Feeling the Effects of the Big Boom

Being a standout generation in sheer volume, the baby boomers, born between 1946 and 1964, are unlike any generation before them. Now considered the most affluent generation in history, the baby boomers have left their marks along the way to such distinction. Some were labeled hippies and flower children when they flashed peace signs at war protests. The same people of this generation now enter the era of a new nickname – senior.

As with their general approach to many of the events that speckle their timelines, aging seems to be one more challenge they aim to do well and better then their predecessors. The baby boomers are an active population and plan to stay that way well into their later years. Given that, they are more involved in their health care, often researching on their own, changing the face of older adult care in the process.

Health alarms

People standing in lineDiabetes continues to be one the most common health concerns among an older patient population, Kevin Carroll, MS, CP, FAAOP, vice president of prosthetics for Hanger Prosthetics and Orthotics, explained.

In 2005, according to the National Diabetes Fact Sheet compiled by the American Diabetes Association in conjunction with the Centers for Disease Control and Prevention, 10.3 million people ages 65 and older had diabetes. This number accounts for 20.9% of this entire age population.

Often, individuals who have been noncompliant about diabetes management find themselves with more serious health concerns, which can lead to amputations of varying degrees. More than 62% of non-traumatic lower-limb amputations occur in people with diabetes.

“The patients who take care of their feet can get many years of good use out of them,” Carroll said. “But if they neglect their feet at all, things can start to go downhill.”

Strokes are also an issue to watch, as there are 750,000 new strokes each year, Deanna Fish, MA, CPO, director of clinical support for Innovative Neurotronics told O&P Business News.

Depending on the nature and severity of the stroke, mobility complications can often be controlled overtime. In some patients, these impairments can reverse completely.

The first action a practitioner must take in an effort to treat these health issues is become acquainted with the way this particular group of patients feel and how to be more sensitive to their needs.

Considering their concerns

An impending change in lifestyle and looming threats on activity levels are enough to scare any patient out of seeking the needed health care. These anxieties along with others felt by an older population are important for practitioners to consider when trying to achieve positive results.

Many older patients are more afraid of falling than anything else, Carroll said. They may have a friend who has not survived a fall, which adds to their worry. Seniors using prosthetic devices are especially nervous about maneuvering cautiously.

“We have to help them overcome the fear of falling,” Carroll said. “You can never say never because the truth is that any of us could fall but the likelihood is slim.”

As practitioners, making sure that the prosthetic or orthotic fit is correct is the best measure to both prevent a fall and set your patients mind at ease.

Physical and occupational therapy are also encouraged to be sure that activities of daily living are achievable.

“For an orthotic patient population when you are talking about somebody who has a stroke or the onset of multiple sclerosis or something effecting them now that didn’t effect them 20 years ago, I think their biggest concern is returning home,” Fish said.

Communication and meeting needs

Even so, these patients are already looking beyond heading home and are anxious to carry out their scheduled golfing outings and fulfill their long laid retirement plans of traveling cross-country.

“They are always looking for an improvement in function and their abilities – anything that will get them back to enjoy the activities and quality of life they had prior to their medical involvement,” she said.

Older patient walking with prosthesis

Clear communication is a vital part of working with older patients. While it seems like common sense, listening to your patients, especially these patients, can make a world of difference. Oftentimes messages are lost through communication.

“It is not that we are bad listeners, but as a profession, we need to take up new listening behaviors to better communicate with this population,” Carroll said.

The key is to be patient with this population because in addition to O&P health issues, there could be additional factors that impede a patient’s success. Take the time when working with patients and pay close attention to their questions and verify that you have answered them.

“Through the evaluation process we determine our patients’ expectations and intentions,” Carroll said. “We design a prosthesis based on their needs.”

There are super lightweight components available for those patients who require them.

“We can build a prosthesis these days that is the same weight as the shoe a patient comes in with,” Carroll said.

Such is the case with one of Carroll’s patients who is 107 years old. The patient is walking around on his lightweight prosthesis using additional support from a walker.

“He is not going to run a marathon,” Carroll said. “You don’t have to overbuild the prosthesis.”

Carroll said that from time to time, older patients are just as hard on their prostheses as their younger counterparts.

“You continually have to monitor the patient if you build a very lightweight prosthesis to make sure that it is holding up to that individual’s specific requirements,” Carroll said.

