Most older people are dealing with health challenges, including two or more chronic conditions.

Staying on top of chronic health conditions is vital to happy, healthy aging.

For instance, all of us can benefit from working to decrease high blood pressure and high blood sugar levels while also reducing risks of heart disease through physical activity and diet before they lead to more serious outcomes.

“A key part of aging well is really good communication between patients, their family and the provider,” said UCHealth geriatric nurse practitioner Maria Vejar. “Build a good health care team and talk about what’s going on. The patient is the captain of the ship. We are all on board, but they are in charge.”

To help people learn how to manage chronic conditions and get the most out of life, we sought advice from Vejar.

What is a chronic condition?

“We typically think of a chronic condition as something that’s gone on for three months or longer, as opposed to a something that is acute,” said Vejar, who is also an assistant professor of geriatric medicine at the University of Colorado School of Medicine on the Anschutz Medical Campus.

When you have chronic condition, it affects how you function in your daily life and requires ongoing care. That could include your ability to drive, cook, clean, bathe and shower, walk and accomplish other life skill chores.

What is the best way to stay on top of multiple medications?

First, talk with your primary care provider, as they can address concerns and questions, especially if they have prescribed the medication, and should be your first point of contact.

Next, speak with your pharmacist.

“We don’t give pharmacists enough credit. They are invaluable for helping patients juggling different medications in terms of side effects, interactions, and whether they need to be adjusted or switched as we get older, and conditions change,” Vejar said.

Other tips for managing multiple medications include:

• Know and track medications you take, as well as any over-the-counter pills, supplements and vitamins.
• Talk with your primary care provider about any symptoms or side effects from your meds.
• Ask questions about medications. “You need to know what you are taking and why,” Vejar said.
• Keep a list of medications handy: on your phone or in your purse or wallet, as well as on your fridge and make sure a friend or loved one has the list too in case of an emergency.

How should I prioritize multiple medical issues?

“When a patient comes in to see us, we look at their conditions, and think about labs, medications, adjusting their drugs and what their everyday life looks like,” Vejar said.

It’s important to ask: How are you doing? What’s working? What’s not? What’s important to you?

“If we are not addressing what’s important, then we are missing the most important thing,” Vejar said. “We are a team and we’re in this together. It usually boils down to staying independent; improving quality of life and maintaining daily functions.”

How do I better take control of my chronic issues/disease/condition?

Empowering patients is key, especially for those who feel despondent that their condition will never improve. For caregivers, friends and family, Vejar said to:

• Praise and support the person for sharing their story and applaud them for asking for help.
• Have frequent interactions, in person, on the phone or virtually.
• Create small goals that are obtainable and make new ones when they are reached.
• Set goals that are centered around what’s important to the person, even if they seem small; for instance, take a grandchild to the park or walk a pet.
• Encourage, motivate and support the person who is dealing with chronic conditions.

How can I improve my overall health and well-being? 

“We know that social connections as you age are extremely important to health. As we age, loneliness becomes a more prevalent issue. We’re not working, we may have moved out of our home and lost a spouse or even children. That can set up a cascade of issues that create isolation,” Vejar said.

Having a special person in your life, or a group of people that can help with those lifestyle changes make it much easier to navigate the pitfalls we face and have a positive impact on managing chronic conditions.

She also recommends:

• Taking advantage of recreation programs or senior centers, even if it’s just eating a meal or playing a card game.
• Participating in on outings or to garden and to stimulate our minds.
• Taking exercise classes.
• Signing up for Meals on Wheels.
• Eating well to meet your nutritional needs.

“Be kind and gentle with yourself. Take baby step and soon you will start to feel the effect from the changes you are making,” Vejar said.

What is best way to reduce pain?

Patients might need over-the-counter pain meds such as acetaminophen and ibuprofen, along with stronger drugs, if they are battling certain conditions. It’s a good idea to talk with your provider or pharmacist before changing or adding any medication, even over the counter ones, to ensure they are safe for you to take.

Vejar also emphasized the benefits of non-medication ways to alleviate pain.

• Movement/activity. Even for people who might be confined to a room or even a bed, she stressed the importance to stretch, strengthen and flex joints and muscles as much as possible. Online fitness classes are an option for those who are unable to attend a class in person. For instance, for Sit and Be Fit classes a person just needs a chair.
• Classes such as Tai chi and yoga, and aquatic courses such as water aerobics and pool therapy.
• Physical therapy (PT) and occupational therapy to help with showers and other self-care chores. If someone has not been mobile in a while, PT is a good way to get started, she said.
• Maintaining a healthy weight, which helps with joint and spine pain.
• Trying acupuncture.
• Seeing if massage therapy is helpful.
• Practicing meditation mindfulness.
• Working with a psychologist, especially if you have chronic pain.
• Getting adequate sleep.
• Using over-the-counter muscle gels and creams.

“It can be daunting to think about moving when you are in pain, but just taking the first few steps can start you on a road with so many long-term benefits,” Vejar said. “Try to think of things that don’t come in a pill to get your body and mind in a healthier state.”

What screening tests do I need?

For older patients, it’s helpful to have an annual Medicare wellness visit which includes a big picture look at your health and any chronic conditions you have, as well as screenings such as mammogram, bone density, osteoporosis, colonoscopy and vaccines.

It’s a good time to discuss end-of-life decisions and fill out advance care planning documents with your family and PCP to make sure your wishes are known before a crisis, she said. That includes:

• Medical Durable Power of Attorney
• An Advanced Directive for Medical or Surgical Treatment (also called a living will)
• Colorado Medical Orders for Scope of Treatment (MOST) goes over medical decisions for life-sustaining procedures.

“There’s peace in facing these difficult but important topics. You can always change your mind anytime you want, but the important thing is having the conversation. You are deciding what you want,” Vejar said.

Should I bring someone with me to appointments?  

Yes, and make a list so your health care team can focus on your priorities. Bringing a friend or loved who can write down answers, interpret the discussion and advocate for your needs can be a game changer, she said. There are also geriatric caseworkers and social workers available as resources.

Take advantage of your online electronic medical records which include office visit notes that summarize the appointment and include follow-up details and scheduled next appointment. For those without a computer, she suggests asking for a hardcopy summary.

How can older adults use technology to stay healthy and engaged

There are several easy and innovative ways that family and friends can use technology to keep in touch with their older loved ones, she said. Ideas include:

• Cameras, with consent, in main living areas so family members can check in and communicate with an elderly loved one.
• Electronic pill timers for those who struggle with complex medication schedules.
• Emergency medical alert bracelet or necklace with a built-in GPS.
• Zoom and FaceTime, in addition to phone calls.
• Echo or Alexis used in a home by an elderly person to help turn on lights and other electronic devices.

What are other tips for caregivers, partners, siblings and children who are helping older people who have chronic conditions

Acknowledge the tough role caregivers play and the difficulties they face, as they care for loved ones while also tending to careers, families and their own life issues, she said.

“We need to make sure they are getting support, and that means sleep, eating well, getting respite, accessing financial assistance if they can, working with social workers and receiving dementia support if it’s needed,” Vejar said. “Many times they forget about their own needs while they take care of others.”