Preventive Health Care and Medicine: Strategies for Post-Menopausal Women - Essay Example

? PREVENTIVE HEALTH CARE AND MEDICINE: STRATEGIES FOR POST-MENOPAUSAL WOMEN Preventive Health Care and Medicine: Strategies for Post-Menopausal WomenOne of the most important tasks of health care personnel and facilities is to maintain the overall health and well-being of citizens to an optimum level, because it is a common belief that healthy citizens are productive citizens (Katz, et al., 2007). However, while facilities can do so much to achieve this goal, it is still up to the people if they wish to remain as healthy as possible, especially since they have greater control over their own health habits. This can happen successfully if health care personnel such as general practitioners, family physicians and clinic or community nurses are able to inform and educate patients regarding ways of avoiding disease onset through health literacy and learning preventive health care and medicine (Bennett, et al., 2009). Such results come from studies that correlate poor health with the lack of health literacy, stating that the combination of low-income and lack of information regarding preventive health care decreases life expectancies, especially among geriatric patients (Nicastri & Fields, 2004; Sudore, et al., 2006; Wallace, 2004). As such, it is integral that physicians and other health care personnel be able to provide much information to citizens, so that they will be more informed about their health, and in turn become motivated and proactive in having a healthy lifestyle aiming to prevent the onset of diseases as much as possible, or delay in the case of patients with advanced ages. Preventive health care and medicine can bring benefits to people in particular those with a high-risk for certain hereditary diseases such as diabetes, Alzheimer’s disease, or cardiovascular diseases when done at the earliest possible time (Katz, et al., 2007). While it seems that certain ages such as beyond 60 years might seem a bit late for preventive health care, patients belonging to this age group were actually known to have health care priorities of their own, and by motivating them to participate in preventive health care they can still reap the rewards of engaging in such measures, especially when their life expectancies are expected to be extended around 5-10 years or more (Schonberg, et al, 2008a; Tannenbaum, Mayo, & Ducharme, 2005). If these geriatric patients are able to maintain their health or improve it through such endeavours, not only will their quality of life improve and be extended, but also their physicians can monitor their health better and prevent onset of debilitating diseases, even more so when compared with patients who do not participate in preventive health and medicine (Katz, et al., 2007; Stieber, 2005). Thus, physicians and other medical personnel are encouraged to counsel patients in improving their health and lifestyles through participation in preventive health care and medicine such as disease screening, risk factor analyses, among others. Opportunities for Preventive Health Care Discussion Patients who have known family histories of certain diseases can greatly benefit from preventive health care in reducing their risks of developing hereditary illnesses at an early age, or delaying the onset of such diseases (Sudore, et al., 2006). For example, considering a woman in post-menopausal age of 63 years whose mother is known to be suffering from Alzheimer’s dementia and osteoporosis, based on this given information she has risks of developing either one or both of the diseases due to the hereditary nature of these two diseases and as such she can benefit greatly from preventive measures such as bone density screening, MRI brain scanning, and prevention of fractures and blood pressure management through pharmacological means, as well as various interventions such as lifestyle modifications and other evidence-based health care recommendations (Brincat, Galera, & Baron, 2007; Cheung, et al., 2004b; Hillard, 2007; Jacobs & Sano, 2007; Lim, et al., 2009; Patterson, et al., 2008; Rao, et al, 2008; Schonberg, et al., 2008b). It is important that the woman is properly informed of the debilitating effects that Alzheimer’s dementia and osteoporosis can do to her physical and cognitive functions such as increased propensity for memory loss or eventual loss of cognition and bone fractures that may not heal or take longer time to heal and reduce her mobility, so that she will be informed of the possible consequences of not acting on early in preventing the onset of these diseases and that she can make informed choices as a result of her additional knowledge regarding these two diseases. Because the woman’s attending physician or family doctor is given the task of providing her with advice and solutions for her to be able to undergo preventive health care and medicine, they must be able to aid in modifying her behaviour and attitude towards her goal of remaining healthy despite aging. Possible steps for physicians to take in making her lean towards preventive medicine would be to first understand how behavioural changes can aid her in having a better health outlook and become more proactive in taking good care of her health. For example, using common theories for behavioural changes such as the health belief model for behaviour modification the woman can be informed that through preventive health care and medicine, she can better prevent the early onset of osteoporosis and Alzheimer’s dementia and delay it for five to 10 years, allowing her to retain her cognitive abilities and other physical functions longer, which in turn suspends her children or spouse for having to take care of her at the earliest possible time (Katz, et al., 2007). Next step for the physicians would be to select the most applicable behavioural change theory for her, so that they may be able to successfully intervene or change her outlook on health and her behaviours, as well as for her to fully accept changes. This is important in the woman’s case since 1) it has been known that behavioural changes, especially in her advanced age can be very difficult, if not confusing or frustrating; and 2) unless she has been informed and is fully aware of her health risks and how these can affect her overall health, she may not be receptive to behavioural changes despite being informed about the possible consequences of having no intervention in preventing disease onset such as Alzheimer’s dementia or osteoporosis (Katz, et al., 2007). In using the health belief model for example, by treating Alzheimer’s dementia and osteoporosis as diseases which can have strong impacts to her quality of life as well as her children possibly inheriting these diseases through her, the woman might become even more interested not just in preventing these diseases to happen to her, but also include her own children in the preventive measures by showing them how she chooses to work hard for her health and prevent herself from becoming a burden to them at an early age. Lastly, in order to help her engage in preventive health care, physicians must allow her to ask pertinent questions related to her own health concerns for them to find out how much she understands about the disease, so that they can gauge how much information she still needs to learn (Dassow, 2005). In addition, physicians must be able to explain to her fully the consequences of undergoing preventive health care, such as its positive and negative results, how such diseases will affect her body and her cognitive state, as well as her possible futures in either choosing to have preventive health care or not choosing