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Better Health While Aging

Practical information for aging health & family caregivers

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    • Preventing Falls in Aging Adults
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How to Maintain Brain Health: The IOM Report on Cognitive Aging

by Leslie Kernisan, MD MPH

Aging brain

If you’ve been wondering just how to maintain a healthy brain for yourself, or for an older relative, then I have some very good news.

In April, the Institute of Medicine (IOM) published a comprehensive report on this very topic. It’s called “Cognitive Aging: Progress in Understanding and Opportunities for Action.”

This report manages to be innovative, comprehensive, and also incredibly useful to regular people and practicing doctors. That’s because the IOM created a number of practical guides and resource sheets, to accompany their detailed and exhaustively researched 385 page report.

To help get the word out about the highlights of this report, I’ve written an article about it for NextAvenue.org:

“4 Myths About Brain Health and How to Stay Sharp“

In this NextAvenue article, I review:

  • The definition of cognitive aging, and why everyone should expect it,
  • 4 commonly believed myths about cognitive aging,
  • 6 actions the IOM recommends people take to protect cognitive health as they age,
  • Why the  IOM is telling doctors to pay special attention to preventing delirium, and identifying risky medications,
  • The IOM’s conclusions regarding diet and brain health,
  • What you should know if you or your relative has been diagnosed with a dementia such as Alzheimer’s.

Since we’re all part of an aging society, it’s good for all of us to learn more about how the brain tends to change with age, and how we can optimize brain health as people get older.

As the health arm of the National Academy of Sciences, the IOM’s job is to provide “independent, objective, evidence-based advice to policy makers, health professionals, the private sector, and the public.”

When an IOM committee makes recommendations on a given health topic, you can rest assured that this represents the best available medical knowledge.

So before you read yet another article about “brain-boosting foods,” take a look at the NextAvenue article summarizing the highlights of the IOM report.

“4 Myths About Brain Health and How to Stay Sharp“

And then let me know which of the report highlights were most interesting to you.

Filed Under: Aging health, Geriatrics For Caregivers Blog Tagged With: brain health

How to Check an Older Adult for Common Health & Safety Problems

by Leslie Kernisan, MD MPH

Senior Health Checklist

Worried about an older relative, but not quite sure what to do?

Common concerns I hear include:

  • Are my parents safe living on their own?
  • Could my mom be getting Alzheimer’s disease?
  • How can I find help for my father who lives alone?
  • I’m worried my mom might fall at home and get hurt.
  • I’m worried that my dad isn’t taking good care of himself.
  • Is it time to move to assisted living?

To help people turn their worries into a practical action plan, I’ve created a special new resource. You can download it here:

Helping Older Parents Quick Start Guide: Check Your Parents in 5 Key Areas 

This guide is modeled on the mental checklists that I use when I first assess an older adult who lives at home.

Specifically, this is a quick version of how I initially check for the most common “don’t miss” health and safety red flags. It includes practical tips, such as who to ask for help, as well as a list of useful online resources.

If you’ve been concerned about an older adult who lives at home or in assisted-living, I hope you’ll take a look!

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles, Useful Links

8 Behaviors to Take Note of if You Think Someone Might Have Alzheimer’s

by Leslie Kernisan, MD MPH

Have you been worried about an older person’s memory or thinking skills? If so, you’ve probably found yourself wondering if this could be Alzheimer’s, or another dementia.

What to do next? If you look online or ask people, the advice is generally this: tell the doctor.

This advice isn’t wrong, but it’s incomplete. Yes, you should tell the doctor. But you’ll dramatically improve your chances of getting to the bottom of things if you come to the doctor with useful information on what you’ve observed.

In fact, research has found that interviewing family members about the presence or absence of eight particular behaviors can be just as effective, when it comes to detecting possible Alzheimer’s, as certain office-based cognitive tests.

8 Alzheimer’s Behaviors to Track

For each of these behaviors, try to make note of the following:

  • Whether there’s been a decline or change compared to the way your parent used to be
  • Whether this seems to be due to memory and thinking, versus physical limitations such as pain, shortness of breath or physical disabilities
  • When you – or another person – first noticed problems, and what you observed
  • What kinds of problems you see your parent having now

If you don’t notice a problem in any of the following eight areas, make a note of this. (E.g., “No such problem noted.”) That way you’ll know you didn’t just forget to consider that behavior.

