(This article previously appeared on Grandparents.com.)
Diabetes. Arthritis. Heart disease. Cancer. Obesity. All these, and so many more, are chronic conditions. According to the Centers for Disease Control and Prevention, about half of all adults, or about 117 million people, have a chronic illness. Half of all adults 65 and older have three or more chronic conditions, according to the American Geriatrics Society.
Chronic conditions come in all shapes and sizes, and some are more serious than others. Dr. James Pacala, associate head of the Family Medicine Department at the University of Minnesota Medical School and a past president of the American Geriatrics Society, says that osteoarthritis, for example, is a chronic illness, but not considered to be life-threatening, while Chronic Obstructive Pulmonary Disease (COPD), a lung disease that makes it difficult to breathe, is also a chronic illness and can be life-threatening.
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Many people who have chronic conditions — even more than one — function quite well and enjoy good quality of life. Others are impaired and markedly debilitated by their diseases. Some of the difference has to do with how you manage your life and your disease.
Everyone Gets Something
We are living longer thanks to better nutrition, better medical care and better health information, but the longer you live, the greater the chance that you will be diagnosed with some type of chronic disease, Pacala says. Almost no one gets away problem-free.
Chronic diseases usually fall into one of three categories, according to Pacala:
- Physical: Problems such as arthritis, diabetes, heart failure or hypertension
- Mental: Cognitive problems such as dementia and Alzheimer’s disease, as well as chronic depression
- Sensory: Hearing and vision loss, which are common problems for older people. “These can have a huge impact on quality of life,” Pacala says. Macular degeneration, tinnitus and other sensory problems can affect people’s ability to take part in social events, hobbies and other activities.
Living Better With A Chronic Illness
For many people, having a chronic illness is a minor bother, Pacala says. Very often, though, something happens that sets patients on a spiral.
If you’ve got arthritis, for example, you may reach a point where you need to have a joint replaced. Or if you’re diabetic, you may have a serious side effect — like a heart attack or loss of vision.
It’s hard to predict, Pacala says, but fixing one problem may beget another. “The treatment may compromise another treatment, and then suddenly everything seems to get worse,” he says. The people who do better in those situations are usually the ones who have paid attention to their disease all along.
“Patients and their families do better in dealing with a chronic illness when they acknowledge it and accept it,” agrees Dr. Matthew McNabney, an associate professor of medicine at Johns Hopkins Medical School who specializes in gerontology. “Most people can live many years and live well if they are thoughtful, proactive and organized about their condition (or conditions).”
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6 Steps to Live Well with a Chronic Illness
Here are six ways to cope with a chronic illness and live well with one:
1. Stay on Top of It
If you were recently diagnosed with a condition that requires medication or lifestyle changes, stick with your doctor’s recommendations.
“There is a tendency to almost dismiss the problem,” McNabney says. “People tend to reject it — to not own it or to wish it away. They want to put it aside and continue to live the way they were living.” But people who age successfully with a chronic condition are the ones who say, “I’ll be as involved in this as I can possibly be,” McNabney adds. They keep their doctors’ appointments, follow the recommended guidelines and take the prescribed medications.
2. Communicate With Your Doctor
Let the doctor know immediately if a treatment is not working or is causing side effects (it probably can be altered or changed). If you don’t understand the treatment plan, ask for another explanation (and don’t worry about feeling “dumb”).
(MORE: 5 Ways to Make Your Doctor Your Partner)
Also, let your doctor know what your life priorities are, McNabney says. One patient may value independence and not want a medication with so many side effects. Another may feel that the side effects are worth it to attack the main problem. Your doctor can give you better care if you discuss these issues with him or her.
3. Be Prepared to Make Tradeoffs
Treating chronic conditions is not an exact science, especially as people age. Many medications may interact with others you’re taking. They may cause new problems or have only marginal benefits. Your doctor may suggest you’ll have to make trade-offs.
For example, if your blood pressure medication causes too many side effects, you may decide to go off it. That will leave you with an elevated blood pressure, however, widely considered to be a heart attack risk factor. But maybe at your age or with your level of activity, or for some other reason, your doctor is willing to allow you to have a slightly higher blood pressure. There is no exact recipe, McNabney says. These things can be discussed.
4. Look for Wellness Advice
If, for example, you have heart disease, instead of looking for medications to ease the condition, you might want to look for exercise or social groups specifically for heart patients. “Our health care system is not designed well for this,” McNabney admits, “but if you look for it, you can find information that is pointed at wellness versus disease management.”
In other words, instead of the doctor starting you on another medication, he or she may be able to point you toward another mode of treatment.
5. See a Geriatrician
These doctors, trained in caring for the elderly, are especially adept at helping people who have chronic illness, Pacala says. “They are trained to look holistically at patients and think, ‘What medicines can I stop or trim, rather than what medications can I start?’ Too many medications can lead to problems — like bad interactions, side effects or even new diseases,” notes Pacala.
6. Treat Your Mind as Well as Your Symptoms
Having a chronic disease can be difficult, psychologically speaking, and may require you to adjust the assumptions you’ve had about growing older and the future of your health.
“Successful aging does not mean having your name read on The Today Show as a 100-year-old,” Pacala says. “It means learning how to deal with the barrier or hurdles of aging. It means you have figured out a way to remain active with the important people in your life.”
McNabney adds, “People have to adopt a new attitude that says, ‘I’m aging, but that’s a normal part of living, and I am going to approach this in a healthy way’ — not as a diseased person who has a disease mindset.”
Protect Yourself From Disease
Pacala says your mother was right; you can control how you age (and manage or fight off disease) by following some good health rules: “There is plenty of research that’s gotten much more robust over the years — in fact, it’s coming in almost weekly — which says that healthy behavior will stave off chronic illness.”
So if you want to be one of the 50 percent who don't have chronic illnesses in your old age, follow these guidelines:
- Tend to your friendships: Social interaction is a huge plus for aging individuals. It keeps your brain connected and boosts your positivity.
- Avoid tobacco: There is no mystery here — people who don’t smoke live longer with fewer diseases.
- Drink moderately: A glass of wine is good for you. A bottle of wine — not so much. Keep your alcohol consumption at a moderate level, and you will live a better life.
- Eat well: Be sure your meals include lots of fresh veggies and try to avoid overdoing the sugar and sweets.
- Exercise: Do it — because its benefits reach far into your body and far into your future in terms of keeping your organs and whole system healthy.
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