who may be part of an interprofessional care team you can also work with.
When you go to any medical appointment, bring a list of all your conditions and your actual medications with you. Its best to write down any questions you have in advance to ensure they are answered. Learn where you can find more information about your conditions and how they are best treated, as well as what each of your medications do and how best to take them. Make sure you know who and when to call for help as well.
Patients who have confidence in their ability to self-manage their conditions often have better health outcomes. The more you understand and can manage your conditions, the better you will be at it and the more confident you will be in your ability to manage your health in the future.
WHERE CAN I FIND MORE INFORMATION?
SINAI HEALTH SYSTEM GERIATRIC MEDICINE CLINICS
Sinai Health System’s Geriatric Medicine Clinics located at Mount Sinai Hosital provide comprehensive assessments and care planning recommendations and services; links to other specialist, primary, home and community services and programs; and ongoing follow-up, support, health education, and counselling as needed to enable healthy and active living.
UHN GERIATRIC MEDICINE CLINICS
The University Health Network’s Geriatric Medicine Clinics located at Toronto Rehabilitation Institute provide comprehensive assessments and care planning recommendations and services; links to other specialist, primary, home and community services and programs; and ongoing follow-up, support, health education, and counseling as needed to enable healthy and active living.
The Toronto Rehabilitation Institute also has a Geriatric Day Hospital that further provides additional specialized assessment and treatment programs for older adults with falls and other changes in function due to ageing and illness.
Modified: 2020-12
We would like to thank the following for their support of our Education Resources to Support Healthy Ageing Initiative
- Mon Sheong Foundation and the Ben and Hilda Katz Foundation have generously provided funding to support printing and translation of our Education Resources to Support Healthy Ageing.
- The Ministry for Seniors and Accessibility supported this initiative with funding through its Seniors Community Grant Program.