House Call: Making your golden years extra golden

I decided to retire this year in June and so I will be handing off authoring the House Call Column to another colleague. While I am looking forward to setting my own schedule and enjoying the freedom that comes with time, the last few months have been bittersweet due to so many cherished goodbyes.

I’m grateful I can retire while I still have health and energy to get the most out of retirement including some traveling with my wife and spending some wintertime in Arizona biking and building up my vitamin D levels!

Reflecting back on my time in medicine I’ve been incredibly blessed by the support of my professional colleagues, office leadership, Nurses, Medical Assistants and wonderful support staff that have helped me and made work fun along the way. Even more gratifying are the wonderful relationships with patients that I’ve developed over the years–people who have stuck with me through multiple professional transitions and have become my friends, shared our joys and sorrows, and brought me true joy! How incredibly humbling to have been allowed the opportunity to become part of their lives.

I started out 36 years ago in a private practice with three other doctors. At that time, family doctors in a small practice fielded every sort of issue, ailment or question. We delivered babies, provided wellness care, and attended three local hospitals taking care of our hospitalized patients. We didn’t have electronic medical records then and primary physicians put in lots of extra time and effort to offer full-spectrum continuity of care for our patients.

Over the years, as medicine evolved and the patient population changed, it become essential to have a more coordinated health care approach where primary providers can collaborate more fluidly with support providers and a multi-disciplinary team. Eventually, I moved over from private practice to the care system at Kaiser Permanente and got a different perspective on delivering care and working within this network of colleagues and specialists.

There have been times I missed the small office feel of my first practice, but change is inevitable, and the healthcare system continues to evolve and by necessity, improve on population-based healthcare. While navigating any healthcare system can sometimes have its challenges, the opportunities and benefits in a larger and more integrated system allowed me to deliver improved quality of care for my patients. During the recent Covid pandemic that greater system support was invaluable. I believe firmly that integrated health systems like Kaiser Permanente offer our best hope of improving the quality of care and controlling costs for our patient population.

As my practice evolved over the years, as many of you know, I moved toward a focus on senior care–not only because I was rapidly becoming one but because of the many joys and challenges with geriatrics care. It’s one of the most rapidly growing segments of the population and older adults typically have increased and complex healthcare needs.

Caring for older adults can be quite challenging at times but it’s extremely gratifying to see how sometimes a small intervention can make such a big difference in quality of life and overall health. Plus, older people are fun! They (we!) have great stories to share and interesting perspectives. Who wouldn’t like taking care of them?

While of course I’ve valued being able to make diagnoses and providing care to help older adults, it’s often the patient’s partnership in making lifestyle changes that makes the biggest impact. As I close out my work with this column, I’m sharing a few of the things I’ve seen make the biggest differences for making the later years some of the best:

• Keep up with preventative medicine: The benefit of checking in with your provider team and routine visits can’t be overstated. Just because you feel good now, there still might be things brewing under the surface which wellness checks can help find and address like skin cancer or issues that have few noticeable symptoms like hypertension.

• Get moving and stay active: Regular activity and exercise, even 30 minutes a day, really does have an amazing number of across-the-board benefits. We tend to know exercise supports healthy weight and healthy hearts, but it also helps creaky knees stay limber, elevates your mood, and even supports your digestion. From water aerobics classes to the pickleball court, it’s also a great way to stay social.

• Keep in touch with loved ones: Staying social and maintaining contact with family, friends and peers, are key for healthy aging (and are healthy at every age). Social connection stimulates your brain, preserves cognitive function and supports mental health.

• Plan for when you need help: We all age and eventually most of us will need some help. I’ve seen many patients wait until there is a crisis before planning how that will happen. Those that plan for needed changes in housing or care and connect with community resources earlier tend to have smoother transitions.

• Have honest conversations: Talking with family and caregivers about support as you age is the first step to getting everyone’s needs met. Talk about assisted living or home care ahead of time, record and share your end-of-life decisions and discuss finances openly with your loved ones.

The golden years can be truly golden if you plan proactively and focus on maintaining your health with exercise, healthy diet and regular care. It’s not only about good health for its own sake, but also about the joys of having time and freedom to do what you want to do and being able to do it on your own terms. In essence, having quality of time without necessarily focusing on quantity.

Getting older and retiring is a huge transition for most of us, but it also provides us with many opportunities to maybe learn a new sport, make new friends, or even move to an over 55 community with lots of engaging activities and opportunities for social engagement. Retiring will be a big change but I’m looking forward to those new challenges and adventures. One retired colleague’s comment summed it up best for me: “You’re going to wonder how you ever had time to work.”

Thanks Spokane and I’ll see you on the bike trails.