Tip Sheet: Black/African American Older Adults: A Guide To Managing Your Health

High blood pressure, heart failure, diabetes, obesity, smoking, and lack of physical activity increase your risk for having a heart attack or stroke. If you have chest pain and/or shortness of breath, you might be having a heart attack. If so, you need to be evaluated in the nearest emergency room. Strokes occur when blood supply to the brain is blocked or stopped. Brain cells can die within minutes.

Eating foods low in fat and getting daily exercise can reduce the chances of having heart disease, strokes and/or heart failure. Talk to your healthcare provider about eating healthy eating, decreasing salt and fat in your diet, exercising, quitting smoking, controlling blood pressure, and taking recommended medications. Following these instructions can reduce your chance of having or improve symptoms of heart disease, strokes, and heart failure.

Diabetes is a serious disease that causes high blood sugar levels. Having diabetes for a long time leads to other health problems. If diabetes is not controlled, this disease can damage your eyes, kidneys, and heart.  Being overweight or obese, eating certain foods like fried foods, burgers, and fries, drinking juices and soda/pop, and doing little or no exercise can cause or make diabetes worse.

Talk with your healthcare provider about a healthier diet, exercise, and medications. Some healthy diet tips include decreasing carbohydrates in your diet like white bread and pasta, eating more vegetables, drinking water (preferred) or sugar-free beverages, and eating low calorie foods.  Try to increase your exercise to 30 minutes per day five days a week. Your healthcare provider will check your blood sugar, blood pressure, cholesterol, and kidney function. 

If you have diabetes, check your feet daily and report any skin breakdown to your healthcare provider immediately. You should have your eyes checked every 1 to 2 years.

Eating more food than your body needs leads to being overweight or obese. Diets high in fats, carbohydrates like pies and cookies, sodas and sugary drinks, fried soul food, and rich gravies cause people to gain weight. It can be hard to afford healthy foods. Little or no exercise, sleep problems, and poor eating habits lead to weight gain. Being overweight or obese can lead to diabetes, high blood pressure, high cholesterol, stroke, heart disease, sleep apnea, and even cancer.  Obesity can make breathing worse and cause more arthritis pain, making it harder to walk.  

Some ways to lose weight are to stop drinking soda/pop, decrease fried foods, decrease your food intake by 500 calories each day, and eat more fruits and vegetables. Walking for 30 minutes a day, five days a week is recommended. Resistance exercises such as lifting weights are important to avoid muscle loss. You could join a silver sneakers exercise program. Some insurance programs will cover this exercise program. A physical therapist can create a good exercise plan with you. Free exercise videos can be found on the internet that can help you develop an exercise program at home. Talk to your healthcare provider about ways to lose weight and improve your fitness and quality of life. A dietitian, a person trained in healthy nutrition, can evaluate what you usually eat and help you create a healthier diet.

Tobacco contains chemicals that are bad for your health. Smoking can cause cancer, lung disease, high blood pressure, and strokes. Smoking marijuana can cause the heart to beat faster and increases blood pressure. When you smoke around your family and friends, they breathe in your smoke and can get health problems from second-hand smoke. Children who live with people who smoke can develop asthma. E-cigarettes (vaping) and smokeless tobacco (chewing gum, snuff tobacco) also cause serious health problems.

Stopping smoking is very important. People in their 80’s and 90’s still benefit from quitting smoking. Nicotine is addictive and it can be hard to stop. Your healthcare provider and pharmacists can discuss ways to successfully quit smoking. For some people, support groups are helpful. 1-800-QUIT-NOW is a toll-free number operated by the National Cancer Institute that will connect you directly to your state’s tobacco quit line support system. Medications also are available to help you stop smoking.

Asthma, chronic obstructive pulmonary disease (COPD), emphysema, chronic bronchitis, and sleep apnea are common in Black/African Americans. Smoking is the most common cause of breathing disorders. If you smoke, the best thing you can do is to quit and stay away from people who are smoking. Air pollutants can make your breathing worse also. Medications and exercise can improve your breathing. Healthcare providers and pharmacists can show you how to use your inhalers correctly.

Black/African American people are more likely to die from cancer than other racial and ethnic groups. These deaths are due to many reasons including limited access to healthcare and high costs, lack of cancer screenings, and health disparities (health differences between different groups of people). Breast, lung, prostate, and colon cancers are the most common.

Limiting alcohol use, stopping smoking, and eating a diet low in salt and fat can decrease your risk of getting cancer. Discovering cancer early also leads to better outcomes. Sometimes waiting too long to discuss new symptoms with a healthcare provider makes disease more difficult to treat. By then, the cancer might be worse and more advanced. 

During clinic visits, your healthcare provider can screen for cancer and detect it earlier. Please make an appointment with your healthcare provider as soon as possible, especially if you feel a lump in your breast or develop new shortness of breath or an ongoing cough.

Depression and severe sadness are not caused by getting older. These symptoms can be due to chemical imbalances in your brain. Depression is a serious health condition and can lead to other health problems. For some older adults, sadness is not the main symptom. Depressive symptoms can include feeling tired or irritable, lacking interest in hobbies and activities you used to enjoy, having trouble sleeping or sleeping too long, and having a poor appetite. Confusion and problems with thinking can be due to depression and might look like Alzheimer’s disease.

