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Doctors offer advice for the aging patient and their caregivers

KYRSTEN MASSA PHOTO Shelter Island’s Dr. Nathanael Desire
KYRSTEN MASSA PHOTO Shelter Island’s Dr. Nathanael Desire

If you’re a senior, you may well be seeing more doctors now in a single year than you did during all the previous years of your life combined.

Many seniors develop more health issues and take more medication as age increases and area doctors see that not just as an inevitability of the body breaking down, but as the result of no longer maintaining an active lifestyle.

We recently spoke to three area physicians about the advice they give seniors and the challenges posed by treating aging patients.

Drs. Lloyd Simon and Jarid Pachter of Eastern Long Island Hospital recommend exercise and healthy eating habits for all patients, but they say it becomes even more important as patients age.

So, too, does the need to regularly see your physicians.

With today’s emphasis on specialized medicine, it’s important to keep your primary care physician at the center of the hub, coordinating and tracking the services of various specialists.

It’s frustrating for all doctors that there’s no central database addressing the various treatments individual patents receive, so it falls to the patient to make sure his or her primary care physician is aware of treatment by others.

“Care can become very fragmented,” Dr. Simon said.

Patients might also receive more treatments than absolutely necessary and duplication of services can occur when there’s insufficient sharing of information, said Dr. Pachter, who practices general medicine.

For example, if one doctor orders blood tests, but the results don’t reach other practitioners, those tests could be repeated.

The same applies to X-rays. Because today’s system requires starting with the simplest procedures and working up, Dr. Nathanael Desire of Shelter Island points out that while he sometimes knows a patient will need an MRI, getting insurance coverage without first performing a simple X-ray first can be difficult.

Dr. Desire said that although he’s able to treat many illnesses without referral, he respects that patients sometimes prefer to see a specialist. He said he’s fine with that — as long as he receives information about the procedures those doctors do and the medications they prescribe.

Dr. Pachter said he also becomes “very territorial” with his patients and avoids sending them out to specialists unless it’s necessary.

Most important, both doctors said, is being able to get to know the whole patient and what factors might enter into the medical picture.

Dr. Pachter said 35 percent of all patients fail to take medications as prescribed and it’s important that they be more attentive to not skipping doses. Some of that may result from an effort to keep costs in check, some from forgetfulness.

Then there are vaccinations that are critical for seniors — flu, pneumonia and shingles among them, Dr. Simon said.

And there’s always concern about patients getting regular eye examinations, hearing checks and monitoring of cognitive abilities, the doctors said.

One way seniors can make sure they are receiving all essential care is to establish support systems within their own families.

In small communities like those on the East End, doctors often have contact with family members who can help seniors who are experiencing cognitive lapses or may need a family member or friend to accompany them to appointments and assist with medications.

It’s important for people to recognize that as they age, their reactions may not be as sharp as they once were and their eyesight may be diminished, especially as it affects night driving. In areas where there is little or no public transportation, seniors are hesitant to give up driving. That’s when family or friends may have to intervene, not just by taking away the keys, but by helping a senior get where he or she needs to go.

Dr. Pachter, one of the younger doctors practicing general medicine on the North Fork, said that while he does give aging patients advice, they also return the favor. There’s one particular tip he said he hears every day: “Don’t get old.”