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Constipation in elderly people is a common health condition. According to the National Institute on Aging, 1 in 3 senior adults has had an episode of constipation. Constipation can cause discomfort, pain, and difficulty in performing daily activities. This can make you anxious, frustrated, or withdraw from social environments. As with any other health problem, the earlier it is caught the better it is, so let’s have a look at what is constipation, where is constipation pain felt, and how to fix constipation. What is constipation? Constipation is when you have a hard time going Number 2. How your body expels waste – Digestive acids in the stomach break food into tiny particles. – Nutrients are extracted and waste materials, like fiber, are sent to the large intestine. – The intestine contracts and relaxes to push waste towards the rectum. – Waste sits in the rectum until expelled from the anus in the form of stool. Symptoms of constipation You haven’t emptied your bowels in 2 days. You’ve had fewer than 3 bowel movements in a week. You strain on the toilet, as if you’re forcing the waste out. Abdominal cramping, bloating, discomfort, or a feeling of heaviness in the stomach. Feeling dissatisfied after a bathroom visit because you don’t feel completely ‘empty’. Lumpy, dry, or hard stools that are painful to pass. Needing to pee frequently, but feeling like your bladder isn’t emptying completely. Manual evacuation needed to dislodge stool trapped in the anal passage. Headaches and/or nausea. anxiety, irritability, depression. Constipation in elderly In senior adults, constipation may be caused by a number of factors. Age The colon contracts and relaxes — kind of how a caterpillar moves along a leaf — to propel waste through the digestive system. With age, this movement slows down, so stool may remain in the colon for longer, becoming harder, drier, and more compacted. Lifestyle A sedentary lifestyle where you aren’t very physically active can lead to muscles in the abdomen growing weak. These muscles have a big role to play in helping the digestive organs, especially the colon, move waste along and out of the body. Environment Dry weather, arid climates, and low humidity also contribute to constipation. Most of us think we lose moisture only if we visibly sweat. But water evaporates from our bodies all the time, even when we’re just sitting around doing nothing. Hot, dry weather, as in some parts of Arizona and Texas, can be very dehydrating. So can air conditioning. But while a warm breeze may leave you craving a refreshing drink, in a pleasantly cool, air conditioned room, you might not even realize you’re thirsty. Illness, disease, chronic conditions Certain chronic conditions, such as diabetes and Parkinson’s disease, are understood to cause constipation because these illnesses damage the nerves that control the function of the digestive system and associated organs. Metabolism slowed down by an underactive thyroid gland may also lead to constipation because it slows down the digestive process. As a result, waste sits in the colon for longer, becoming hard, dry, and difficult to expel. Medications and polypharmacy Constipation is a side effect of many drugs, whether they be prescription or over-the-counter. The active ingredients in many medications can: Interfere with nerves that control bowel movements Affect the function of the digestive tract Alter how your body absorbs water Polypharmacy means taking 5 or more different drugs on a regular basis. Among older adults, this is quite common. It also raises their chances of having more frequent episodes of constipation. Where is constipation pain felt Constipation pain is typically felt in the lower abdomen, where the large intestine is located. The pain can range from a mild discomfort to intense pressure and cramping. Some people may also feel soreness in and around the anus, as straining to push hard, lumpy stools out may cause microtears in the skin. What to do for constipation The first steps are drinking lots of water and eating lots of fiber. Why water is important Drinking water keeps waste soft. Soft waste moves much more easily through the colon and comes out without stressing the rectum or tearing the anal opening. In temperate weather, 4-6 glasses (48–64 oz) of water daily may provide adequate hydration. In warmer, drier climates like parts of Arizona and Texas, you may need to drink more. Some people might forget to drink water, so use reminders, alarms, and schedules to prevent dehydration. You can also ‘eat’ some of your water quota by consuming soups and water-rich fruit and vegetables like watermelon, cantaloupe, oranges, pineapple, apples, and all kinds of berries. Cucumbers, lettuce, celery, green bell peppers, and asparagus are also great choices. Why fiber is important Eating water-rich fruits and vegetables means you’re also consuming their fiber content. Fiber or roughage is the material that builds the structure of fruits and vegetables, and holds their flavor, nutrients, and liquid. Fiber is not digested by your body. As it is highly absorbent, it helps keep waste in the colon soft. Good sources of dietary fiber are: Most fruit and vegetables (eat the peel whenever possible). Whole grains like oatmeal, brown rice, and quinoa. Legumes, beans, and lentils. Nuts and seeds.   Experts recommend eating 25-30 grams of fiber every day. Here’s a handy chart to help you add high-fiber foods in your daily meals. Learn more: Why is the Mediterranean Diet voted best in the world Other ways to relieve constipation Exercise Walking daily, even for just 15-20 minutes, promotes digestion. Gentle exercises like chair yoga, leg lifts, or light stretches can be done indoors to avoid midday heat. Click here to find the right doctors for exercise guidance in Arizona and Texas Train your bowels Some people are able to train their bodies to have regular bowel movements by establishing a routine. Try to go to the bathroom at the same time daily, ideally after a meal. Breathe deeply, relax, and don’t strain or push. Let things happen on their own.