Have you noticed:

  1. Signs of poor judgment? This means behaviors or situations that suggest bad decisions. Examples include worrisome spending, or not noticing a safety issue others are concerned about.
  2. Reduced Interest in Leisure Activities? This means being less interested and involved in one’s usual favorite hobbies and activities. You should especially pay attention if there isn’t a physical health issue interfering with doing the activity.
  3. Repeating Oneself? Has your parent started repeating questions or stories more than he used to?
  4. Difficulty Learning to Use Something New? Common examples include having trouble with a new kitchen appliance or gadget. This can be a tricky one to decide on, given that gadgets become more complicated every year. But if you’ve noticed anything, jot it down.
  5. Forgetting the Year or Month? Especially once one stops working, it can be easy to lose track of the date or day of the week. But if you notice your parent forgetting the year or month, make a note of this.
  6. Difficulty Managing Money and Finances? Common examples include having trouble paying bills on time, struggling to balance the checkbook, or otherwise having more difficulty than one used to have managing finances.
  7. Problems with Appointments and Commitments? If you’ve noticed that your parent is having more trouble keeping track of appointments and plans, make note of this.
  8. Daily Struggles with Memory or Thinking? It’s normal for older adults to take a little longer to remember things, since many brain functions do slow a bit with aging. But it seems that your parent often can’t remember things that happened, or otherwise seems to be more confused with thinking, make note of this.

For more on diagnosing Alzheimer’s and other dementias

  • If you’re worried that your older relative might have dementia, I recommend you learn more here: How We Diagnose Dementia: The Practical Basics to Know
  • My book, “When Your Aging Parent Needs Help“, also comes with worksheets to help you check for signs of dementia, a handy checklist of what information to bring to the doctors, and more.
  • In this Youtube video I share 10 early warning signs of Alzheimer’s Disease that often catch my attention, and what to do if you’ve noticed these warning signs.
  • In this Youtube video, I cover 21 signs and behaviors that families sometimes assume are “normal aging,” but in fact are usually signs of a brain health disorder. It includes the 8 behaviors listed in this article, and many more.

Remember, being proactive usually leads to better results and less stress overall!

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles Tagged With: alzheimer's, dementia, memory

4 Practical Health & Aging Highlights from 2014

by Leslie Kernisan, MD MPH

Better Aging

Happy New Year!

In this post, I want to share four notable 2014 developments related to better health for older adults. They all struck me as practical information that should be useful to those of you helping an aging person with health and wellbeing.

In no particular order, here are my four geriatrics health highlights from 2014:

1. Two Separate One-Time Pneumococcal Vaccines Now Recommended for Older Adults

For several years now, the CDC and other experts have recommended that all seniors aged 65 or older get a one-time pneumonococcal vaccine. The particular vaccine recommended for older adults was the “23 valent” type (which means it protects against 23 subtypes of pneumococcal bacteria), branded as Pneumovax. Another vaccine, a “13 valent” branded as Prevnar, was recommended for children and some adults with weakened immune systems.

In September 2014, the US Advisory Committee on Immunization Practices (ACIP) published its recommendation that all adults aged 65+ get both types of pneumococcal vaccination (Prevnar and Pneumovax). This recommendation was based on their review of scientific studies.

For the ACIP’s technical statement explaining this recommendation, see “Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine Among Adults Aged ≥65 Years: Recommendations of the Advisory Committee on Immunization Practices (ACIP).” This document was obviously not written for the lay public, but it provides a lot of important detail for those who want to dig into the nitty-gritty. (You can find a basic CDC page on this topic here.)

I’ll admit that I’ve read the ACIP’s statement and I don’t yet feel I clearly understand just how much extra protection an older person should expect, if she has already been vaccinated with Pneumovax and now should get Prevnar. (I do tend to err on the side of following guidelines unless I have good reason to believe that the likely harms outweigh the proposed likely benefit.)

Key things you should know: Yes, there are now two one-time “pneumonia” vaccines that are recommended for older adults. You should also know that these are not supposed to be given at the same time. For more information on how to space out these vaccines, talk to your doctor or take a look at the ACIP document mentioned above.

2. Benzodiazepines Linked (Again) to Higher Alzheimer’s Risk

Benzodiazepines are sedatives/tranquilizers that are often prescribed to treat anxiety or insomnia. Commonly used benzos include lorazepam, alprazolam, and diazepam (Ativan, Xanax, and Valium respectively).

