Getting Older, Getting Better – March/April 2006
Healthy aging with homeopathic and natural medicines
by Amy Rothenberg, ND, DHANP
(from the website of The National Center of Homeopathy)
I will never forget the first time I treated an older patient. I was a mere 26 years old, fresh out of naturopathic medical school, and before me sat a woman of 98 with long, flowing white hair and bright eyes that lit up her face. The fine wrinkles around her mouth broke into an easy smile when I walked into the room. Perhaps she was amused at how young they were letting people practice medicine, and a woman to boot!
She shared her story of deep and overpowering sleepiness ever since she’d had cataract surgery four months earlier. Falling asleep frequently might not seem to be a real complaint in someone of this age, but for this patient, it was. Her 80-year-old daughter, who had brought her in to see me, confirmed that her mother had never been like this before the surgery. As I sat in awe of these two older women and the grace, gentleness, and good humor with which they related to one another and the world, I had found yet another reason to love my job.
In 1900, average life expectancy in the U.S. was 47 years. By 2000, that number had increased by about 50 percent to the current age of 74. More than 35 million people, about 12 percent of the U.S. population, are older than 65. This number will nearly double by 2030.
The “very old” (considered to be those older than 85) make up the fastest growing segment of our population at 1.5 percent. In the year 2000, just 1 out of 5,578 reached the ripe old age of 100; in 2050 tat is predicted to rise to 1 out of 472!
Living longer than they used to, people are experiencing more of the effects of aging and general wear-and-tear than did previous generations. For this reason, health care issues have become central to many of our aging patients. Likewise, adults caring for their own parents must face all manner of health care decisions.
In 20 years of practice, I have successfully used homeopathy with older and even with “very old” patients. I pray that, at 46, I am at the halfway point of my own life. Wouldn’t it be nice to live to 92? I envision myself healthy and strong, my mind still clear and my day-to-day life filled with family, friends, work, art, and play. Can homeopathy help me and the older people I serve reach a ripe old age? Does using homeopathy along with other preventive measures such as supportive, nourishing, natural medicines offer anything useful to those in their later years? Based on my experience, I certainly believe so, and as the decades fly by, I sure as heck hope so!
For baby boomers entering their 50s and 60s, expectations have shifted considerably from those of the previous generation. Many who come to see me are well-informed about their ailments and about natural medicine options. Many have done a decent job of making healthy lifestyle choices in terms of diet, exercise, and the occasional use of botanical medicine or nutritional supplements. They seek homeopathic care for specific concerns, such as digestive disorders, joint problems, cognitive shifts, skin changes, urinary or prostate problems, or issues related to anxiety or depression. Homeopathy is well-suited to these patients: we can expect a successful constitutional remedy to improve the chief complaint while also helping the patient’s overall well-being, energy level, digestion, and sleep.
There is no trick to treating the older patient. We homeopaths still take the full case, seeking to understand all elements of the chief complaint and how that fits into the person’s overall health. We include a thorough review of the patient’s body systems and try to get an understanding of the stresses that impact their lives.
I am also careful to ask about family health history, so that I have a sense of potential genetic predispositions. For instance, if a patient with a strong family history of heart disease comes to see me for something largely unrelated, such as chronic digestive problems or migraines, I will do my best to find a remedy to help that chief complaint; but I will also take time to advise them on topics related to weight loss, proper diet, or exercise. A homeopathic remedy can help the migraines, but to counter genetic inheritance, it’s important to address lifestyle issues. For patients who find such changes difficult—and many patients of all ages do—I believe that a well-prescribed constitutional remedy will give them a bit more resolve, so they can make the changes they know are necessary.
Sometimes clear-headed older patients without cognitive problems are not so clear about past medical care or the reasons they had particular surgeries or diagnoses. When I first began to practice, this always caught me off guard. How could someone not know why they had a hysterectomy 25 years ago? How could someone not know why their thyroid gland was removed? But it was a different era then; patients were not encouraged to ask questions, and physicians did not always explain.
Even without access to a complete health history, however, there is usually no shortage of information on which to base a homeopathic prescription, so I simply let go of trying to know every detail. As people age, there are usually many examples of imbalance that we can explore, with sufficient colorful detail to all manner of symptoms.
Taking time to understand
With very old patients, I take more time to understand their living situation and social dynamics. Many experience isolation and loneliness, and I want to understand how that might impact their case. I’m always glad when a relative or support person accompanies them to the appointment, helping to clarify important details of the patient’s health history and current complaint. If the patient’s main issues are in the mental, cognitive sphere, I’m especially glad to have this support person in the interview to help us. I can take the homeopathic case either way, but it’s helpful to have this other voice.
One of my goals when treating older patients is to keep them living independently, if they so choose, functioning well enough to be safe and engaged in life. It is common for older people to have more disability with their illnesses, so while taking the case I also assess this. I try to speak with patients and their family members early on about the sort of care they would like as they age further, or perhaps when they are dying. I try to be forthcoming and direct without being intrusive, and I hope my patients and their families appreciate this.
Some of my patients in their 70s and 80s have told me that they especially appreciate my taking ample time to hear their stories and trying to understand their situations. In fact, I often feel that I have gained much more than they have from our time together—particularly when a patient has remained optimistic and caring, engaged in life, and enthusiastic about something—family, friends, books, nature, community service, music, politics, etc. I am often left inspired and energized by our visits together, and I hope that homeopathy can ease the patient’s aches and pains or give them more mental clarity or energy so that they can pursue the things that stir their imagination, spirit, body, or mind.