You may have heard the term before. Maybe you’ve even had one for years. But many people still wonder: What does a primary care physician do? Or, what is a primary care doctor? Find primary care physicians in Arizona What is a primary care doctor? A primary care doctor is your first checkpoint for everything, from routine healthcare to allergy shots, to long-term chronic care, to when your partner says, “You snore like a truck. Please get that checked.” Importance of primary care physicians Think of your body as an orchestra in which hundreds of separate ‘musicians’ — organs, glands, bones, blood vessels, muscles — work together to produce beautiful music. Your primary care physician is the conductor of that orchestra. They listen closely for any ‘musician’ playing off-key, identify the problem, and look for ways to fix it. Sometimes the fix is as simple as tightening a cello string (i.e. altering drug dosage). At other times, they may bring in a specialist for more in-depth repairs (i.e. seeing an endocrinologist for an underperforming thyroid gland). What does a primary care physician do Primary care doctors are trained to look at the overall picture you present. They: Perform regular checkups to make sure everything is working as it should Primary care doctors see you even when nothing appears wrong. Somewhat like a routine tune-up for your body, they track your overall health — blood pressure, weight, heart and lung function, and more — to catch small issues before they become big problems. Diagnose and treat illnesses, both acute and everyday Your primary care doctor will deal with your sore throat, flu, sinus infection, or minor skin rash. If you’re doubled over with a sudden pain in your side, the same PCP will examine you for all possible problems, such as appendicitis, a kidney stone, diverticulitis, or even a heart attack. Administer vaccines Staying up to date on your vaccines is especially important as you get older. Your doctor will make sure you get the right shots, like your annual flu shot, shingles vaccine, or pneumonia vaccine, at the right time to help keep you protected. Help with managing long-term chronic conditions Many senior adults live with one or more chronic conditions, such as diabetes, high blood pressure, or chronic obstructive pulmonary disorder (COPD). Your PCP works with you to manage these illnesses over time, keeping track of your symptoms, medications, and lab results. This lets you avoid complications and feel more in control of your health. Guide you to the right specialists as and when needed Not every health issue can be handled by one care provider. When something requires a deeper look, your primary doctor will refer you to the right kind of specialist — cardiologist, endocrinologist, or dermatologist — without delay. Coordinate and manage your medications Senior adults with multiple health conditions may have to take many different medications. Your primary care doctor makes sure all your medications work together safely and effectively. They watch out for side effects and negative interactions, review your prescriptions regularly, and adjust dosages as needed. Coordinate your care If you see more than one doctor or have a lot of medical appointments, your primary care doctor can help keep everything organized. They act as the central point for your care team, making sure everyone is on the same page so your treatments and medications don’t overlap or conflict. Guide and advise on living well Your doctor is not just there when you’re sick. They can help you live better every day. Whether you want to eat healthier, move more, or quit smoking, they’ll guide you with realistic advice tailored to your health goals and age. Take charge of preventive care Your PCP helps you avoid serious health problems by catching illnesses and diseases early. Regular screenings, blood work, and early testing are all part of primary care. This means fewer surprises and better chances to fix something before it becomes serious. PCPs know your story Your primary care provider knows your medical history. They know what’s normal for you, what works for you, and what doesn’t. This makes it easier to spot when something is off. Click here to find PCPs in Texas Primary care with Medicare For senior adults enrolled in Original Medicare (government-sponsored healthcare, also known as Medicare Part A and Medicare Part B) or Medicare Advantage (also known as Part C, offered by private insurance providers), primary care doctors: Stay on top of your health With patients enrolled in Medicare, doctors are rewarded for keeping you healthy, not just treating you when you’re sick. Through regular checkups and preventive care, they are more likely to catch health issues early before they develop or progress to serious levels. Focus on prevention Senior patients enrolled in Original Medicare or Medicare Advantage plans are eligible for several preventive screenings usually at no cost. Your primary care provider will recommend screenings for cancer, glaucoma, osteoporosis, heart disease, depression, and other health issues if they think you are at risk. Aim to keep you out of the hospital A hospital stay means a health condition may have gone out of control. This can be distressing in many ways. Your primary care doctor’s goal is to help you stay well at home, not in a hospital bed. Seeing a primary care doctor regularly reduces the likelihood of needing emergency care. That’s a big deal, both for your health and your peace of mind. Encourage annual Medicare benefits reviews Medicare plans, and the benefits offered, can change from year to year. Your PCP can help you review your current benefits and make sure you’re getting the care, screenings, and services you’re entitled to. For example, there are some Medicare plans that are specifically designed to help you get the quality affordable care that you need if you have chronic conditions diabetes, heart disease, or COPD. How to find a good primary care doctor    If you are a senior adult in search of a doctor

Bone health becomes a critical concern as we grow older. Senior adults, especially women after menopause, are at a higher risk of bone loss and osteoporosis. This article will discuss how to improve bone density during menopause, as well as ways of increasing bone density after menopause, and how to prevent bone loss after menopause. If you’re an IntraCare patient and concerned about these issues popping up, be sure to ask your IntraCare primary care provider about how they can help you prevent and manage these issues. What is bone density? Bone density refers to how strong and hard your bones are, primarily because of their mineral content. The average make-up of human bones is: 65% inorganic mineral matter, mainly calcium and phosphorus. These give bones their strength and hardness. 35% organic, mainly collagen. This is a protein that holds all the mineral crystals together. Water, to fill in the blanks. The denser your bones, the sturdier they are and less likely to break. Dense bones support you better and reduce your risk of falls and fractures. When bone density drops below a healthy level, you may develop chronic conditions like osteopenia (mild bone loss) and osteoporosis (severe bone weakening). Why bone density matters in older women Our bodies naturally weaken and become brittle as we grow older. This is called losing bone mass. Estrogen plays a key role in maintaining bone strength, so for women — whose bones are much thinner than men’s to begin with — this process speeds up significantly after menopause when estrogen levels drop. Note: Men are also at risk of bone loss as they age, especially if they have medical conditions that affect bone health, such as low testosterone, or vitamin D deficiency. Low bone density means bones are brittle and can break more easily, even from simple movements or minor falls. According to the Centers for Disease Control and Prevention (CDC), falls are a leading cause of injury and death among individuals aged 65 and older. Bone health