If you have depressive symptoms, especially if you have thoughts of hurting yourself or others, talk to your healthcare provider who can recommend counseling and medications. Family members and friends can support you when you are depressed. 

Sometimes shame and stigma prevent Black/African Americans from seeking mental health care.  These illnesses are diseases like heart or lung diseases and need to be treated. Medications and behavior therapy are very effective and can help you feel better.  

Memory loss and dementia are not a normal part of aging. Alzheimer’s disease and vascular dementia are the most common types of dementia.  Diabetes, high blood pressure, obesity, high cholesterol, depression, smoking, hearing loss, and little or no exercise can increase your risk of developing dementia. 

In the beginning, people forget things that happened within the last week or month, known as short-term memory loss. They also ask the same questions over and over. However, their long-term memory can still be very good. Older adults might forget about an upcoming doctor’s appointment but be able to tell great stories about growing up. As people’s memory gets worse, they have difficulty doing certain activities such as driving, taking their medications, and paying bills. As this dementia gets worse, some older adults have behavior changes.  Family members will need to help older adults with daily activities like eating, bathing, and dressing. 

If you notice that you or your loved ones show signs of worsening memory, talk to your healthcare provider.  Understanding dementia will help you be a better caregiver. Some treatments could slow memory loss. Many resources are available for this disease. Your healthcare provider and social workers are here to connect you to these treatments and resources.

Preventing or discovering disease early rather than waiting until the disease has caused damage to your body is best. At first, some diseases start with no symptoms, so you might not know you have the disease. Your healthcare provider has more information than your family and friends, so please seek medical advice early. Seeing your healthcare provider at least once a year will help identify diseases early so that they are easier to treat. Diseases identified early, especially cancers, can have better results. Your healthcare provider will discuss cancer screenings with you.

Some common screening tests are mammograms, prostate exams, and colonoscopies. Vaccinations including flu, pneumonia, shingles, and COVID-19 shots can prevent serious infections. If you are concerned about getting vaccinations, ask your healthcare provider for more information. Working with your healthcare provider will improve your health. Let your healthcare provider and pharmacists know if you take home remedies, herbal agents, vitamins, and supplements to make sure these therapies are safe to take with your other medications and treatments.

• If you have not seen your healthcare provider in a long time, try to schedule a longer appointment time.
• Come to appointments 30 minutes before the scheduled time.
• If you cannot come to your appointment, tell your healthcare providers as soon as possible.  

• Ask healthcare providers to explain everything you do not understand.
• Bring a family member or friend with you for support and to help remember health discussions. 
   

Share your cultural beliefs with your healthcare providers. Let your healthcare providers know if:

• You prefer a certain name to be used (for example your last name, first name, or nickname). 
• You fast on holy days or during Ramadan. Your medications might need to be changed during fasting.
• You prefer no direct eye contact, not to shake hands, or other customs that make you feel uncomfortable. 
• You have long-standing friends that are like family members, known as fictive kin. Tell your healthcare providers about these important people in your life and if you want them to be part of your family healthcare decision team.
• You take care of grandchildren.
• You believe your health problems are a punishment from God.
• You believe in the fate/will of God for your medical conditions.
• You believe your health condition is from something evil, such as voodoo or a hex.
• You plan to discuss your medical conditions with your religious leader.
• You have fears about the healthcare system including medications, vaccines, and costs. 
• You have not had previous long-term relationships with healthcare providers.
• You are concerned that the healthcare system might perform experiments on you without your consent.
• You have experienced racism or discrimination in previous medical care.
• You have trust concerns with the American health system.
• You do not want certain family members and fictive kin to know about your medical conditions.
• You want someone (family member, fictive kin, or friend) to make healthcare decisions for you.
• You are hesitant about discussing disability or end-of-life care.

Tell your healthcare providers if:

• You take traditional treatments such as herbs and supplements, as they can affect other medications.
• You use any home remedies to treat your health condition. 
• You use prayer to treat your health condition. 
• Spirits affect you in a good or bad way.
• You work with another healer such as a priest, minister, root doctor, or voodoo priest or priestess.

• Bring all your medications and supplements or a list of them to every appointment so your healthcare providers and pharmacists know what you are taking.
• Tell your healthcare providers about all your medications:
  • Why you take them.
  • How you take them.
  • If they help or not.
  • If they make you feel bad. 
  • If you have stopped or forget to take them.
  • If you cannot afford them.
• Describe any allergies you have.
   

• Problems with memory, bowel movements, urination, sleep, and sexual function are common in older adults. Talk to your healthcare providers so they can help you. These health problems often improve with treatment.

• An advance directive is a legal document that lets your healthcare provider know your wishes. This document describes how you want to be treated if you become very ill.  This document will improve the quality of health care you receive.
• A durable power of attorney for finances and health care are important. Ask your healthcare provider for more information.
• Completing these documents early will provide better care going forward. 
• These documents are used only when you cannot make your own decisions.  In this event, the person you named, such as a family member, fictive kin, or close friend, will make decisions for you.
• Discussions about these topics can be difficult.  Discussing your wishes with your family and fictive kin while you are feeling healthy can make the decision-making easier in the future.  These decisions can be changed at any time.
• You do not need to hire a lawyer to complete these forms.  Ask your healthcare provider for these forms.