5 simple strategies for managing multiple health conditions
By Elizabeth Millard
Use these tips and tools to help stay on top of your care
Chances are you’ve spent a fair amount of your adulthood juggling things — workloads, family schedules, community commitments, hobbies. Sound familiar? As you get older, you may be able to drop a few of those balls, but life has a way of tossing in a few new ones: health concerns.
More than two-thirds of adults over the age of 65 are managing at least two chronic health conditions, according to the National Council on Aging. Some may have three or more. What counts as a chronic condition? The Centers for Disease Control and Prevention (CDC) defines it as any health problem that lasts a year or longer and requires ongoing medical care or limits daily activities or both.
High blood pressure and diabetes are two of the more common chronic health problems. But the list is long and includes:
- Alzheimer’s disease and dementia
- Chronic pain
- Heart, lung and kidney diseases
- High cholesterol
“When these conditions layer on top of each other, there can be a significant ripple effect across all aspects of health,” says Scott Kaiser, M.D., director of geriatric cognitive health at Pacific Neuroscience Institute’s Brain Health Center in California. For example, you might dial back your activity because you tire easily or have a hard time breathing. You also could come up short on your sleep needs, a problem that’s been shown to worsen heart problems, according to a 2020 study in the Journal of the American College of Cardiology.
That means following the treatment plans outlined by your health care providers has an impact on your quality of life as well as your medical issues, says Dr. Kaiser. With multiple medications, specialists, side effects and symptoms, managing it all can feel like an overwhelming task. Still, some simple strategies can help, and it starts with having the right perspective.
“Consider this an opportunity to take charge of your health,” he suggests. “There are unique challenges in managing multiple conditions, but if you approach it as a chance to be engaged in your treatment, it can make a huge difference.”
With that new mindset in place, here are five tips and tools that can help you get more organized — and also help you feel more in control.
1. Set goals with your health care team
It may seem like simply staying on top of your conditions from day to day is enough of a target, but it’s useful to think longer-term, says Michelle Ogunwole, M.D., a Johns Hopkins research fellow in internal medicine.
“As doctors, we need to know what’s important to you, and what would represent a meaningful goal for you,” Dr. Ogunwole says. “Maybe you want to be able to walk every day without feeling exhausted, or you want to cut down on how many medications you’re taking, or you want to sleep better. These are all great goals.”
Having a milestone will give you a sense of progress and something to work toward, she adds. It will also help your health care team consider different approaches to get you to that goal.
2. Line up support
As part of managing multiple conditions, it’s likely you’ll be seeing several specialists. If you have COPD and kidney disease, for example, you’ll have appointments with a primary care provider, but also with a pulmonologist for your lung care and a nephrologist who oversees your kidney care.
No matter which conditions you might be dealing with, there’s a host of other health professionals you can tap for support, says Dr. Kaiser. Physical therapists, nutritionists, social workers, cardiac rehab specialists, respiratory therapists, psychologists, pharmacists and others can all play key roles in helping you feel your best.
And let’s not forget your family and friends. They may not wear white lab coats, but they’re an important part of your care, Dr. Kaiser says. He tells his patients that it’s important to lean on trusted relatives, friends, a spiritual advisor, a fitness group and even people in online communities that focus on the conditions you have.
“All of these people are part of your team. They all play a role,” says Dr. Kaiser. “It helps you see that you’re far from alone. When you’re navigating serious illness, having as much support as possible can make a huge difference in your quality of life.”
3. Simplify your daily medication routine
Multiple conditions often come with two or more medications. It’s crucial to manage them in a way that doesn’t feel complicated or difficult to maintain, says Donald Mack, M.D., a geriatric medicine specialist at The Ohio State University’s Wexner Medical Center.
“People sometimes think there is one central database where all your medication information is stored, and that it’s automatically cross-checked for potential interactions,” says Dr. Mack. “That would be fantastic, but unfortunately, that doesn’t exist right now.”
When you go to new specialists or have a hospital visit, you may have even more medications added. And then there may be drugs that control the side effects of other drugs, he says. You might take a medication for dementia that causes diarrhea, for example, so you’re given another medication to control that. But now you’re constipated and seeking an over-the-counter remedy for relief.
“This is pretty common, and it’s what we call a ‘prescribing cascade,’” says Dr. Mack. “There are good solutions for handling it, and it often starts with your pharmacist or getting a medication review from your doctor.”
If you take several medications for more than one chronic health issue, you may also qualify for a Medicare program called Medication Therapy Management that provides an extra medication review each year by a pharmacist or other health care provider.
It’s also a good idea to use a pillbox to help organize your medications. There are plenty of versions — everything from a plain plastic one with separate tabs for
each day to an electronic one that will blink, beep or alert you with medication reminders. Shop around to find one that works best for you.
4. Use technology to your advantage
Even if you’re not a big fan of gadgets, tech tools can be very helpful for keeping your information organized and handy. At the very least, says Dr. Kaiser, consider using your health care provider’s online patient portal. Here, you can access appointment reminders, test results and other data. There’s also usually a tool for you to send messages or questions to members of your health care team.
Similarly, there are websites and apps that focus on prescription management, appointment setting and symptom tracking. Some feature an easy-to-use digital journal where you can jot down your symptoms every day, or get reminders about medication schedules.
Having all this information in one place makes it easier to share with your provider. It also helps you spot trends you may not have noticed otherwise. For instance, maybe you get a headache an hour after taking a certain medication, but you never connected those two events before. With that information, you’ll be able to ask your provider if there’s a different medication to try.
5. Remember that lifestyle changes are important
Treatment plans for many chronic conditions aren’t limited to what your provider writes out on the prescription pad, says Dr. Ogunwole. Your daily habits count, too.
“Lifestyle changes can be very meaningful, especially when you have multiple conditions,” says Dr. Ogunwole. “They can make a difference not just for your feeling of well-being today, but also for the progression of your conditions in the long term.”
Lifestyle habits that help you reach and maintain a healthy weight — think exercise, sleep and healthy eating — can have a significant effect on conditions like diabetes, heart disease, kidney issues and others, she says. “They can be just as important for your health as the medications your doctor has prescribed,” she adds. If you need help improving your diet or getting started with a new fitness routine, ask your provider for help in finding resources that are available to you.
It’s also important to maintain strong social connections and find activities that make you feel lighter and more joyful. These can be a huge boon for helping you see that you are much more than your diagnoses.
“For people with multiple conditions, especially older adults, it can be easy to feel overwhelmed, and sometimes that can lead to feeling down about managing it all,” says Dr. Ogunwole. “So finding ways to make life feel meaningful and important can go a long way toward better health.”