and menopause: What women need to know For many women, the years surrounding menopause are when bone loss begins to speed up. In fact, women can lose up to 20% of their bone density in the 5-7 years after menopause. This makes the time around and after menopause critical for prevention. How to improve bone density during menopause Get regular bone tests called DEXA (Dual-energy X-ray absorptiometry) scans, to monitor changes early. Eat foods rich in calcium and vitamin D. Stay active with weight-bearing exercises. Avoid smoking and limit alcohol. Talk to your doctor about bone-building medications or supplements if needed. Find doctors for osteoporosis in Arizona and Texas Increasing bone density after menopause: Stay strong with strong bones Even after menopause, you can take action to build and protect your bones by: Resistance training (like light weights or resistance bands). Incorporating balance and flexibility exercises to prevent falls. Getting regular check-ups to track progress and make adjustments to your plan. How to prevent osteoporosis after hysterectomy Women who have had a hysterectomy, especially if ovaries were removed, are at higher risk of bone loss because of decreased hormone levels. To protect bones from becoming too soft and brittle: Begin bone health strategies immediately after surgery. Use hormone replacement therapy (HRT) if recommended by your provider. Take more calcium and vitamin D through diet or supplements. Stay active as much as possible. How to prevent bone loss after menopause Preventing bone loss is easier than replacing lost bone matter. Key areas to focus on are: Diet Sunlight Exercise Medications Eat a bone-building diet A balanced diet is your first line of defense. Try to incorporate into your daily meals as many foods as possible that are rich in calcium, vitamin D, magnesium, and protein. Include: Dairy products like milk, yogurt, and cheese (look for low-fat or fortified options if needed). Leafy greens such as kale, collard greens, spinach, and bok choy. Fatty fish such as salmon, sardines, or mackerel, as these are great sources of vitamin D and omega-3s. Fortified foods such as cereals, orange juice, plant-based milks. Nuts and seeds, especially almonds and chia seeds, which offer magnesium and protein. Soy products, such as tofu and tempeh, may help mimic estrogen-like effects on bones.   Tip: Women over 50 should aim for 1,200 mg of calcium and 800-1,000 IU of vitamin D daily, either from food, supplements, or both. Get safe sun exposure Vitamin D helps your body absorb calcium and supports bone remodeling. One of the best natural sources? The sun. Aim for 10-15 minutes of morning sunlight on your arms, hands, or face, several times a week. Be cautious not to overdo it. Seniors may have thinner skin and a higher risk of sunburn. In cloudy climates or winter months, a vitamin D supplement might be necessary. Ask your doctor to check your levels. Stay active with bone-strengthening exercises Regular movement is essential for bone maintenance and preventing falls. Weight-bearing and balance-focused activities are the most effective for improving bone density. Recommended activities include: Walking: Brisk or at your own pace, 30 minutes a day. Tai chi: Improves balance and coordination, is great for fall prevention. Yoga or Pilates: Improve flexibility, posture, and strength. Resistance training: Uses light weights or resistance bands to help stimulate bone formation. Stair-climbing, dancing, or gardening: Low-impact yet bone-challenging movement. Consider medications if needed For women with osteopenia or osteoporosis (diagnosed through a bone density test), lifestyle changes may not be enough. Based on lab results, your doctor may prescribe medications to help slow bone loss, or even build new bone. Common options include: Bisphosphonates that slow down bone loss, keeping existing bone tissue intact for longer. Selective estrogen receptor modulators (SERMs), that mimic estrogen’s protective effect. Hormone replacement therapy (HRT) may be an option for younger postmenopausal women. Anabolic agents that help build bone. Anabolic medications encourage your body to produce more bone tissue. This helps strengthen bones and lowers the risks of fractures. Habits

Many people are perplexed by the family medicine vs general medicine question, or by the difference between general practice and family practice. That’s understandable. These two branches of medicine have so many similarities and overlaps that it can be tough to tell them apart. As we age, choosing the right type of doctor becomes more important. For patients managing chronic conditions or looking for whole-person care in either Original Medicare or Medicare Advantage plans, IntraCare has doctors who can meet your unique needs. Are general practice and family medicine providers the same as primary care providers (PCPs)? According to the American Academy of General Physicians, general medicine providers (also called general practice) and family medicine providers are types of PCPs, that also includes internal medicine, and pediatrics. Let’s go over the differences of general physicians and family physicians. General physicians General physicians do not necessarily specialize in any one particular illness or disease. Instead, they focus on keeping you healthy as a whole. General medicine is especially important if you’re an adult patient who needs regular checkups, long-term care, or help managing multiple health issues. Provides overall care. Treats a wide range of health problems, from infections to chronic diseases like diabetes or high blood pressure. Manages complex or multiple conditions. Conducts Medicare Annual Wellness Visits for patients with Medicare Advantage plans. Refers patients to specialists if needed. Read more: Can a primary care physician treat diabetes? Family medicine: Care for all ages A family medicine doctor is also a PCP trained to care for people of all ages, from newborns to teenagers, adults, and seniors. Since families often include people of different ages, many prefer to choose one doctor who can care for everyone. Instead of seeing a separate specialist for each family member, a family medicine doctor offers a convenient, all-in-one solution. When children, parents, and grandparents all see the same doctor, that doctor gets to know the family’s health history, lifestyle, and environment. This deeper understanding can help spot health issues early and identify patterns that run in the family. Are trained in many areas, including child care, senior care, women’s health, mental health, and more. Diagnose, treat, and prevent both acute illnesses and long-term chronic conditions. Do minor surgical procedures like stitching up a cut, removing a skin lesion, or performing a biopsy on a suspicious-looking mole. May do home visits. Care for both physical and mental health. Build strong, lasting relationships with patients. Read more: 6 signs of a good doctor Click here to schedule an introductory visit with primary care doctors who understand senior patients’ needs Which doctor is right for you? As family medicine comes under the larger umbrella of general medicine, you can certainly see a family medicine doctor for your health needs. But you may also consider a doctor of internal medicine who has deeper experience with treating complex health conditions in older adults. When is family medicine preferable for senior adults? It depends on your health needs. A family medicine doctor should be able to provide excellent care if you: Value a long-term relationship with a provider who knows your family and lifestyle. Want continuous care across life stages, including mental and social support. Are mostly healthy and want someone to monitor your wellness from year to year. Want to continue with a provider you’ve been seeing for years already, long before you turned 65. Want help in managing one or two common chronic conditions, like high cholesterol or early-stage diabetes. When should a senior adult go for an