A:
Your annual physical exam is an opportunity for you and your doctor to prevent medical problems or find new problems when they are still at an early stage.
In my opinion, spotting problems that affect quality of life and independence are the top concerns for people older than 75. Tell your doctor if you have:
- difficulty hearing
- vision problems
- fallen or come close to falling
- a depressed mood and loss of pleasure in things you used to enjoy
- difficulty chewing or swallowing (even if this is from dentures that don't fit well)
- memory problems
- difficulty controlling your bladder or bowels
Your doctor may send you for tests or refer you to specialists to help with these problems. Your doctor will also want to know if you are drinking an unwise amount of alcohol or still smoking. During the exam, your doctor will check your blood pressure and height (or posture). Treating high blood pressure at any age reduces the risk of stroke.
And if your doctor notices that you have lost height or are stooped over, you may have thin bones (osteoporosis). All women should get a bone density test at least once after menopause.
Other tests your doctor might order include blood tests for diabetes, cholesterol level, kidney function and/or vitamin D. The annual exam is also a time to catch up on vaccinations. You should have a yearly flu shot and, once after age 65, a pneumonia vaccine.
The annual physical is a good time to let your doctor know what sort of end of life care you want. If you become very ill, with almost no chance of recovery, what care would you want? For example, if your heart stopped, would you want your natural death to be allowed or would you want emergency professionals to try to restart your heart, even if your ability to function normally and be independent is highly unlikely.
Your doctor can record your decisions. It is also a good idea to write these decisions down in a formal "advance directive." This is a legal document that lets you name someone to make decisions for you if you can't speak for yourself.
