Overview

Many people have more than one long-term (chronic) health problem. You may be one of them. For example, you may have high blood pressure and diabetes, or you may have high blood pressure, diabetes, and heart failure. When you have more than one problem, doctors call the health problems comorbidities.

One health problem may lead to another, causing the comorbidity. For example, diabetes can damage the lining of your blood vessels. This can lead to hardening of the arteries (atherosclerosis) and a heart attack. And a heart attack can lead to heart failure.

You also may have health problems that are not linked to each other, such as COPD (chronic obstructive pulmonary disease) and diabetes.

When you have more than one health problem, you have different health care needs. One disease can make another disease worse, and the total effect of all the diseases may be more than each on its own.

You also may have more symptoms and may need more treatment and medicines. You most likely will have to do more to take care of your health.

You may need to see more than one doctor and may need more than one treatment and medicine.

Dealing With Medicines

When you have more than one health problem, it usually means that you need at least a few medicines. Dealing with medicines can be one of the harder parts of your care. Medicines can save your life, but they can also harm you. You have to track them, know how to take them, and perhaps deal with side effects.

You and all your doctors need to be aware of all the medicines you are taking. This makes it less likely that one doctor will give you a medicine that interacts with another medicine. For example, one medicine may cause side effects that create problems with other medicines. Or one medicine may make another medicine stronger or weaker.

Older adults have to be even more careful with medicine. As you age, your body becomes more sensitive to medicines. As a result, the medicines may build up in your body and affect you as if you had taken a larger dose than prescribed. This can be harmful. So make sure you know how to stay safe when you take several medicines.

For example, it's a good idea to:

• Ask your doctor about your medicines. Also ask about:
  • Dealing with side effects and medicine interactions.
  • Lowering the cost of medicine.
• Take your medicines as prescribed.
• Organize your medicines.
• Keep a list of all of your medicines including prescription and over-the-counter medicine.
• Make a daily medicine schedule to remind you when to take your medicines.

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Working With Your Doctors

Good treatment depends on making sure that all of your doctors know about all of your health problems. Everyone you see for health care needs to know how you are being treated for each health problem you have.

Think of your doctors as your team. Tell each doctor that you expect them to talk with the other doctors about your care. If you feel comfortable doing so, bring a family member or friend with you to appointments so they can help you remember symptoms or problems that you want to talk about with the doctor.

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Taking Care of Yourself

When you have more than one health problem, you can do a lot to help yourself. One of the most important things is to get support. This can be your partner, a family member, a close friend, or a group of people in the same situation you're in. These people can do a lot to make you feel better physically and emotionally.

You can also help yourself by making some lifestyle changes. Something as simple as eating healthy foods and staying active can help your overall health a lot.

Here are some ways to help yourself:

• Get support.
• Watch out for depression and anxiety.
• Eat right.
• Be active.
• Relieve and avoid stress.
• Deal with pain, if you have health problems that cause long-term pain.
• Get regular checkups from your doctor.

Another way you can help yourself is to keep a personal health record. This is a place where you keep all the information about your health, such as your medicines, past health problems, and allergies. This information can help your doctors. And it's valuable if you change doctors, move, get sick when you're away from home, or end up in an emergency room. If any of these things happen and you have your records, you may get treatment more quickly and your treatment will be safer.

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Making Your Wishes Known

It can be hard to live with an illness that cannot be cured. But if your health is getting worse, you may want to make decisions about end-of-life care. Planning for the end of your life does not mean that you are giving up. It is a way to make sure that your wishes are met. Clearly stating your wishes can make it easier for your loved ones. Making plans while you are still able may also ease your mind and make your final days less stressful and more meaningful.

An advance directive is a legal way to state your wishes at the end of your life. It tells your family and your doctor what to do if you can't say what you want.

There are two main types of advance directives. You can change them any time your wishes change.

Living will.

This form tells your family and your doctor your wishes about life support and other treatment. The form is also called a declaration.

Medical power of attorney.

This form lets you name a person to make treatment decisions for you when you can't speak for yourself. This person is called a health care agent (health care proxy, health care surrogate). The form is also called a durable power of attorney for health care.

If you do not have an advance directive, decisions about your medical care may be made by a family member, or by a doctor or a judge who doesn't know you.

It may help to think of an advance directive as a gift to the people who care for you. If you have one, they won't have to make tough decisions by themselves.

For more information, including forms for your state, see the CaringInfo website (www.caringinfo.org/planning/advance-directives/).

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For Caregivers

Many people care for a partner, a parent, a friend, or a family member who has a disability or illness. Caregiving can be a rewarding experience. But caregiving can also be stressful.

There are three steps to being a good caregiver:

Take care of yourself.

Exercise regularly, get proper rest and nutrition, and have regular medical checkups. And take time off to take part in pleasant, nurturing activities.

Don't help too much.

Help the person you care for to be as independent as possible. For example, let the person make as many decisions as possible.

Ask for help.

Accept support from others. A helping hand at the right time can make all the difference. For example, ask family or friends to pick up a few items at the grocery store.

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