internist? Internists have more in-depth knowledge of health conditions that specifically affect adults. You might want to see an internist if you: Have complex adult conditions, such as multiple serious chronic diseases. Are seeing one or more specialists, so need thorough and meticulous care coordination. Require frequent hospital care. Take multiple prescription drugs, over-the-counter medications, and other supplements, so need someone to be vigilant about your medication management and medication adherence. Click here to find internists in Texas Can’t decide? The two scenarios below may help in figuring out what kind of doctor you need. Scenario 1: Margaret, 66, Phoenix, AZ Has very mild arthritis and occasional insomnia. Takes ibuprofen now and then for pain relief. Been seeing her doctor for 25 years. Daughter and grandkids are patients of the same doctor. Margaret should do just fine with her family medicine doctor for the foreseeable future. Scenario 2: David, 72, Bedford, TX Has diabetes, hypertension, high cholesterol, and a stent in his right coronary artery. Had a stroke last year. Recently developed a strong case of Restless Legs Syndrome. Takes 7 different prescription drugs. David should see an internist experienced in delivering the specialized care he needs. How Medicare covers general medicine and family medicine Medicare-eligible adults enrolled in Original Medicare can get care from any PCP, general physician, family medicine doctor, or internist who accepts Medicare. Patients enrolled in Medicare Advantage (known as Medicare Part C plans, provided by private insurance companies) can receive care from any primary care provider, general physician, family medicine doctor, or internist who is a member of their plan’s provider network. Choosing the right doctor at IntraCare Health Centers IntraCare Health Centers across Arizona and Texas are staffed with skilled, board-certified and experienced primary care providers, general physicians, family medicine doctors, and internal medicine primary care doctors who provide whole-person healthcare designed specifically for older adults. Our doctors don’t just treat problems; they help prevent them with early diagnosis, regular check-ups, medication reviews, and lifestyle support to keep you healthy and independent. We proudly help seniors in Texas and Arizona enrolled in Original Medicare (Parts A and B) or Medicare Advantage (Part C) plans stay strong, active, and in control of your health. Find the right doctor near you Browse our provider directory to connect with top-rated primary care physicians, internists, and family medicine doctors. Learn more about our services, from chronic disease management and wellness programs to Medicare guidance and ongoing care. Find

Blood pressure is one of the most important indicators of health, especially as you get older. It is a window into how efficiently your heart is pumping blood through your body. For individuals 65 years and up, knowing your blood pressure numbers and keeping them within a healthy range supports brain, heart, and kidney health as you age. At IntraCare Health Centers, many of our patients and their families ask questions like: “What is normal blood pressure for people over 60?” or “What is a normal blood pressure range for a 70-year-old?” Our care providers take a proactive approach to heart health and aging well, so let’s dive into these questions and more, below. Click here to find the right doctors for blood pressure management in Arizona and Texas What is blood pressure? Blood pressure is the force at which circulating blood pushes against the walls of your arteries. It is recorded with two numbers: Systolic pressure: The top number which measures pressure during a heartbeat. When the heart pumps, pressure rises, so this number is larger. Diastolic pressure: The bottom number which measures the pressure between beats, when the heart is at rest. As the heart takes a break, the pressure falls, so this number is smaller. For example, a blood pressure reading of 120/80 means the systolic pressure is 120, and the diastolic pressure is 80. What is normal blood pressure? Know your numbers! According to the American Heart Association and most major medical guidelines: Normal: Less than 120/80 Elevated: 120-129 systolic and less than 80 diastolic Stage 1 Hypertension: 130-139 systolic or 80-89 diastolic Stage 2 Hypertension: 140 or higher systolic or 90 or higher diastolic Hypertensive Crisis: Over 180 systolic and/or over 120 diastolic. In this case, emergency care is needed Reasons why blood pressure fluctuates Aging stiffens our blood vessels, which affects the force at which blood moves along inside them. Other reasons blood pressure may go up or down are: Your heart isn’t pumping as strongly. A side effect of medications. You’re not drinking enough water. Water keeps blood volume at a certain level. When blood volume falls because of dehydration, blood pressure also falls. Neurological illnesses such as Parkinson’s disease, chronic diseases like diabetes, and other health conditions like poor thyroid function. For these reasons, the definition of “normal” can vary slightly with age and overall health. Click here to explore chronic condition management at IntraCare Health Centers Age-based blood pressure guidelines Blood pressure doesn’t vary too much simply based on age, but here are some numbers to keep in mind. Age-Based Blood Pressure Question Recommended Blood Pressure Range What is normal blood pressure for a 60-year-old? For healthy adults in their 60s, a target of below 130/80 is ideal. But readings may occasionally be slightly higher, depending on other medical conditions. What is normal blood pressure for a 70-year-old? Many healthcare providers recommend 140/90 for people in their 70s. What should an 80-year-old’s blood pressure be? For those in their 80s, the focus often shifts to avoiding low blood pressure (hypotension). A range of 130–145 systolic and 70–90 diastolic is usually safe. Blood pressure for 90-year-old women (and men) In the 90s, the ideal blood pressure is often 140–150 systolic and 70–90 diastolic, particularly if there are no signs of dizziness or fatigue.   Important: These numbers are general guidelines. Your target may be different based on your health history, medications, and risk factors. How can you tell if your blood pressure is off? The most accurate way to tell is by measuring with a blood pressure monitor to know your exact numbers. However, your body often gives warning signs when things aren’t right. Symptoms of high blood pressure, or hypertension: Headaches, especially in the morning Blurred or double vision Dizziness or confusion Shortness of breath Chest discomfort Nosebleeds (in severe cases) Symptoms of low blood pressure, or hypotension: Dizziness or fainting, especially when standing up quickly Falling down Blurry vision Fatigue or weakness Cold, clammy skin Confusion, especially in older adults How to stay safe when your blood pressure rises, or falls If your blood pressure is too high: Stay calm and sit down. Stress can make readings go even higher. Avoid salty food, caffeine, and alcohol. Take your prescribed medication if you’ve missed a dose. Check again in 15 to 30 minutes. Call your provider if it’s above 180/120 or you have any of the symptoms listed above. If your blood pressure is too low: Lie down and raise your feet slightly above heart level. This lets blood flow back to the heart more easily. Drink water. Thickened blood is a common cause of low pressure. Avoid suddenly standing or bending. Eat small, frequent meals. Notify your doctor if it happens regularly or causes any of the symptoms noted above. Discover how you can eat your way to better cholesterol When to contact your care provider You should call your doctor if: Your readings are consistently over 130/80. You feel dizzy or faint. It’s hard to breathe without gasping. Shortness of breath feels like you can’t get enough air into your lungs. Your feet swell. When blood doesn’t have enough pressure to circulate, it starts to pool in your lower legs and feet. How to keep your blood pressure stable: 9 lifestyle tips The foods you eat, what you drink, and how much you exercise play a big role in keeping blood pressure under control. Here are 9 lifestyle tips to ensure your blood pressure stays within healthy numbers. Dine DASH (Dietary Approaches to Stop Hypertension) Healthy Food Categories & Examples Fruits and vegetables: Both raw and cooked. Whole grains: Whole wheat bread and pasta, brown rice, quinoa, and oatmeal. Healthy fats: Olive and canola oils, all kinds of nuts and seeds. Unprocessed lean meats: Skinless chicken breast, white-fleshed fish (cod, bass, halibut). Keep red meat to a minimum. Non-meat proteins: Beans, cottage cheese, and Greek yogurt. Move every day Even light activity like walking, gardening, or seated exercises can improve