Watching out for other medical issues

It is also important to keep your eyes open for any additional medical issues that may arise. Chances are, your patient is seeing a small network of physicians. Refer to their primary care physician if you have a concern that warrants further investigation.

“It is not just a matter of delivering the prosthesis or orthotic device,” Carroll said. “You have to take the holistic approach.

Working with other health care providers enhances the overall care provided to patients. But what is most important to patients, is that prosthetists and orthotists are available for them.

“The big thing is opening up your doors and being available to these individuals,” Carroll said. “If you have to go out to their house and take the prosthesis off for them, sometimes you do that if the person gets confused.”

Woman walking with orthotic device Through the evaluation process doctors determine their patients’ expectations
Patients are looking beyond heading home and are anxious to carry out their scheduled retirement plans.
Images reprinted with permission of Hanger Prosthetics & Orthotics Inc.

Never underestimate your patients

If you work with different age groups, you know that you approach them all differently. Carroll explained that when working with small children, you go into your appointment with a gentle heart and a soft voice, perhaps using a sort of baby talk to get to know the patient and make him or her more comfortable. With teenagers, practitioners change their tone from a childlike speak to mirror the actions of a youthful culture – high-fives and all. With adults, practitioners and patients talk like friends on the same level.

“As patients get older again, sometimes practitioners unknowingly revert back to speaking to them like they are children,” he said. “You can have fun with them as you would have fun with anybody, but do not underestimate them. You are not dealing with the senior of the past anymore.”

They are adults and it is important that practitioners speak to them as such.

Number of Older Americans
Data for 2010-2050 are projections of the population. For the reference population, the data refer to the resident population.
Source: U.S. Census Bureau, Decennial Census and Projections.

Changes of the computer age

The Internet has made information more widely available in all areas. This aging population is not only computer savvy, but they are putting those skills to good use and doing some of their own research before they come into your office.

“They come in armed with some good information about their condition and sometimes about O&P products,” Fish said. “Many times, they will come in with a list of brand names of different products and ask how products compare to one another.”

Fish continued that part of the motivation for seniors to be proactive when it comes to their health care is because they are contributing more money than before to receive the products they need.

“They are now asked to pay a greater percentage of the cost of the orthosis or prosthesis so the copays are higher,” Fish said. “They have to become more responsible financially.”

While it is important to make recommendations to patients, this age group also wants to know about their options. It is important for practitioners to stay informed about the different products that might come into play when working with this age population and be prepared to talk to their patients about each one.

“We need to be able to provide patients with an array of options and give them the pros and cons of each one — not only in regard to cost but also in regard to what we can functionally expect each product to provide for them,” Fish said, “The best thing we can do is keep abreast of all new technological developments and integrate that into daily patient care options and patient care skills.”

The baby boomers want to return to their activities as soon as they can. They are going to bring big changes to the world of health care as they have in so many other areas during their upbringing.

Preparing Your Facility

Preparing your business for this expected influx of patients goes beyond stocking extra lightweight materials and reading up on senior health issues. Preparing your facility can help to make your patient’s visit more comfortable and less frustrating with a few changes that might otherwise be overlooked.

Safety

Consider the safety of the environment. These items were probably covered during your last insurance evaluation but reevaluating the level of safety at your office is an important part of meeting the needs of aging patients.

Are tile floors inside your facility a slip hazard? Consider carpeting high traffic areas. Also be sure to clearly mark exits, restrooms and employee only areas so that your patients have an easier time navigating your facility.

Be careful not to overlook the importance of a well-kept exterior. Make sure curbs are appropriately marked and painted. Do your best to keep the parking lot and sidewalks free of debris year-round and especially during the winter months if ice and snow are problems in your area.

Comfort

Comfort can be just as important as safety for your older patients. In order to get the most out of your time together, you want to make their visit as stress-free as you can. By eliminating outside distractions, you will be able to communicate better.

Their visit starts when they pull into the parking lot of your facility. Consider your location. Many health care offices are located in larger complexes, which can be hard to navigate to a first-time visitor.

A lack of clear signage can leave many patients frustrated before they enter your office. While the choice in building markings may be out of your control, do your best to direct patients when scheduling appointments.

Another helpful item to consider is the materials you hand out to patients. When possible, use a larger font for forms and materials you give your patients to take home and look over.

 

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