A five-minute walk from the historic On Leong Chinese Merchants Association building in Chinatown brings you to the Biewend building on Tremont Street. Dr. Wei Wang, a geriatrician and primary care physician, sees elderly patients here at Tufts Medicine’s primary care offices. He told Sampan that many elderly people living in Chinatown deal with chronic medical conditions like diabetes, high cholesterol, and high blood pressure. This is true of older adults more generally. In the United States, nearly 95% of adults aged 65 or older have at least one chronic condition, and 80% have two or more.
Geriatric health is becoming more important as the population of the United States ages. By 2040, 20% of Americans will be 65 or older. The Urban Institute projects that the number of adults aged 85 and older, the group most often needing help with basic personal care, will more than double in the next 20 years. At the same time, birthrates in the United States are declining. Boston is not immune from these trends. The UMass Donohue Institute predicts an increase in the older population in Boston from around 90,000 seniors to 130,000 by 2030. Births in Massachusetts are also declining, down 3.9% in 2020 from the previous year, and will likely continue to drop or plateau (numbers from 2021 to now have not yet been made available).
All of this means that healthcare systems will be seeing more and more elderly patients in the future, and doctors must be prepared for the challenges associated with treating an older population. Dr. Wang spoke to Sampan about these challenges and about elderly health more generally. He sees “quite a lot of the elderly Chinese in Chinatown with chronic medical conditions,” and tells us that one of the biggest problems is ensuring that patients adhere to their treatment plans. “The medications you take for chronic illnesses control the illnesses while you’re taking the medication,” Dr. Wang says. “They do not cure the chronic conditions.” Sometimes, elderly patients stop taking their medications and their conditions worsen. “They come back to my office and have to be restarted on their medications.” Chronic conditions like heart disease, cancer, Alzheimer’s disease, and diabetes are among the leading causes of death for older adults in the United States. It’s therefore imperative that people with these conditions follow their treatments as directed by their doctors.
It’s also important for elderly patients to have support from their families and healthcare professionals. Dr. Wang points out that “for the Chinatown community, a lot of them don’t speak English. They rely on their adult children who speak English, so the kids need to help out with the parents.” He speaks Mandarin as well as English, but told us that many Chinatown residents only speak the Cantonese dialect and may struggle to find doctors who speak their language. Culturally and linguistically sensitive healthcare systems are crucial for patient health and safety, as language barriers can lead to miscommunication and worsen patient outcomes. Tufts, like all major hospitals, uses in-person as well as phone translator services for patients that speak a different language or dialect. (Dr. Wang often uses the phone translator service for Cantonese-speaking patients.)
When it comes to treatment, Dr. Wang has some advice for elderly patients and their caregivers. “It’s my experience with elderly patients in general that doctors keep prescribing medications and patients only take them when they remember or feel like it. For the children of elderly patients with memory issues, it’s helpful to get their parents weekly pill boxes to organize all the medications they have to take.” Dr. Wang also suggests visiting a primary care physician more frequently as you age. “In your twenties, you rarely need to go to your doctor that much. When you’re 70 or older, you may need to go 3 or 4 times a year at least.” Seniors should also bring their medications to their appointments so that their doctors can go over the medications with them.
Research from surveys on aging in the United States has shown how important a family support system is for elderly health, and Dr. Wang reiterates this. “I see a lot of my elderly patients coming to appointments by themselves. It would be helpful if their children want to get involved. The older you get, the more your health is going to decline, and you’re going to need more help with your medical problems.” Dr. Wang knows this from personal experience. He studied geriatric medicine in part because his parents are getting older. “I’m grateful I went through training in geriatrics, because I can use what I’ve learned to help my own parents.” Children of elderly parents should follow Dr. Wang’s example and become more involved in their parents’ healthcare if possible. And given that over 20% of Chinatown’s population is over 65, good geriatric care continues to be a priority for our community.