Maximizing your doctor’s visit, especially during a general check-up or a health evaluation such as your Medicare Annual Wellness Visit, starts with asking the right questions. One efficient way to do that is to know beforehand exactly what to ask an internal medicine doctor or primary care physician. Read more: The meaning of Value-based Care Why asking the right questions matters Around 2 in every 5 senior adults leave their doctor’s appointment feeling unheard. Their concerns remain unaddressed, or symptoms are overlooked, often because the doctor is in a hurry to complete the appointment, or sometimes because the patient gets sidetracked with talking about another problem. This is a problem that can be easily avoided if patients come prepared with a checklist of key questions. Whether it’s your first appointment with an internist or a routine check-up, having an internist visit checklist of key questions helps you: ✅ Stay informed about your health status ✅ Understand treatment options and medication side effects ✅ Prevent complications from existing conditions ✅ Optimize Medicare benefits for necessary tests and therapies Read more: How to find a good doctor you can trust in Texas The most important questions to ask your care provider Here are 4 important questions you should ask your internal medicine doctor to keep your health on track. Question 1: I’m [your age] years old. Based on my age and the state of my health, what preventative screenings or tests should I get? Preventative screenings may help catch potential chronic diseases early enough for your doctor to figure out care plans to treat or manage them effectively. All senior adults aged 65 years and older with Medicare Part B, or a Medicare Advantage plan are entitled to free annual screenings for several health conditions. Every patient should avail this benefit, especially for: Diabetes Chronic heart failure (CHF) and other cardiovascular issues Cancer Bone density to check for osteoporosis Depression and other mental health concerns Glaucoma and other eye problems Pro tip: Always ask if there is a new test or screening recommended for your age group since your last visit. Medicare often modifies the benefits patients receive from year to year, so a new screening might have been added since the last time you got checked. Follow-up questions: How should I prepare for the screening or test? Should I eat or not? Take my meds or not? What else should I keep in mind? Looking for a primary care physician in Arizona? Question 2: What non-medication methods are there to manage my chronic conditions? According to research, 9 out of 10 senior adults have at least one chronic condition, while nearly 3 out of 4 have two or more comorbidities or multi-morbidities. The most frequent combinations of chronic conditions include hypertension, high cholesterol, arthritis, and the root of most problems — obesity. Treatment plans for chronic conditions often include prescription medications. With multiple illnesses requiring different kinds of medication, there is a risk of drugs reacting negatively with each other. Ask your doctor if there’s a way to cut down dependence on drugs and treat chronic conditions with a combination of diet, exercise, and other lifestyle changes. Sometimes, a little knowledge and adjustment can make a huge difference. For example, did you know that losing as little as 10% of excess weight can have a significant impact on bringing blood sugar under control? Pro tip: Maintain a list of your chronic conditions and the medications you take for each, as well as any vitamin or herbal supplements, and over-the-counter meds. Bring this list to every doctor’s appointment in case your internist decides to add or subtract a medication. Having all your meds listed in one place makes it easier to cross-check for potential negative interactions. Follow-up questions: Have any new medications or therapies become available since my last visit? Can we go through my list of meds and cut out any that are not absolutely necessary? Read more: How to read the label of a prescription pill bottle Question 3: Are there any warning signs or symptoms I should tell you about immediately? With senior adults, new and unexpected changes can crop up on a regular basis. So it’s understandable that you might not pay much attention to an unfamiliar spot that appeared on your hand this morning. Or, even though you’ve noticed you’re wheezing a bit more lately, you dismiss it as just ‘one of those things’. Ask your doctor for a comprehensive list of symptoms and warning signs that you need to watch out for. For instance: Chest pain — this could signal a possible heart attack Can’t move one side of your mouth — could be stroke Feeling dizzy or sleepy — could be dehydration or hypotension Sudden, severe shortness of breath — could be heart or lung issues Spots or moles — could signal melanoma Blood in your underwear — even if it’s a barely noticeable dot, tell your doctor at once. It could indicate anything from hemorrhoids to colon cancer Pro tip: Ask if your provider offers Remote Patient Monitoring services that can keep an eye on you 24/7 and will send an alert to the care staff in case your readings go off-track. Follow-up questions: What warrants an emergency room visit as opposed to ‘watchful waiting’ and scheduling an urgent visit with you? Do you offer after-hours telehealth for urgent concerns? What should I do if something happens on a weekend? Read more: Heatstroke can happen in minutes, hours, or slowly over several days Question 4: How can I improve my overall health before my next visit? If there’s anything good doctors appreciate, it’s a patient who works with them to maintain their health goals. Patients who are eager and willing to listen to their doctor, follow instructions, practice medication adherence, and stick to diet and exercise plans stand a much higher chance of keeping their health under control and staying out of the hospital. Pro tip: Visit your local senior center, fitness center, health club, gym, or