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Useful Links

How To Be An Engaged Patient or Caregiver

by Leslie Kernisan, MD MPH

Partnering with your doctor

Have you ever wondered what it means to be an “engaged patient,” or an engaged caregiver?

This is a hot topic right now within healthcare. The basic idea is simple: people get more from their healthcare when they are active participants, especially when they are proactive about their health. (Such people are sometimes called “e-patients,” with the “e” standing for engaged, enabled, equipped, and educated.)

This means doing things like asking questions, researching your health problems online, connecting with others facing similar health challenges, and most of all: making sure the healthcare providers know what’s important to YOU.

For instance, you should be actively involved in developing the medical plan, meaning that at a minimum, you should let the doctors know whether what they’re proposing sounds ok to you. And, you should be able to let them know if the treatment plan isn’t working out well for you.

Now, one big problem is that we’re often feeling sick when we’re involved with the healthcare system, especially when it comes to hospitals. Which is why family caregivers are very important, when it comes to being proactive and involved with healthcare. When a person has a family member or friend helping them be proactive, getting better healthcare is much more likely.

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog Tagged With: being a savvy patient, e-patients, get better healthcare

How to Use a Personal Health Record to Improve an Older Person’s Healthcare

by Leslie Kernisan, MD MPH

Loving Granddaugher

All family caregivers want their older loved ones to get the right medical care. But doctors are often lacking key medical information at the time they see your aging relative.

The solution: setting up and using a personal health record (PHR).

This is a big step up from what many families do, which is to create an “in-case-of-emergency” packet. Such medical information packets usually include a list of medications, chronic conditions, and allergies, along with the names of next-of-kin and perhaps a POLST form.

I’ve reviewed such medical information packets, and they are certainly better than nothing. But in general, they don’t help older adults avoid these very common — and potentially serious — problems with their medical care:

  • Delays in treatment/action because test results aren’t available. Often doctors need test results in order to know how to proceed medically. If tests have been done but the results aren’t available, the doctor’s options are to fly blind, re-order the tests, or plan to request the test results and then see you again once the results are available.
  • Getting worse care in the emergency room, or in urgent care. An urgent medical problem often means seeing new doctors. Those doctors have to offer help quickly, but if they are lacking detailed medical information, it’s generally harder for them to offer the right medical management.
  • Suboptimal medication prescribing. Whenever medications  are prescribed without first considering all other medications being taken, a senior’s health is being put at risk. Although bringing an up-to-date medication list (or better yet, all the medication bottles) is very helpful, it’s also valuable for doctors to understand why another doctor prescribed a medication.
  • Suboptimal care from a new primary care provider (PCP). Adults in late life often move and have to establish care with a new PCP. Especially when a senior has multiple chronic conditions or a complicated health history, delays in getting medical information means it often takes the new PCP months to get up to speed so that he or she can properly help the older person with his or health concerns.
  • Inadequate help from a specialist or consultant. Aging adults are often referred to specialists, but studies have found that specialists often don’t receive enough information to do their work. Again, at best this means delays and inconvenience for you; at worst this can lead to serious health problems if a senior gets the wrong care, or gets the needed care too late.

Fortunately,  even a very basic and low-tech PHR can help your older loved one avoid the problems listed above.

At a minimum, you’ll save yourself hassle and the extra appointments that get scheduled because the doctor didn’t have the needed medical information the first time around. You’ll also spare your loved one the discomfort and expense of enduring duplicate testing.

More importantly, properly maintaining and using a personal health record (PHR) will go a long way to ensuring that your loved one gets better, safer medical care. It can also help you avoid potentially life-threatening medical mishaps.

The key is to learn what medical information to put into this PHR, and how to use it effectively for care coordination.  This post will tell you what you need to know, to set up and use a PHR.

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles Tagged With: being a savvy patient, get better healthcare, personal health record

POLST: Resources & Tips on Avoiding Pitfalls

by Leslie Kernisan, MD MPH

California POLST page 1

In this post —  the last in a 4-part series on better planning for health crises and end-of-life care — I want to tell you about a document that I wish more families knew about: POLST.

POLST (which stands for Physician Orders for Life-Sustaining Treatment) is a legal document meant to tell healthcare professionals what you want done, in the event of a medical emergency. It’s kind of like a pre-hospital DNR (do-not-resuscitate), but much much better. (For starters, you don’t have to be DNR to use a POLST form.)

Note that POLST is not an advance directive, although when doctors ask if there is an advance directive, they are often thinking of POLST as well. (Because what they are really asking is, is there any pre-existing documentation that can help us understand what we should and shouldn’t do?)

