Life at 65+: Why regular doctor visits are key to healthy aging.

If you’re 65 or above — and feeling just fine — you might not think you need to see a doctor every year. But Dr. Sakeitha Crowder of Novant Health Adult Primary Care Harper Hill would like you to reconsider. As she tells her patients, 65 is a pivotal age — it’s a time when your body starts to change, even if you might not be aware of it.

For example, you might have shrugged off elevated cholesterol in your forties, but now that you’re 65, you’re at higher risk of suffering from myocardial infarction, stroke or peripheral arterial disease (blocked arteries). Yikes.

“As I tell my patients, we don’t want to find anything abnormal during our visit,” Crowder said. “We just want to screen for potentially fatal medical conditions early. We prefer being proactive and prevent a problem rather than waiting until a major medical event occurs then backtracking to correct the medical issue.”

Crowder said at 65, patients should make an appointment for their free Medicare annual wellness exam and annual physical. A quick overview of the differences:

• The wellness exam is focused on health risk assessment for older adults. Patients are asked to fill out a health risk assessments ahead of the appointment to gather basic information: who they live with, risk assessment for falls and mental health screenings for depression, home safety or cognitive abilities. It does not require a complete physical examination or laboratory tests. According to Medicare.gov, the Medicare wellness visit allows a patient to develop or update their personalized plan to help prevent disease or disability, based on their current health risk factors.
• The annual physical exam includes a comprehensive examination and may include screening labs as a review of a patient’s medical chart. This chart includes information about a patient’s vital signs, allergies, medications, chronic conditions and any pertinent family or social history. The physical exam also gives doctors a chance to remind patients about being updated on their vaccines, colon cancer screenings or breast cancer screenings.

In this Q&A, Crowder shares why people over 65 need to establish a relationship with a doctor if they haven’t already.

Tell us why a personalized approach is an important thing to look for when choosing a doctor.

My fellow Novant Health doctors and I don’t look at every patient the same way. Even something as seemingly straightforward as managing blood pressure can be different, based on the patient’s personal history.

We make recommendations that are personalized for each person, depending on their lifestyle, risk factors or family history. I want people to come into their appointment and feel ready to interact and engage. We talk a lot during our appointments because we want to make the recommendations tailored to the patient, their family history and current concerns.

Aging is tough. What are some ways to make it easier?

Here’s what I tell my patients:

1. Make sure your blood pressure and cholesterol are under control.
2. Stop smoking. Your doctor can refer you to a smoking cessation program.
3. Eat a balanced diet of fresh fruit, vegetables, fiber and lean meat. Don’t forget to stay hydrated, too.
4. Get a good night’s rest: Six to eight hours of uninterrupted sleep is ideal.

Primary care can make a huge difference in a patient’s life. But sometimes primary care clinicians also make a referral to a specialist. Can you share a story about how a referral you gave changed a person’s life?

I had a patient in his early seventies who ate Bojangles three times a day. His cholesterol was high, diabetes uncontrolled and his leg was swollen (a result of too much sodium in his diet). Educating this patient on proper nutrition was key.

I sent him to Novant Health Diabetes & Nutrition center, where he could sit one-on-one with a registered dietitian who helped him come up with a healthier eating plan. Now, his diabetes is under control and his leg is no longer swollen. Plus, his blood pressure and cholesterol levels have improved due to dietary choices and medication.

If you have a specific health challenge, you might be tempted to call up a specialist. I recommend seeing a primary care provider first because they can help guide you on where and how to receive the best possible services.

How can your doctor guide you through your advanced care directive?

An advanced care directive (also known as a living will) is a legal document that tells your medical team what type of care or interventions you prefer if you can’t communicate your wishes. Patients typically get these forms during their first Medicare wellness visit. Then, they are more than welcome to schedule a separate appointment with their doctor if they have any questions or want to discuss it in more detail. We can also post all these documents on your patient portal and can make any changes, if needed.

Check out Novant Health’s Choices and Champions page where you’ll find a lot of resources. You’ll find a lot of good information in this Healthy Headlines story as well: How having ‘the talk’ can spare families anguish and uncertainty.