When trying to figure out what kind of doctor they should see, many people ask ‘what is an internal medicine doctor’ or ‘what does internal medicine mean?’ For senior adults enrolled in a Medicare plan, knowing what an internal medicine doctor does can help in choosing the right care provider for their unique needs. Let’s go into what an internal medicine physician is, what differentiates them from other kinds of primary care providers, and the role an internal medicine specialist plays in the healthcare of senior adults, especially those enrolled in Original Medicare or Medicare Advantage plans. Click here for internists in Arizona What is a doctor of internal medicine An internal medicine doctor, also known as an internal medicine physician or internist, is a doctor who helps prevent, diagnose, and treat diseases in adults. Internists are primary care physicians who manage a wide range of health conditions, from common illnesses to chronic diseases that frequently affect adults, such as diabetes, hypertension, and heart failure. They provide preventative care including screenings, immunizations, and lifestyle counselling. They also educate patients about their health and treatment options available to them. Internists coordinate care with other specialists when needed, and oversee care transitions from hospital to home (or rehabilitation facility). Read more: Why does falling down send 1 in 4 senior Americans to the hospital What does internal medicine mean? The term ‘internal medicine’ refers to the areas that physicians focus on in this medical specialty. An internist treats diseases of the internal organs, such as the heart, lungs, liver, and kidneys. Internal medicine specialists use scientific knowledge and clinical expertise to diagnose, treat, prevent illnesses in, and provide comprehensive care to adults. Internists often serve as primary care providers for senior adults aged 65 years and above. Internists do not provide surgical or pediatric care. Related read: What can your internist discover from your fingernails The difference between an internal medicine doctor and a family doctor Internists and family doctors can both serve as primary care physicians, but their training, focus, and scope of practical experience differ. Internists Specialize in adult medicine only Treat patients aged 18 years and over Often have specialist knowledge of complex, chronic, or multisystem adult diseases Are trained in hospital and outpatient adult care Family doctors Treat patients of all ages, from babies to geriatrics The same doctor often treats all members of the family Have broad knowledge of diseases that affect people at large Looking for an internist in Dallas, TX? Examples of internal medicine Internal medicine covers a vast array of conditions and subspecialties in geriatrics, including: Chronic Conditions Specialty Areas Heart disease (cardiology) Cancer (oncology) Diabetes and thyroid disorders (endocrinology) Blood disorders (hematology) Lung diseases like COPD and asthma (pulmonology) Infectious diseases (such as pneumonia or sepsis) Arthritis and autoimmune conditions (rheumatology) Digestive disorders (gastroenterology) Kidney disease (nephrology) What does an internist do? As your primary care provider, your internal medicine doctor is responsible for maintaining your health at a consistent level. They do so with: Medicare Annual Wellness Visits Your Medicare Annual Wellness Visit is a once-in-a-year visit to your doctor to evaluate your general wellness and well-being. It’s important because it gives your primary care physician a lot of the information they need to create a health and well-being plan specifically for you. Your internist will schedule your Medicare Annual Wellness visit, send reminders when you’re due for a visit, and update your records as needed. Preventive screenings covered by Original Medicare and Medicare Advantage Patients enrolled in Original Medicare (also known as Part A and Part B) and Medicare Advantage (also known as Part C) are eligible for several preventative screenings. These are cautionary check-ups that look for potential illnesses and diseases. Catching such a disease early makes it possible to create better, more effective treatment plans. Senior adults are at risk of developing certain diseases with increasing age. Your internist will regularly evaluate your chances of getting such an illness and recommend relevant screenings at the necessary time. Manage chronic conditions It is quite common for senior adults to have one or more than one chronic condition, such as diabetes or COPD. Your internist will keep an eye on your condition, monitor and track its progression, prescribe appropriate medication, create diet and nutrition plans, design exercise plans, and/or refer you to a specialist if needed. Monitor your health Your internist will keep an eye on your blood pressure, cholesterol, and blood sugar levels. In certain cases, they might use Remote Patient Monitoring, which lets care providers watch out for you when you can’t visit the clinic. Review and update your medications Patients dealing with multiple health conditions may need to take several different kinds of medications. Some drugs may be prescribed by your primary care provider, some by your specialists. As the main healthcare professional responsible for you, your internal medicine doctor will keep track of all your meds and also watch for possible interactions between different drugs. Coordinate your care Internists often have thorough knowledge of illnesses and diseases common among their patients. However, if your health condition is at an advanced stage, they may want you to see a specialist. Your internist may also direct you to mental health professionals if they see signs of depression or other mental health conditions. As your PCP, your internist will coordinate your care between all your specialist doctors and make sure your health records are kept up to date. Provide vaccinations and immunizations Internal medicine doctors will ensure you are up to date with all your vaccinations and flu shots. Encourage you to conduct annual benefits reviews Medicare offers several benefits for patients with certain health issues. These benefits are revised and updated regularly and can be very helpful for patients with limited finances, limited mobility, and other difficult circumstances. For guidance and help with Medicare benefits for Chronic Condition Special Needs Plans (C-SNPs), call our Patient Relations Team today at 800-941-1106 I’m looking for an internist near me. What

There can be many reasons why you might want to change your primary care physician. For Medicare beneficiaries, especially, understanding when and how to make the switch is key to maintaining continuous, high-quality care. Below, we walk through: How to switch Medicare primary care doctors How often can you change your primary care physician And when it comes to other people like you, how often do patients change doctors Why do people change primary care doctors? Changing primary care doctors is more common than you might think. According to one survey, around 4 out of 10 patients switch care providers over time. The more frequent reasons include: Your health needs have changed Aging changes your body in many, and often surprising, ways. There are new aches and pains, new chronic conditions, and existing health conditions may grow worse. Because of this, you might need a doctor who is more knowledgeable and experienced in treating your new conditions, or is a specialist in your pre-existing chronic disease. Many senior adults might also switch to a geriatrician. These are doctors who specialize in procedures, practices, and treatments that serve the very specific needs of older adults. Read more: What is geriatric care and why is it important Your Medicare plan has changed Shake-ups in healthcare plans, especially in Medicare Advantage (also known as Part C and provided by private insurance companies) are commonplace. Care providers may decide not to renew contracts with insurance providers, which means they will no longer accept your insurance. In such a case, you would have to choose between switching doctors, or switching your healthcare plan. What you should know about Medicare Advantage Open Enrollment Period You’ve moved Moving to a new area, say from Arizona to Texas, would make it necessary to find a more accessible doctor, within a reasonable distance from your new home. Your current doctor has retired Sometimes it’s not a patient’s choice, but a necessity if your doctor is the one stepping away. Doctors may change workplaces, move away, or retire. In this case, you must find a new provider, whether you are ready for the switch or not. It’s just not working out If you have started seeing a new doctor recently, you’re probably still in the process of evaluating them. Are you happy with the way they communicate? Do you feel heard? Do you have confidence in the doctor’s ability to provide satisfactory care? Are you comfortable with the wait times at the clinic? Ideally, you want a doctor you can keep seeing for as long as possible, because a long and satisfactory