REPOST: As You Age, Here’s How To Steer Your Health Care

Is it possible to model one’s healthcare plan after his or her lifestyle and personal preferences? In a person-centered direction, perhaps? Here’s an article from Forbes for some discussion:

 

Say you have a preference about the kind of treatment you want from your doctor. Maybe you dislike the cost, the risk of side effects or just the idea of depending on prescription medications and building your day-to-day routines around them. You want to give priority to alternative treatments like walking, yoga, nutrition or meditation whenever that makes sense.

Or maybe there’s something important in your life — a family event, a sport you want to pursue, a craft — and you want to keep your health issues and your health care from interfering with it if you can.

 

 

How do you make sure that your preferences and priorities get on the agenda with your health care providers? And how do you make sure they stay on the agenda beyond a single office visit?

“You have a right to ask” for that, says Dr. Phyllis Hayes-Reams, chief of the department of geriatrics for Kaiser Permanente of Southern California. Ideas like patient preference and quality of life tend to get linked to end-of-life care, but health care providers “want to move the conversation upstream” she says, to all the years that come before end of life.

 

What You Want Is Person-Centered Care

“It’s the things that aren’t said that cause us to go down the wrong path” sometimes, Hayes-Reams adds. “Most physicians would welcome the opportunity to know what’s important to the patient, because it gives them some guidance.” She acknowledges that time-constrained appointments can make this a challenge on both sides of the conversation.

Dr. Debra Saliba served on an American Geriatrics Society panel a couple years ago that pinned down a definition of person-centered care and the central role that people’s individual preferences and goals should have in shaping their care. In short, the definition said that:

  • providers should ask about a person’s values, goals and preferences
  • they should use that information to guide all aspects of the person’s care
  • and they should do so in a coordinated and collaborative way as a health care team, including coordinating with the patient and other people the patient may want to include in the care relationship.

Saliba, a physician in the Los Angeles Veterans Administration health system, is also director of the University of Southern California Los Angeles/Jewish Home Borun Center for Gerontological Research and the new president of the American Geriatrics Society (AGS). The definition of person-centered care mirrors a focus on quality of life that geriatricians have had for years, she says. But in her field and across the health industry as a whole, there’s still a long way to go before the AGS definition of person-centered care is a reality in patients’ experience of care.

“I think it’s aspirational for the health system,” Saliba says.

 

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