And it’s not a perfect approach to making sure older adults get the care they want and need, when a health crisis hits. If you have heard of POLST, you may very well have heard some negative things; I’ve certainly heard some complaints over the years about POLST forms, or about how something didn’t quite work out despite the presence of a POLST.

Still, I really like POLST, and discuss POLST forms with many of the older adults and families that I work with. In California, POLST has largely replaced the pre-hospital DNR forms that some older adults used to have.

Furthermore, a study published in 2014 confirmed that in Oregon, where the POLST approach was first pioneered, POLST forms have helped get end-of-life wishes honored more often. (The New Old Age Blog published a related post recently, titled “When Advance Directives Are Ignored.”)

If you’re caring for a frail older person and you live in one of the many states with a POLST program — click here to find out if your state has POLST — I highly recommend you incorporate this tool into your loved one’s advance care planning. In most cases, a surrogate medical decision-maker can complete a POLST form.

In this post, I’ll share some resources on learning to use POLST to better plan for health crises and end-of-life care.

I’ll also offer some tips on avoiding common pitfalls, such as completing POLST without first addressing the learning and conversing parts of advance care planning.

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles Tagged With: Advance Care Planning, end-of-life care

5 Tips to Help You With End-of-Life Planning

by Leslie Kernisan, MD MPH

Balancing Scale

Living wills. Advance directives. Powers of attorney for healthcare. Making your wishes known.

Many older adults have never gotten around to addressing these issues.

Others are overdue for a review. After all, this is not something where you should “set-it-and-forget-it.” Especially not if you completed the paperwork with a lawyer years ago, and have experienced changes in your health since then.

In previous posts on this site, I’ve shared two true stories about older adults facing health crises, and possible end-of-life situations. (See here and here.)

In both situations, the older person and his/her family had to weigh their options. We also helped them consider the benefits versus the burdens of the choices available.

It is these kinds of situations that advance care planning is supposed to help us — patient, family, healthcare providers — prepare for.

But I know that many older people haven’t gotten around to completing — or revising — their advance care planning. Which is a shame, since this will make it harder for their family and doctors to provide the right help if a medical emergency arises.

So in this article, I’ll try to make this process easier for you and your family. Here’s what we’ll cover:

  • What is advance care planning,
  • The four key steps that should always be part of advance care planning,
  • Five tips to help you — or your older parent — address advance care planning.

I’ll also tell you about some of my favorite resources available to help seniors with all of this. These can really make it easier for older adults to sort out what they want, and have the necessary conversations with others.

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles Tagged With: Advance Care Planning, end-of-life care, Healthcare

5 More Treatments You Should Question in Older Adults

by Leslie Kernisan, MD MPH

Choosing Wisely

Last week, I wrote about the first Choosing Wisely list of 5 treatments that older adults and their doctors should question.

In this post, I’ll cover the 2014 Choosing Wisely list for healthcare in aging adults, which was released by the American Geriatrics Society (AGS) this past February. This 2014 edition of things to question include:

  • The most popular class of medications prescribed for Alzheimer’s and other dementias,
  • Breast, colon, and prostate cancer screening,
  • A common approach to weight loss and poor appetite,
  • The prescribing of additional medications,
  • A common — but risky — approach to handling confusion during hospitalization.

As I explained in my last post, Choosing Wisely is a health education campaign meant to help patients and their doctors more easily spot common tests and treatments that are often overused. 

For the Choosing Wisely items selected by AGS (my specialty society), I’d say the real problem is that these are healthcare interventions that are usually used before safer alternatives have been tried.

Many older adults and their caregivers are never told that a safer alternative exists. People often also have an overly optimistic understanding of the likely benefits, but haven’t been properly informed of the risks.

Aren’t doctors supposed to offer the safest alternatives first? Of course they are. However, many doctors haven’t been trained in modifying healthcare to better fit the needs of aging adults. And it’s often hard for a busy clinician to keep up with the latest recommendations from experts in geriatrics.

By learning about the Choosing Wisely recommendations, you can prepare yourself to be a “smarter” patient or caregiver, and you can be more proactive about making sure the healthcare you get is a good fit for your family’s needs. That’s why Choosing Wisely is supported by Consumer Reports, which makes the recommendations available on their website.

In this post, I’ll review the 2014 list of five Choosing Wisely items that older adults — and their families — should question. I’ll also share some tips for caregivers, related to each item.