patient-provider relationship makes a strong foundation for good continuity of care. Some patients can figure out if they click with their doctor or not during their very first appointment. Others might need a few more visits. Either way, both have the freedom to continue meeting new physicians until they are satisfied. Worried about making the switch? Some common concerns You may be apprehensive about changing your care provider, especially if you’ve been seeing them for a long time. You may worry you will ‘upset’ your doctor, or that it’s rude, or that you’re doubting their capabilities. These feelings are common. However, your own health and comfort are the priority here, and a good doctor should understand that. If your current doctor gets upset that you don’t want to see them anymore, that’s a red flag, because responsible care professionals understand that patients’ needs evolve, and your decision to switch is about your well-being, not a personal affront to them. Do I have to give reasons or explanations for switching doctors? If you feel you must explain your decision to soothe your doctor’s hurt feelings, then no. There is no need to do that. On the other hand, your current doctor may be able to help with suggestions and recommendations if they know why you’re switching. For instance, if your COPD is worsening, they may guide you toward another doctor who is more experienced in the treatment and care of the disease. Learn more: What is Chronic Obstructive Pulmonary Disease (COPD) Can my current care provider cause any problems if I move to another doctor? Some senior patients worry that their current care provider may not transfer their health records to the new provider, but HIPAA gives you the right to transfer your medical records. Under the Health Insurance Portability and Accountability Act (HIPAA), you have the lawful right to access and transfer your medical records whenever you want, to whichever care provider you want. Transferring medical records to a new physician is necessary to ensure continuity of care. As a standard procedure, your records are usually transferred to your new doctor within 30 days of requesting them. Brush up on Your rights as a patient How often can you change your primary care physician? You can switch doctors as often as you need to, or whenever you want to. On Original Medicare: You can see any doctor who accepts assignment. There’s no need to notify anyone when switching. On Medicare Advantage: You can only see doctors in your plan’s network. Before switching, check your plan’s provider directory or contact your insurer, or you may have to deal with high out-of-pocket costs. You may also need to update your PCP selection with the plan. What’s the downside of switching doctors too often? Even though there’s no limit to how often you can switch doctors, it’s not advisable. Seeing the same doctor for long helps establish good continuity of care. Frequent switches can make it harder for any doctor to get a full picture of your health history, whereas having one provider who really knows your medical history is one of the best ways to catch problems early and manage chronic illness better. Step-by-step: How to change your Medicare primary care doctor Changing doctors is a serious decision because establishing trust with a new care provider may take time. Here are the 10 steps, in sequence, to help you

The difference between PCP and internal medicine might seem small, but for senior adults enrolled in Original Medicare or Medicare Advantage plans, it can sometimes mean the difference between routine care and specialized support. What’s the difference between internal medicine and primary care? Both a PCP and an internist can manage your regular healthcare needs. But they come from slightly different medical backgrounds and focus on different things. Primary care vs internal medicine at a glance Feature Primary Care Doctor (PCP) Internal Medicine Doctor Treats adults Yes Yes Treats children Yes (if trained in family medicine) No Focuses on geriatric care Often Yes Treats complex conditions Yes Yes Provides preventative care Yes Yes Manages hospital care Sometimes Always Coordinates care Yes Yes Find a PCP in Arizona or Texas Most internists are PCPs, but not every PCP is an internist because, as you can see from the table, some PCPs specialize in treating children. At IntraCare Health Centers, we discuss the choice in detail with our senior adult patients and/or their caregivers, to help them determine which kind of care provider would best suit the patient’s needs. Read more: How to find a doctor in your area you can trust Do you need a PCP or an internist? If you’re 65 years of age or older and managing one more multiple chronic conditions, choosing the right type of doctor may help you stay healthier, reduce the frequency of hospital visits, and allow you to make the most of your Medicare plan. Let’s walk through the real distinctions between a primary care physician or primary care provider (PCP) and an internal medicine doctor (internist), and learn how to decide which one best suits your needs. Primary care physicians (PCP) A primary care physician is generally every person’s main point of contact for nearly all healthcare needs that aren’t urgent or life-threatening. PCPs provide a number of services to patients of all ages, from children to adults. For senior adults, the services of a PCP may include: Performing check-ups and Medicare-recommended health screenings Managing long-term conditions like high blood pressure, diabetes, arthritis, and heart disease Treating short-term illnesses like infections Cleaning, treating, and dressing minor injuries Performing necessary vaccinations Coordinating specialist referrals Tracking your medications and health goals Conducting Medicare Annual Wellness Visits PCPs may be trained in family medicine, internal medicine, or even geriatric care. Read more: 5 immunizations you should get after age 65 Internal medicine doctor (internist) Internal medicine doctors are called that because their area of expertise is the internal organs and their care. Internal medicine doctors focus on adult medicine, and their patients are typically aged 18 years and up. But they’re especially valued for treating older, senior adults with complex, chronic conditions. Internists: Provide all or many of the same services that PCPs do Are trained to handle multiple co-existing illnesses and health problems Often coordinate care during hospital stays Specialize in the prevention, diagnosis, and treatment of diseases in adults Typically do not treat children or pregnant women Remember: Doctors of internal medicine are usually PCPs, but not all PCPs are internists Is an intern and internist the same thing? No. Interns are recent medical school graduates in their first year of residency training. They cannot practice unsupervised. Internists are qualified physicians who have completed their residency training. They are licensed to practice medicine and may be board-certified. Read more: 6 signs of a good doctor When to choose a PCP A universal primary care doctor may be ideal if you: Are mostly healthy and want someone to monitor your wellness from year to year Need guidance on Medicare-covered preventive screenings Want to continue with a provider you’ve been seeing for years already, long before you turned 65 Want help managing one or two chronic conditions, like high cholesterol or early-stage diabetes Related read: What to expect at your FREE Medicare Annual Wellness Visit When to choose an internist Consider choosing an internal medicine doctor if you: Have multiple chronic illnesses, such as diabetes, congestive heart failure, and COPD Are taking several medications that need careful coordination Have had recent hospital stays and need follow-up care Want a provider with deep expertise in managing complex adult health problems Read more: What does the label on your bottle of prescription medication mean? Why this choice matters more as you age As we get older, our bodies don’t bounce