Multiple disease processes
When older patients consult me about a chronic problem, I often find that they have several disease processes occurring at once. For example, I recently saw Jim, a 70-year-old man with benign prostatic enlargement who also had frequent bouts of prostatitis, gastro-esophageal reflux (GERD), and seasonal allergies. Multiple diseases like this do not pose a problem for the homeopath, since we prescribe for the whole person. Often we can see patterns in the person’s complaints that are helpful to making a prescription.
In Jim’s case, for example, he experienced burning pain with each of his complaints: burning in the esophagus, burning on urination, and a burning nasal discharge with his allergies. Seeing such a pattern can lead us to a successful remedy and keep us from being overwhelmed by minutiae. Jim responded very well to the remedy Arsenicum album, as do many patients who experience burning sensations with their complaints. Jim’s tendency to be very organized, conscientious, and anxious when under pressure confirmed the prescription of Arsenicum.
I also gave Jim an herbal medicine derived from Ulmus fulva (slippery elm) to help coat and soothe the lining of his esophagus. We spoke about some of the basic dietary considerations for those with GERD (not drinking with meals, not lying down after meals, sleeping with an extra pillow, etc.)
At our first follow-up visit two months after taking Arsenicum, Jim reported that he was only waking once a night to urinate, down from 3–4 times, and he had not had an episode of prostatitis. As his GERD was markedly improved, he was able to cut out one of his conventional GERD medications.
Long lists of pharmaceuticals
One thing that always surprises me is the lengthy list of pharmaceutical products many of my older patients are taking. These drugs can produce unwanted side-effects—often the very problem the patient is complaining about. The fact that few of these medications are tested in combination during drug studies is of further concern. And we all lack a full understanding of drug and nutrient interactions, which, for many patients who take more than 8 or 10 medications a day, must certainly be a factor. So I spend a fair amount of time with the patient discussing why each medication has been prescribed and in what dosage, how compliant they’ve been about taking the drug, and whether they experience any known side-effects.
The drug history is important to a homeopath because it impacts our understanding of the patient: am I seeing true symptoms of the patient or symptoms related to the medications they take? Understanding the patient’s medications also informs our choice of potency and repetition of the homeopathic medicine. For instance, Gladys, a woman in her 70s, came to see me with end-stage emphysema and lung cancer. She was taking 20 mg of prednisone a day, along with a myriad of other preparations. Rather than give her one dose of a high potency homeopathic remedy as I often do, I gave her the indicated remedy in a 12c potency to take once a day. I felt that the strength and frequency of her other medicines could interfere with the action of the homeopathic remedy if given only once, whereas a lower potency taken more frequently would give the remedy a chance to act. When treating a patient in such a severe condition, I certainly don’t expect miracles. I would perhaps expect to gradually (and in conjunction with her other prescribing physicians) reduce Gladys’ prednisone level. I would hope to see her become more comfortable and come to some sort of peace with her situation.
Another issue that can arise when treating older patients is their actual ability to take the remedy. Can they open the container and tap out the prescribed number of pellets? If someone is visually impaired or has difficulty using their hands, then I may give a single dose of a remedy in my office.
Treating acute illnesses
I am often called upon to treat an older patient who is suffering from an acute illness, be it pneumonia, sinusitis, a urinary tract infection, or perhaps issues related to a recent surgery, such as severe constipation or pain at the site of an incision. I love to use homeopathy in such situations because an accurate homeopathic prescription can help the patient avoid taking yet another conventional medication with its probable side-effects.
When their general physical symptoms and mental/emotional symptoms have shifted from their usual constitutional state, these patients may need a true acute remedy. Other times they simply need a dose of their constitutional remedy to help them over a tough spot. I recall the case of one of my older patients, Annabelle, who had come down with pneumonia while in the hospital for a hip replacement. The last thing she needed was all the coughing and difficulty breathing. Her left lower lobe pneumonia, accompanied by severe diarrhea and a high fever, made me think she probably just needed a dose of her constitutional remedy, Sulphur. Her daughter administered a dose in the hospital, and Annabelle got over her pneumonia more quickly than her doctors anticipated. She also made a wonderful recovery from the hip surgery.
Back to the beginning
As to my 98-year-old sleepy patient described earlier, she was in a true acute situation, probably a reaction to the anesthesia used during her cataract surgery. The sleepiness, coupled with a dry mouth and a recent, new symptom of constipation, led me to prescribe, for the first time in my then short career, the remedy Nux moschata. This brought her back, in short order, to her more robust self. I had the pleasure of treating both mother and daughter for several more years until they passed away, several months apart, when the mother was well past the century mark.
I would like to send this article off to my parents, Doris Cynthia Jaffe Rothenberg and Harry Rothenberg, neither of whom made it to age 50, although I imagine they would have really enjoyed their older years. They were both fond of the saying, “Only the good die young.” How right they were.
About the Author
Amy Rothenberg, ND, DHANP, practices in Enfield, Connecticut. She teaches for the New England School of Homeopathy. Information on the NESH two-year course as well as the Herscu Letter can be found at www.nesh.com.