to have it at all (Bennett, et al., 2009; Dubey, et al., 2006; Nicastri & Fields, 2004; Tannenbaum, et al, 2005). In allowing the patient to talk freely about her health concerns, physicians in turn can create better health care steps for her to follow since these would mostly be based on her priorities and what diseases she puts greater weight on, making her feel much more empowered and motivated while at the same time she will not feel resentful towards her physicians for forcing preventive health care unto her, especially since in her age of 63 years it can be expected that she may have difficulties following instructions easily without proper explanations for doing so and might become frustrated or avoid doing it altogether (Tannenbaum, et al, 2005). Possible Issues Related to Preventive Care Various issues can arise once the patient is given information with regards to how she can prevent the onset of Alzheimer’s dementia and osteoporosis, which are diseases that her own mother acquired. One issue that the patient might open up is that she may start asking more about the diseases, such as how these diseases affect the body, if she has any risks in developing either one or both of these diseases, availability of potential cures and costs, and if it is possible to avoid these diseases altogether (Nicastri & Fields, 2004). To address her concerns about the disease, it is essential to be honest with her about the disease, to answer her queries without any kind of prejudice and as much as possible to give her enough information that she can easily understand even without too much technical terms. For example, if she raises concerns about the onset of Alzheimer’s dementia, the physicians must be able to answer her questions in accordance to what she might need, such as its causes (e.g. hereditary factors such as genes, biological factors such as formation of plaques in the brain, lifestyle factors such as the onset of cardiovascular diseases), what other diseases are related to its onset (e.g. cardiovascular diseases), what ages are usually affected by it; its effects on the person’s mental and physical capabilities (e.g. cognitive degeneration leading to memory or muscle control loss), how this disease can affect the people around her (e.g. she has to ask for assistance if she happens to lose the use of her body), and possible ways of preventing early onset of the disease (e.g. exercises, leisurely activities, socialisation, pharmacological therapies) (Chertkow, 2008; Cheung, et al., 2004a; Rovio, et al., 2005; Warburton, et al., 2007). After asking about the disease, she might also ask how much the preventive health care and medicine costs, if there are health risks involved through such measures and if the benefits outweigh these costs. In the case of preventive health measures regarding Alzheimer’s dementia, diagnostics can be rather costly compared to osteoporosis preventive measures since the former is done repeatedly in a span of weeks before getting the necessary information about the patient’s mental state, while the latter can be done in a single session to get the results and have it discussed with the patient (Feldman, et al., 2008). In addition, basic laboratory tests and structural imaging may cost more than short cognitive screening tests and physical examinations since imaging and laboratory examinations use equipment and other consumables that the patient must also have to pay, while the cognitive screening tests and physical examinations rarely use sophisticated equipment. Depending on her health care plans, she may have to pay for these tests out of her own pocket as some health insurances normally do not cover expenses for preventive health care measures, and she must be advised about this issue as early as possible to prevent cost problems in the future should she opt to have various tests taken (Stieber, 2005). As for potential health risks, so far only hormonal replacement therapy has been reported to carry risks which outweigh health benefits with regards to being used by postmenopausal patients due to increased risks for cardiovascular diseases, breast cancer, and dementia despite having protective effects on osteoporosis development due to increased collagen production, while other preventive measures previously mentioned such as screening tests normally do not pose risks to patients (Brincat, et al., 2007; Jacobs & Sano, 2007; Wathen, et al., 2004). It is relevant to explain such instances to patients so that they and their immediate relations will be much more careful in choosing which preventive method they plan to use, even more so when they opt for pharmacological methods. Explaining to the patients and their families the importance of undergoing such tests, how each test is conducted and how the benefits of these tests can outweigh their initial costs in preventing early onset of diseases can better inform them of preventative health measures, and contribute to their knowledge of the diseases that they want to avoid or delay having, and in the case of the 63 year-old woman this would be the prevention of Alzheimer’s dementia and osteoporosis. Streamlining Preventive Health Care Delivery Initiatives that can be done for delivering preventive health care not just for patients at-risk for certain diseases but also to the general public would be to provide them a list of diseases that can be prevented through practicing preventive health care and medicine, as well as the corresponding efforts to prevent each disease such as lifestyle changes, pharmacological therapy, and available screening and diagnostic tests. Such efforts are made in the premise that informing people of health risks and how to prevent them can help them make informed choices as to how they could better manage their overall health (Katz, et al., 2007). Lastly, medical personnel must make it a point to address their patients’ queries regarding diseases without any form of prejudice, so as to help them become much more open in asking them about other options in improving their health. By providing patients with an opportunity to ask questions and have them answered by health professionals, they gain health literacy which is noted to be important in improved overall health through informed choices and development of preventive health behaviours (Bennett, et al., 2009; Hillard, 2007; Nicastri & Fields, 2004). Individual initiatives of general practitioners or other health care personnel in imparting preventive health care to patients can greatly improve their attitudes toward striving for better health, but this can be augmented by the participation of other specialists so that any patient in any age can have their chronic and complex medical needs be better taken care of easily and with greater efficiency (Stieber, 2005). Also, it can be expected that in the case of advanced ages such as the 63 year-old woman in the example, going to various doctors or specialists on her own while doing the coordination and schedule reservations by herself can be tiresome and might change her mind in doing preventive care. She can benefit even more when her family physician or general practitioner have improved coordination with other specialists such as those performing imaging diagnostics and cognitive tests, and that aside from having an extended network of support she also does not have to worry about possible conflicts in the test results that her specialists and general practitioner or family physician might have since there are open communications between these various specialists and her doctors in discussing options or alternatives for her health (Stieber, 2005). 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