Alternative medicine is "practices not taught in medical schools, not widely available in mainstream medicine, and not usually covered by medical insurance," explains Dr. Mladen Golubic, MD, Ph.D., a research physician at Cleveland Clinic whose work focuses, in part, on non-traditional medical therapies.

So many alternative practices-acupuncture, mega-doses of vitamins and minerals (orthomolecular therapy), biofeedback, aromatherapy, etc.-have moved into mainstream medicine, however, that it's become increasingly difficult to draw the line between good alternative and good mainstream medical practices. That's why, says Dr. Golubic, increasing numbers of physicians refer to it as complementary, integrative, or holistic medicine.

It's not just physicians who have recognized the health benefits many "alternative" therapies can provide. According to a study published in Journal of the American Geriatric Society, nearly one third of older Americans have discovered alternative medicine, too.

Pain management is a major reason most older adults cite for using alternative health care practices-such as acupuncture or guided imagery-says Dr. Golubic. "Mostly, they want to manage the chronic pain of rheumatic and arthritic disorders and lower back pain," he adds.

Maintenance of general health status, especially mental function, and management of urinary-prostate and post-menopausal symptoms are the reasons they are taking supplements, says Cathy Jacob, a nurse-clinician specializing in geriatric mental health at Benjamin Rose Place's Kethley House, a long-term care and rehabilitation facility.

"They are getting their information on things [i.e., ginko biloba and ginger, saw palmetto, soy products] from television, AARP's magazine, and by word-of-mouth from their friends and family caregivers. But, what works for a neighbor or their daughter may not work for them."

Or worse yet, they may actually cause or worsen problems. That's because supplements can negatively interact with the procedures, programs, and/or medications the person is getting with their conventional medical care and cause adverse reactions. Those reactions can masquerade as confusion, depression, hyperactivity, etc. They can also be much more severe in older people because they have less robust immune systems, slower metabolisms, and diminished liver and kidney function.

These adverse interactions and reactions are the reason that before starting any alternative therapy-even ones as seemingly benign as tai chi to increase strength and balance or drinking green tea for its documented anti-cancer benefits-older adults should do their homework.

Research the procedure, product, or program at the National Center for Complementary and Alternative Medicine's website. "If scientific studies on humans have been done on it, you are going to find the results there," said Dr. Golubic.

Consult with a physician. "The consult," said Jacob, "must be thorough." Discuss the pros and cons and risks and benefits of the therapies, procedures, and programs-including clinical trials-you are thinking of using. Talk about foods eaten, and when they are consumed. Talk about over-the-counter pills and medical prescriptions being taken, and the vitamin and mineral supplements and herbals being considered.

"A lot of people tell the physician about pills and prescriptions, but don't mention the herbals," says Dr. Golubic. "Just because something is natural does not mean it won't cause problems. For example, green tea is a natural product, but if you are drinking 6 cups of it a day and you are taking blood thinning drugs, too, you could have a problem with post-surgical bleeding."

And finally, when you do decide to use an alternative therapy, listen very closely to your body. "If you don't feel right, stop what you are doing and contact your physician," said Jacob.

Sources and Resources
Web Sites:
Alternative Medicine - http://www.intmed.mcw.edu/gimcme/altmed.html
American Botanical Council (herbal information) - http://www.hergalgram.org
Health A-to-Z (health/medical information) - http://www.healthAtoZ.com
National Center for Complementary and Alternative Medicine - http://www.nccam.nih.gov
Quackwatch (health fraud site) - http://www.quackwatch.com

Books:
Alternative Medicine: What works , Adriane Fuge-Berman, MD
Arthritis Foundation's Guide to Alternative Therapies , Arthritis Foundation
Herbs that Heal , Michael A. Weiner, Ph.D.