As we grow older, maintaining health is often less about treating a single illness and more about managing several aspects of health at once. Pain, reduced mobility, poor sleep, digestive difficulties, anxiety, fatigue and other chronic symptoms may occur alongside conditions requiring conventional medical treatment.
For some older people, acupuncture may offer a gentle form of complementary care, particularly where the aim is to relieve symptoms, improve comfort and support quality of life.
Acupuncture does not replace medical diagnosis or treatment. Rather, it can form part of a wider programme of care alongside a person’s GP, geriatrician, nurses, physiotherapists and other healthcare professionals.
A complementary approach to geriatric care
Older people often have several medical conditions at the same time and may take a number of different medications. This can make the management of symptoms more complicated, particularly when medicines themselves produce unwanted effects.
Geriatric medicine therefore places considerable emphasis not only on treating disease, but also on maintaining mobility, independence, comfort, sleep, mood and overall quality of life.
This is an area in which acupuncture may have a useful complementary role.
Rather than attempting to treat the underlying medical conditions for which a person is receiving conventional care, acupuncture can sometimes be used to address particular symptoms that are affecting their day-to-day wellbeing.
These may include:
- chronic musculoskeletal pain and stiffness
- osteoarthritis and other painful conditions
- difficulties with sleep
- tension and anxiety
- headaches
- digestive discomfort
- some forms of chronic pain
- symptoms associated with reduced mobility
- general feelings of tension or physical discomfort
The evidence for acupuncture varies considerably between conditions, and it is important not to make claims beyond what the evidence supports. My approach is therefore to consider acupuncture as one possible component of an individual’s overall care, rather than as a replacement for established medical treatment.
Acupuncture and quality of life
For an older person, a relatively modest improvement in a symptom can sometimes have a significant effect on everyday life.
Persistent pain, for example, may make it difficult to walk comfortably, sleep well or participate in social activities. Poor sleep can contribute to tiredness and reduced resilience during the day. Digestive discomfort may affect appetite and enjoyment of food.
Consequently, the purpose of treatment is not necessarily to eliminate a particular diagnosis. Sometimes the more meaningful goal is simply to help a person feel more comfortable and function a little better in their daily life.
This is consistent with the broader philosophy of modern geriatric care, in which preserving function, independence and quality of life can be as important as treating disease itself.
A Chinese medicine perspective on ageing
Traditional Chinese medicine has its own way of understanding the changes that accompany ageing.
Classical Chinese medicine places particular importance on the gradual decline of the body’s reserves over the course of life. Concepts such as Qi, Blood, Yin and Yang, and the Kidney system are used to describe patterns of reduced vitality, weakness, dryness, stiffness, poor sleep and other changes that may become more apparent with advancing age.
These are concepts belonging to the traditional Chinese medical system and should not be confused with anatomical or physiological descriptions used in modern medicine.
One of the interesting features of Chinese medicine is that it does not regard ageing simply as a collection of separate diseases. Instead, the practitioner considers the person’s overall pattern of health: their constitution, symptoms, sleep, digestion, energy, emotional state and physical condition.
Treatment is then adapted to the individual rather than assuming that everyone with the same diagnosis should receive the same treatment.
Treatment for older and frail people
Acupuncture treatment for an older person should be adapted to their circumstances.
Someone who is frail, has limited mobility or is easily fatigued may require a different approach from a younger and otherwise healthy patient. Treatment may be shorter and gentler, and particular care needs to be taken with positioning and comfort.
The person’s medical history is also important. Existing illnesses, medications, anticoagulants, osteoporosis, fragile skin, impaired sensation and other factors may influence whether acupuncture is appropriate and how it should be administered.
Where necessary, treatment can be discussed with the person’s medical or nursing team. Good complementary care should fit comfortably within the person’s existing healthcare rather than operate separately from it.
Working alongside conventional medicine
I see acupuncture as complementary to, rather than competing with, conventional medicine.
A resident who is being cared for by a geriatrician should continue to receive appropriate medical assessment and treatment. Acupuncture should not be used to delay investigation of a new or potentially serious symptom, nor should prescribed medication be stopped or altered because of acupuncture treatment.
Instead, acupuncture may sometimes provide an additional means of addressing symptoms which remain troublesome despite conventional management, or where a person and their medical team feel that complementary treatment might be worthwhile.
For residential care, this collaborative approach is particularly important. Communication with the existing healthcare team helps ensure that treatment is appropriate to the individual’s circumstances and that any significant changes in their health are recognised promptly.
What might a course of treatment involve?
There is no standard acupuncture treatment for older people as a group.
I would first take time to understand the person’s principal concerns, medical history and current treatment. We can then identify realistic aims for acupuncture and decide whether treatment is appropriate.
Treatment itself is generally gentle. Depending on the individual, only a small number of acupuncture points may be used.
The response to treatment is also assessed rather than assuming that a predetermined number of sessions will be necessary. If there is no meaningful improvement in the symptoms being treated, I would reconsider whether continuing acupuncture is worthwhile.
For some people the most useful outcome may be a reduction in pain. For another person it may be improved sleep or greater ease of movement. In older adults, these apparently small changes can sometimes make a meaningful difference to everyday wellbeing.
An individual approach
Older people are not a homogeneous group. There is an enormous difference between a healthy and active person in their seventies and someone in their nineties living with frailty and several chronic conditions.
For this reason, I do not approach acupuncture for older people as a separate catalogue of diseases. I prefer to consider the individual: their medical circumstances, their symptoms, their level of function and, most importantly, what they themselves would like to improve.
Acupuncture cannot reverse the ageing process, and it cannot replace appropriate geriatric or medical care. But used carefully and within appropriate boundaries, it may provide another way of helping some older people manage troublesome symptoms and maintain comfort and quality of life.
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