By: Jennifer Garrett
My father is not the kind of person you would expect to get acupuncture. He's nearly ninety and, I thought, rather set in his ways. Yet he also has a host of (mostly) age-related health issues including arthritis. And pain, I've learned, is a powerful motivator.
My dad's arthritis is fairly severe and greatly restricts his mobility. He shuffles around stiffly with a cane or walker. He barely lifts his feet and trips on the slightest threshold. Subsequently, he falls about twice a year. He usually lands on a shoulder and often hits his head on the way down. He has—knock on wood—never broken anything. He does, however, sustain a lot of soft-tissue damage.
To ease the pain, he usually ends up taking some kind of narcotics. One side effect is constipation. Sometimes it gets so severe that he starts to go into shock. This throws his heart into atrial fibrillation (or irregular heartbeat), something with which he has struggled my whole life. His doctors were able to correct the last bout with medication and electrical cardioversion, but he developed severe tremors immediately afterward. One doctor diagnosed it as a form of Parkinson's disease and prescribed more medication.
My mother was dubious and started talking to friends, one of whom recommended acupuncture. I don't know whether my mom had to convince my dad to try it. I didn't even know he was considering it. All I know is that she told me after the fact that the acupuncture had worked. He went regularly for months until the tremors abated completely. He still has his other health issues, but his hands and feet don't shake anymore.
I was surprised not that the acupuncture worked but that my dad was willing to consider it at all. It turns out that I shouldn't have been. Of course I am well aware of the growing popularity of organic foods, mindfulness and yoga—some of the mainstays of what was formerly labeled alternative, holistic or complementary medicine. I didn't realize, however, how willing older populations would be to adopt some of these practices and treatments.
When the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health, conducted a National Health Interview Survey in 2007 (the most recent survey period), it found that forty-one percent of individuals aged sixty to sixty-nine, thirty-two percent of those aged seventy to eighty-four, and nearly a quarter of the seniors older than that used some kind of complementary medicine.
"I don't see any lack of willingness of senior citizens to try integrative medicine," says Robert Edwards, a physician with the Dean Clinic in Lake Delton. Edwards is a primary care doctor who also performs integrative consultations. "A lot of people who find themselves on a lot of different medications are willing to try different things to get help … Senior citizens are definitely willing to try other things and look at other things. I don't even differentiate age-wise."
Edwards is one of many local health care practitioners who prefer the term "integrative medicine" to other labels, including "alternative" or "complementary" medicine. Whatever you call it, IM generally refers to an approach to health, illness and wellness that factors in the whole person—body, mind and spirit. More practically, it's an approach that blends practices and treatments from different cultures and disciplines to find a balance that suits each patient's needs, tolerances and sensibilities.
Edwards says he finds that many of the senior citizens he sees are already familiar with the home remedies and non-invasive treatment options that he recommends. He notes that they recognize that they are at greater risk for drug interactions because of their age, and they readily seek out ways to avoid deleterious side effects of pharmaceuticals and other traditional treatment options.
In fact, Edwards says the most common barrier isn't lack of awareness or information. It's not even an unwillingness to try new things. Rather, he says the biggest obstacle for seniors—particularly those on fixed incomes—is cost, as many health insurance plans do not cover the full range of IM treatment options.
My dad was no exception. He paid out of pocket for his acupuncture even though his health insurance would have covered pharmaceutical treatments. My parents could afford it; not all seniors can.
David Rakel, an associate professor in the UW School of Medicine and Public Health as well as the director of the UW Integrative Medicine Program, acknowledges that cost is a common limitation for all patients, not just seniors. However, Rakel is optimistic about the future for IM and people like my dad. Specifically, he expects that insurance companies will eventually embrace IM, as many of its disciplines and modalities cost less than conventional pharmaceuticals or medical procedures. He admits that the insurance industry can move slowly, but he says the bottom line could drive change more quickly in this instance. Rakel says that as doctors develop expertise in IM, it could reduce the demand for more expensive solutions.
To make his point, he uses a familiar issue that brings senior citizens to the doctor's office: pain. Rakel explains that a common mainstream treatment is epidural steroid injections. "If you look at the research for epidural steroids, the effects are short-term at best. It's very expensive and has to be done in the hospital," Rakel says. "Acupuncture [can have] long-term benefits and it's much cheaper."
Rakel expects that demand for IM will only continue to grow among patients and providers; National Health Information Survey results support that. Rakel also points to UW's IM program, which celebrated its tenth anniversary last year. In that time it grew from four to forty physicians and other care providers. It now offers myriad clinical and complementary services, including acupuncture, massage, mindfulness and various bodywork disciplines, as well as a fellowship program.
"We have people looking at how we can facilitate health and healing … instead of just focusing on how we fix things once they're broken," Rakel says, noting that moving from illness- to wellness-based medicine is a dramatic paradigm shift for Western medicine. Even so, he thinks we can all expect better options in the near future.
"Our opportunity here is for a different approach," he says. "I have faith. That's a very powerful process that we often don't give credence to."
Jennifer Garrett is a Madison-based freelance writer.
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