Five (More) Things to Question for Healthcare in Aging Adults

1. Don’t prescribe cholinesterase inhibitors for dementia without periodic assessment for perceived cognitive benefits and adverse gastrointestinal effects. In other words, after starting a dementia medication such as donepezil (brand name Aricept), don’t forget to follow-up! You’ll want to make sure that the drug is making thinking or behavior better, and that the side-effects are tolerable. Other cholinesterase inhibitors include rivastigmine and galantamine (brand names Exelon and Razadyne, respectively).

Why: Although these drugs are often prescribed in Alzheimer’s, clinical studies suggest that the likely benefits are smaller than many people realize. Also, although these drugs may improve cognitive symptoms for a minority of patients, they are not “disease-modifying” and don’t truly slow the progression of Alzheimer’s. (Want to avoid acceleration of Alzheimer’s? See this post.)

A comprehensive review in 2008 described the benefits of these medications as “clinically marginal,” especially since it’s been hard to prove that these drugs improve quality of life or overall life function. Another review calculated that 12 people have to be treated with these drugs, in order for one person to experience marginal improvement or better; the same review noted that about 1 in 12 people will experience a significant side-effect (usually diarrhea or stomach-related).

Because some clinical trials suggest that the drugs work better for some people than others, many experts now recommend a time-limited trial of these medications: if a patient or family notice an improvement, the drugs should be continued. If not, the care team should consider stopping them.

Tips for caregivers: The main thing to realize is that it’s not at all guaranteed that these medications will help in Alzheimer’s. In fact, it’s fairly common for these drugs to seem to have no effect at all, and sometimes they do cause uncomfortable diarrhea or stomach upset. If you don’t see much improvement, know that it’s reasonable to consider stopping these medications, especially if you want to reduce costs or pill burden.

That said, I find that these drugs tend to cause fewer side-effects and risks than many of the other drugs older adults often take; generally the greatest harm from Aricept is to the wallet. Although all medications should come with a plan to assess effectiveness and side-effects regularly, these types of medications are usually lower on my priority list. They likely aren’t helping as much as people think they are, but at least they aren’t very risky. (Whereas antipsychotics and benzodiazepines — commonly used for difficult Alzheimer’s patients — are risky; they are on the original Choosing Wisely list.)

2. Don’t recommend screening for breast or colorectal cancer, nor prostate cancer (with the PSA test) without considering life expectancy and the risks of testing, overdiagnosis and overtreatment. This means that doctors shouldn’t automatically refer older adults for cancer screening. Instead, doctors and patients should consider life expectancy and the risks of screening, before deciding whether to proceed.

Why: Cancer screening is an important part of preventive health. But most people do reach a point at which their age, or their chronic illnesses, make it unlikely that cancer screening will be beneficial. That’s because research suggests that cancer screening is most likely to help those who are likely to live another 10 years or more. Furthermore, screening for cancer does harm some patients, due to overdiagnosis or complications of procedures such as colonoscopy.

Cancer screening used to be reflexively recommended for most adult patients, no matter what their age or health status. But today, experts recommend that people first weigh the likely benefits and risks. This is called individualized cancer screening.

At this time, US Preventive Services Task Force (USPSTF) recommends against routine colon cancer screening in adults older than 75 years. Breast cancer screening is recommended for women aged 50-74.

Tips for caregivers: If your older loved one is older than 75, or is in declining health, be sure to ask questions if cancer screening is recommended without first having a thoughtful conversation.

Wondering how long your loved one is likely to live? A team of UCSF geriatricians offers access to mortality calculators at ePrognosis.org. I find the life-expectancy graphs here to be especially helpful.

 3. Avoid using prescription appetite stimulants or high-calorie supplements for treatment of anorexia or cachexia in older adults; instead, optimize social supports, provide feeding assistance and clarify patient goals and expectations. In other words, for older adults who are losing weight or seem to not be eating well, don’t start by requesting medication, or a nutritional drink such as Ensure. Instead, make sure the person gets any help he or she needs with grocery shopping and meal preparation. You’ll also want to talk to the doctor about the health status; if weight loss is due to a medical problem such as depression, or cancer (a cause of cachexia), you’ll need to discuss goals and management options before you turn to stimulants and supplements.

