Dr. Denis Grillo, Ear, Nose & Throat, 12/11/12

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The aging of America: Is your ENT doctor up to date?

As we know, the fastest-growing portion of the United States population are those 65 years of age and older. Decreased birth rates and increasing life spans are the factors. It is commonly accepted that our older patients see certain doctors with more frequency, i.e. orthopedists, urologists and cardiologists, to name a few.

As ear, nose and throat (ENT) doctors, we, too, will see an increase in our senior adult patient population.

In the next 10 to 20 years, baby boomers — on whom we have done multiple tonsillectomies, adnoidectomies and ear surgeries — will enter this age group. 

However, in the future, we will need to change our way of thinking and become more proficient in the diagnosis and treatment of head and neck problems, such as hearing loss, ringing of the ears, skin cancers and growths in the head and neck area.

Since the 1960s, the number of people 65 and older has doubled to 33 million people. A century ago, seniors accounted for 4 percent of the U.S. population. Currently, this figure has tripled, and by estimates will reach more than 20 percent by 2030.

In 1996, one-quarter of the senior population assessed their health as fair or poor, compared to 10 percent for all persons. Most older people have at least one chronic condition, and most have multiple conditions. 

Of the most frequently occurring ENT problems, hearing loss and sinusitis were in the top 5 percent of the complaints.

In an effort to better communicate and meet the needs our senior population, the ENT must focus on the more common complaints that affect patients 65 years of age and older. This will include ear problems such as hearing loss, balance disorders, noises in the ear and wax obstruction. 

Nasal problems include allergies and sinusitis as the most common and can be as involved as severe nose bleeds, secondary to high blood pressure and blood thinners. Other nasal problems can affect airway and quality of sleep, which is often a common problem in the elderly. 

Diminished smell and taste disorders are widespread, but fortunately benign. Head and neck cancer is very common because many people from this generation were unaware, early on, of the dangers of alcohol and tobacco consumption.

It is important that the ENT understands a senior adult’s need for quality of life, not just the issue of longevity at any price. There are many factors that enter into this equation. Families tend to play a greater role in the decision-making process for elderly patients. Surrogate decision-makers need to be evaluated closely. Achieving consensus may require more time and effort. 

On the other hand, an individual who is the sole caregiver for an ailing spouse may have special needs. An example of this type of situation is an elderly gentleman with throat cancer and a wife who has Alzheimer’s. The husband may not be able to undergo a complicated surgery with a lengthy recovery time in the hospital, and may need to opt for outpatient radiation therapy, which will allow him to continue to care for his wife.

A future ENT will have to take these factors into account, or he will not be able to properly address the problems of the senior patient. Currently, there are efforts by the Academy of Otolaryngologists to address this concern in the training of new doctors.

Denis Grillo, D.O., FOCOO, is an ear, nose and throat specialist in Crystal River. Call him at 352-795-0011 or visit CrystalCommunityENT.com.