back from illnesses, diseases, and viruses like they used to. Medications can interact differently with each other, or with supplements, or with certain foods. Illnesses show up in unexpected ways. And we’re more likely to have overlapping conditions that affect each other. Choosing the right type of doctor means: Your healthcare is better coordinated across multiple care providers You are at lower risk of hospitalization Any illnesses, current or potential, stand a better chance of being properly diagnosed You are able to manage medications more effectively You get personalized care plans based on your age, goals, and Medicare plan Useful read: Brush up on the best vitamins for seniors over 65 How Medicare covers PCPs vs internists Original Medicare (the standard government plan, also known as Part A and Part B) considers both PCPs and internists eligible for coverage as long as they are properly credentialed and accept assignment. Most Medicare Advantage (also known as Part C, and usually provided by private health insurance companies) plans do not differentiate between PCPs and internists either. All you need to do is make sure your provider is included in your healthcare plan’s coverage network. What is covered under Original Medicare and Medicare Advantage plans Whether you are seeing a primary care physician or internal medicine doctor, you will likely be covered for: Medicare Annual Wellness Visits Chronic care management Preventative screenings for diabetes, breast cancer, prostate cancer Medicare reviews Referrals to specialist consultants Coordinated care Read more: Understanding Medicare Enrollment periods, renewals, and re-enrollment The IntraCare difference: Coordinated, compassionate care At IntraCare, we place a lot of emphasis on

Wondering if your primary care doctor can help manage your diabetes? For seniors in Texas and Arizona, they may be your best long-term partner in care. Learn how PCPs support diabetes treatment and how Medicare covers key services. How PCPs help manage diabetes If you’re asking, “Can a primary care doctor treat diabetes?”, the answer is yes. Primary care providers can definitely help with the treatment and management of diabetes mellitus, also known as type 2 diabetes. In fact, for senior adults aged 65 years and above, especially those enrolled in Original Medicare or Medicare Advantage plans, your primary care doctor is often the best person to help manage your diabetes. Why? Because a good primary care provider offers continuous, personalized care, helps you navigate Medicare-covered services, and coordinates with specialists when needed. In other words, they’re your quarterback in the game of long-term health. Let’s walk through why your primary care provider, or PCP, is fully equipped to help you manage diabetes, and how you can make the most of that relationship. Click here to find diabetes doctors in Arizona What is diabetes management? Before we dive into the role of your primary care doctor, let’s talk about what managing diabetes really means. At present, around 1 in 8 Americans has diabetes. When looking at people aged 65 and above, the number jumps to 1 in 4. As a result, diabetes is the eighth leading cause of death in the US Whether you’ve been diagnosed with type 2 diabetes, type 1 diabetes, or prediabetes, ongoing management of the chronic condition is essential. That includes: Regular blood sugar monitoring Lifestyle changes like diet and exercise Medications or insulin therapy Routine screenings for complications (eye exams, foot checks, kidney function tests) Managing other chronic conditions like high blood pressure or cholesterol That’s a lot of things to keep track of, but for convenient, consistent care, your PCP may be your best long-term partner in managing diabetes. Click here to find diabetes doctors in Texas How PCPs help manage diabetes Your primary care provider spent years in medical school training in internal medicine or family medicine, both of which include chronic disease management. For most senior adults with type 2 diabetes, which is the most common form of this chronic illness, primary care is often all you need for effective, long-term management. Your primary care provider is likely qualified and trained to: Diagnose diabetes based on lab results Start you on medications like metformin Order A1C tests, cholesterol checks, and kidney function tests Help you set realistic goals for blood sugar, diet, and activity Screen for complications like neuropathy or retinopathy If you’re stable and your numbers are good, you may never need an endocrinology specialist. But if things get more complicated, your primary care physician can bring in reinforcements. What is an A1C test?An A1C test, also known as a hemoglobin A1C (HbA1C) test, is a blood test that measures your average blood sugar levels over a period of two to three months. It helps to determine if you have diabetes or are prediabetic. If you are already diagnosed with diabetes, the test can help identify if you’re successfully controlling your blood sugar levels. How to read A1C levels – Below 5.7 — Normal – 5.7-6.4 — Prediabetes – 6.5 or higher — Diabetes When do you need an endocrinologist? Most people with type 2 diabetes can go years, or even forever, without needing an endocrinologist. But your primary care physician might want to refer you to an endocrinologist if you have: Difficulty controlling blood sugar despite taking meds regularly and according to doctor’s instructions Frequent episodes of hypoglycemia, or low blood sugar Complications affecting your eyes, nerves, or kidneys Even when an endocrinologist takes charge of your diabetes care, your primary care provider stays in the loop, kind of like a project manager for your health, making sure all the pieces of your healthcare fit together. Diabetes management for seniors: Why primary care matters more than ever As we age, managing diabetes becomes more complex. You may also be simultaneously juggling other health conditions like arthritis, high blood pressure, or heart disease. Your primary care physician is uniquely qualified to see the big picture. In fact, studies show that people with diabetes who regularly see a primary care doctor have better blood sugar control and fewer complications over time. Senior adults may benefit even more, because as your long-term care provider, your doctor: Knows how diabetes interacts with age-related health issues Will tailor your treatment goals based on your age, lifestyle, and other conditions Will monitor for medication side effects and drug interactions Will help you avoid unnecessary referrals, tests, or hospital visits Helpful read: What happens if you don’t pay a hospital bill Medicare and diabetes: What’s covered Here’s where things get really practical. Both Original Medicare (Parts A and B) and Medicare Advantage (Part C) plans cover a wide range of diabetes-related services. Your primary care doctor is your main point of contact to help you access them. Here’s what’s typically covered, and how your physician fits in: Service What it does How your PCP helps Medicare Annual Wellness Visit Reviews your health status and risks Creates a personalized preventative care plan Diabetes screenings Detects prediabetes or undiagnosed diabetes Orders blood sugar and A1C tests Medical Nutrition Therapy (MNT) Personalized counseling from a registered dietitian Refers you for covered sessions Diabetes Self-Management Training (DSMT) Education on meal planning, activity, monitoring Orders DSMT and monitors your progress Foot exams Checks for nerve damage or ulcers Performs basic exams, refers to podiatrist if needed Eye exams Screens for diabetic retinopathy Refers to ophthalmologist and follows up Therapeutic shoes Help prevent ulcers and foot damage Certifies medical need for footwear Lifestyle support from your PCP Lifestyle changes are easier said than done, especially when mobility is an issue or cooking healthy meals feels like a chore. But your doctor won’t just hand you a pamphlet and send you on your