PRACTICE PEARLS

 

Fam Pract Manag. 2019 Mar-Apr;26(2):32.

PAVE A TRAIL FOR SEDENTARY PATIENTS

Getting sedentary patients to exercise can be a challenge. I often encourage them to reinitiate an activity they enjoyed when they were younger because I believe they are more likely to stick with it. But it can be difficult if the patient only liked team sports, so instead I will advise him or her to start walking more. I’ve found that giving the patient detailed instructions in either paper or electronic form, including walk duration and number of days, can help. To make it easier and address common barriers to exercise, our practice developed a guide that details places patients can walk in our area, which we offer on our practice website. Our office staff has visited most of the sites, and our guide includes the ease of terrain, quality of trail surfaces, hours of operation, type and location of parking, and availability of restrooms.

IDENTIFY WHAT MATTERS TO OLDER PATIENTS

As patients get older, they tend to accumulate health conditions, such as heart issues or diabetes, and undergo major life changes, including physical or memory limitations. Physicians are trained to focus on curing or treating as many health problems as possible, but in the process, they can lose focus on what outcomes matter most to the patient. To avoid this, address the “4Ms”:

  • What Matters (What outcomes are most important to the patient?)

  • Medication (What are the drug’s side effects?)

  • Mentation (Is the patient affected by depression, dementia, or delirium?)

  • Mobility (How well can the patient move around?)

Make sure you address these issues as a whole, not individually, which can be confusing and sometimes contradictory. For example, a patient with Parkinson’s disease typically has trouble with mobility. The medications used to treat Parkinson’s can improve mobility but degrade memory or the

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Practice Pearls presents readers' advice on practice operations and patient care, along with tips drawn from the literature. Send us your best pearl (250 words of less), and you'll earn $50 if we publish it. We also welcome questions for our Q&A section. Send pearls, questions, and comments to fpmedit@aafp.org, or add your comments below.

 
 

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