The vast majority of older adults in the United States — around 80% — are living with at least one chronic condition, and 77% live with at least two. What’s more, nearly half of all Americans suffer from at least one chronic condition, and that number continues to rise each year. Many of these conditions can be fairly easily treated, prevented, or even reversed altogether — so long as patients stick to the care plan that’s been prescribed to them by their healthcare providers.
Yet for quite some time, many seniors — and all patients, for that matter — have been unable to adequately adhere to these care plan(s) on their own. In fact, nonadherence rates for chronic illness regimens and lifestyle changes (for all patients) are only around 50%. Why is that? Sadly, there’s no simple answer — there are a variety of factors at play, each contributing to this issue.
With millions of seniors’ health outcomes at stake, the time for change is long overdue. We need to shift our focus towards empowering seniors to take their health into their own hands, and inspiring them to maintain a healthy lifestyle and routine. In this post, we’ll explain why care plan adherence is so challenging, especially among seniors — and how we can begin to change the current paradigm, to help them stay healthy, active, and thriving on their own.
What is a care plan?
No matter what age we are, there are certain healthy behaviors we should all be partaking in to maintain an optimal level of health. Examples include: drinking enough water, getting the right amount of sleep and exercise, eating right, taking our medicine at the proper time, and so on. Over the years, adhering to a healthy routine becomes even more imperative, as our risk for developing chronic conditions naturally increases.
As such, many healthcare providers prescribe their senior patients with a personalized care plan — a health regimen tailored just for them, that they must stick to in order to maintain, and ideally improve, their overall health. This care plan will include instructions regarding the criteria noted above: how often they should exercise, how many hours of sleep to get per night, what types of foods they should eat or avoid, which medications to take (and when), and so on.
But in order for healthcare providers to prescribe seniors with the ideal care plan, they must first assess each patient’s overall level of health — their biometric data, health condition(s), and existing health routines (or lack thereof). Based on that information, they can establish the overall goals for the care plan — whether it’s to help the patient cope with or improve their current condition(s), or to prevent additional ones from arising down the line — in order to prescribe them with a care plan that will help them attain these goals.
It’s important to note that effective communication is a key element of the care plan prescription process. Providers need to ensure that their patients fully comprehend the scope of what’s required of them as part of their care plan, and that they are able to effectively adhere to it. Once the senior patients have been prescribed their care plan, they can begin to execute it — carrying out their new health regimen on a daily basis.
Adhering to a care plan is tougher than it seems
Why is it so tough for seniors — let alone everyone else — to adhere to the care plans that they’ve been prescribed? The simplest answer is: it’s complicated.
For one, following a new care plan often requires some serious adjustments to patients’ daily lifestyles, such as adopting new habits, taking new medication(s), or otherwise. Not surprisingly, change tends to be difficult for us all, even more so for seniors that are more isolated, set in their ways, or lacking a source of nearby motivation or support.
Unfortunately, despite tons of research on this topic, there’s still no perfect answer as to why care plan adherence is so much tougher than it might seem. Researchers have found a few aspects at play that tend to influence overall patient adherence. The graphic below summarizes most of these factors quite nicely.
Additional factors impacting patients’ adherence to their care plans include:
- Cognitive impairment — Sadly, over the years, our cognitive abilities naturally weaken, thus making it more difficult for us to remember new information, and inherently, maintain new health regimens.
- Psychological factors — Patients’ beliefs about their condition(s) (i.e. denial about their existence or doubts about the efficacy of the care plan) as well as behavioral disorders (i.e. anxiety, depression, or high stress levels) also tend to impact their adherence.
- Lack of incentive — Making a major lifestyle change is hard. Without consistent motivation or support (from healthcare providers, loved ones, peers, or technology), adhering to a care plan will remain a tremendous challenge.
- Confusion or lack of clarity — If a patient’s care plan is too complex, or if they tend to have frequent questions for their doctors about it (that they can’t get answers to easily), patients will be more prone to adherence errors.
- Difficulty remembering — As with cognitive impairment with age, we naturally have a harder time absorbing new information. Therefore, the more complex the care plan is, the harder it will ultimately be to adhere to.
- Other barriers — There are a variety of miscellaneous barriers to care plan adherence, such as convenience and proximity (i.e. distance to the pharmacy or a grocery store with healthy options), financial barriers (i.e. the prescribed medication or regime is more costly), and more.
Nonadherence among seniors has serious consequences
By this point, it’s quite clear that care plan adherence is a challenge — one that’s far easier said than done, especially for senior patients. But why is nonadherence so problematic?
As noted above, the majority of seniors in the US live with one or more chronic conditions — putting them at a constant, much higher risk for hospitalizations, injury, and more serious health repercussions. In other words, there’s a lot more at stake for senior patients when it comes to nonadherence, both in terms of these health impacts, and the costs involved.
One imperative component of care plan adherence — medication adherence — has proven to be a serious problem thus far. Believe it or not, as much as 75% of Americans do not take their medication as prescribed. Furthermore, medication nonadherence alone accounts for up to 69% of all hospitalizations, and 125,000+ deaths per year — as well as up to $300B in costs to the American healthcare system.
By failing to adhere to their prescribed care plans — the plans intended to help them improve, eradicate, or prevent future chronic conditions — seniors’ health conditions will inevitably worsen over time. In addition to the costs noted above, this will also become very expensive to patients themselves in the long run, as they may need to pay for expensive surgeries or medications — which could have easily been avoided by adhering to their care plans.
How can we help seniors adhere to their prescribed care plan more easily?
Now that we have a deeper understanding as to why nonadherence is such a crucial, yet highly complex issue, let’s dive into some potential solutions. Obviously there’s no perfect “quick fix” — research thus far has concluded that no strategy has proven effective in improving adherence across all patients, conditions, and settings — and further research is needed.
For now, there are several components that should be explored further:
- Support and motivation — By offering seniors with continuous support, inspiration, and encouragement (whether from providers, loved ones, or those living with the same conditions), senior patients will have an easier time sticking to their care plan long-term.
- Educational resources — As mentioned earlier, many seniors simply lack access to the full scope of information they need when it comes to their care plan. By providing them with more ample educational resources (i.e. videos or interactive activities) or an easier way of contacting their providers, they’ll have answers to all the questions that are hindering their adherence levels.
- Digital health technology — By leveraging digital health technology such as telehealth, wearables, and voice technology, providers can continuously monitor, support, and engage senior patients, to ensure that they’re adhering to their care plan from afar, 24/7.
All this said, these are just a few of the potential solutions, and this topic is still being heavily researched. Any future solutions must be holistic and multidisciplinary, taking a wide variety of senior patients’ unique health and wellness needs into account.
Let’s continue empowering and inspiring seniors to adhere to their care plans on their own
Looking ahead, though care plan adherence is a major challenge for everyone — and for senior patients, it tends to be even more so — improving adherence rates will take some serious, concerted effort on all fronts. Whether we’re a senior patient, a caregiver, a healthcare provider, an insurance company, or otherwise, we all play an important role in evoking positive change in this arena.
Healthcare transcends far beyond the doctor’s office or clinic, and COVID-19 has shown us just how badly seniors today need better, more frequent access to and support from their physicians within the home. Hopefully soon, with the growing prevalence and adoption of digital health solutions among older adults, providers will begin to leverage technology to help motivate and support them in staying healthy, active, and thriving under any circumstances.
For now, let’s continue to empower and inspire seniors to take their health outcomes into their own hands, so they can reach their health and wellness goals, and remain independent and thriving like never before. We look forward to witnessing more older adults — and all patients, for that matter — successfully adhering to their care plans, and proactively improving their health for the long haul.