Why: Weight loss and malnourishment are fairly common in older adults, and it’s very important to spot these issues and address them. However, research studies have found that prescription appetite stimulants often don’t provide a lot of benefit, and can cause problematic side-effects.  Nutritional supplements such as Ensure or Boost are safer in that there’s usually little risk of side-effects. But comprehensive reviews of clinical research suggest that the benefits are usually slim.

Tips for caregivers: If you’re worried about appetite or weight loss in an older person, start by asking for help assessing the underlying cause — or causes — of the problem. For instance, some aging adults develop difficulty getting and preparing food, due to physical disabilities (such as crippling arthritis) or memory problems. In other cases, the problem is an underlying medical problems, such as depression, heart failure, lung disease, or cancer. You should also make sure an oral evaluation is done; tooth pain or chewing problems can affect nutrition.

 4. Don’t prescribe a medication without conducting a drug regimen review. This recommendation is pretty straight-forward. Before accepting a new prescription for a medication, always make sure the clinician has an up-to-date medication list, and has reviewed it.

Why: Polypharmacy (the taking of multiple medications) raises the risk of potentially dangerous medication interactions. Older adults also tend to be more vulnerable to side-effects of medications. A 2011 study estimated that seniors experienced over 250,000 emergency room visits per year, due to medications. People aged 80+ were especially likely to need hospitalization.

Tips for caregivers: This is a common-sense recommendation that can still be tricky to implement, because many clinicians are used to handing out prescriptions fairly quickly. You’ll want to be prepared, by making sure you always have an up-to-date medication list handy. And then be ready to be gently persistent: if the doctor doesn’t ask to review all medications, ask that she does so. You may also want to ask if the new drug is on the Beer’s List of medications to be used with caution.

For tips on maintaining an up-to-date medication list, read this post.

For a link to a free online drug interaction checker, see this post.

5. Avoid physical restraints to manage behavioral symptoms of hospitalized older adults with delirium. This means that if your older loved one becomes confused and difficult during a hospitalization, don’t let the staff tie him or her down, unless all other options have failed.

Why: It’s very common for older adults to develop delirium — a state of worse-than-usual confusion — during a hospitalization. While confused, people may pull at IVs, thrash around in bed, or try to get up when they are too weak to do so safely. This understandably looks dangerous, and historically hospital staff have responded by tying patients’ arms down. However, research has found that this approach does not improve outcomes. Feeling tied down can increase an older person’s confusion and panic, and people often still manage to struggle partly out of bed despite restraints. A more effective approach is for hospital staff to use comprehensive approaches that soothe restless patients and minimize stressors.

Tips for caregivers: If an older person becomes restless and confused in the hospital, be sure to bring it to the attention of the doctors. Studies have found that delirium is often missed by busy hospital staff. To prevent — and to help treat — delirium, it often helps to have family at the bedside, to provide reassurance and support.

To learn more about how delirium is treated, including tips on what you can do as a caregiver, see here.

Delirium is especially common in people with Alzheimer’s and other dementias; for more information and resources, see this post.

Questions or comments about these Choosing Wisely recommendations? I’d love to hear from you in the comments below.

Filed Under: Aging health, Geriatrics For Caregivers Blog Tagged With: being a savvy patient, get better healthcare

Choosing Wisely: 5 Treatments You Should Question

by Leslie Kernisan, MD MPH

Balancing benefits & burdens

Did you know that it’s important to think about “Choosing Wisely,” when it comes to healthcare?

It’s true! Choosing Wisely is a health education campaign meant to help patients and their doctors more easily spot common tests and treatments that are often overused. To do this, many medical societies are creating lists of “Five Things Physicians and Patients Should Question.” Consumer Reports is also a partner in this project.

If you’re a caregiver for an aging person, you probably should know about the Choosing Wisely items identified by the American Geriatrics Society (AGS). These are treatments or tests that are:

  • Commonly given to older adults,
  • Often unlikely to help aging adults live better, or longer,
  • Riskier than many patients and caregivers realize.

In other words, these are treatments that older adults often don’t receive, when geriatricians are involved.

Of course, most older adults aren’t under the care of a geriatrician. If this is your family’s situation, learning about the Choosing Wisely items can be a good way to make sure your older relative avoids healthcare that is unnecessary, or even harmful.

In this post, I’ll review the “Five Things to Question” that were identified by the AGS in their intial Choosing Wisely list. (The AGS recently published a second list; I’ll review those items in a follow-up post.) I’ll also share some tips for caregivers, related to each item.

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog Tagged With: being a savvy patient, get better healthcare

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