Better Health While Aging

Practical information for aging health & family caregivers

5 Top Causes of Sleep Problems in Aging, & Proven Ways to Treat Insomnia

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Older woman sleeping outside.

What should you do if an older person complains of insomnia, or is not sleeping well at night?

Experts do believe that “normal aging” brings on some changes to sleep. (See this post for more on how sleep changes with aging.) Basically, older adults tend to get sleepy earlier in the evening, and tend to sleep less deeply than when they were younger.

So it’s probably not realistic to expect that as you get older, you’ll sleep as long or as soundly as when you were younger.

That said, although aging by itself does change sleep, it’s also quite common for older adults to develop health problems that can cause sleep disturbances. So if you’re older and aren’t sleeping well, you’ll want to make sure you’ve been checked for these. Figuring out what’s going on is always the first step in being able to improve things.

And remember, getting enough good quality sleep helps maintain brain health, physical health, and mood.

In this article, I’ll cover the top causes of sleep problems in older adults. I’ll also tell you about what approaches have been proven to work, to help treat insomnia and sleep problems in older adults.

Last but not least, if you (or your older relative) have experienced the very common combination of waking up to pee at night and difficulty sleeping, I highly recommend listening to this podcast episode, which features a geriatrician who is an expert on this: 092- Interview: Addressing Nighttime Urination & Insomnia in Aging.

5 Common Causes of Sleep Disturbances in Older Adults

[Read more…]

3 Ways Home Blood Pressure Monitors Help Older Adults

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how to check BP at homeIf I had to recommend one key piece of healthcare equipment that older adults & caregivers should have at home, it would be this: a good home blood pressure (BP) monitor.

Why? Because BP measurements (and pulse measurements, which machines check at the same time) are an incredibly useful tool when it comes to assessing and optimizing an older person’s health and well-being. This is true even for those older people who aren’t being treated for hypertension (chronic high BP).

As I’d love for more older adults and families to understand how home BP monitors can help them, in this article I’ll explain how home BP monitors can be helpful specifically for older adults. (And then see my related article here: Choosing & Using a Home Blood Pressure Monitor, & What to Ask the Doctor .)

3 ways a home blood pressure monitor can help you

[Read more…]

Medications Older Adults Should Avoid or Use with Caution:
The American Geriatrics Society Beers Criteria

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Today we’re covering a touchstone resource for geriatricians: the “Beers List” of medications that older adults should avoid or use with caution.

(Technically, it’s called “The AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults.” I personally think of it as the list of “risky medications” for older adults.)

If you want to know which medications older adults should be careful about, this is the list!

This list gets updated every few years, so the Beers Criteria published in May 2023 is about as up-to-date as you can get for this type of guideline document. 

You should know that experts in geriatrics and in medication safety go through a very careful process of reviewing the research on medications, and of updating this list of medications that older adults should avoid or use with caution.

So in this article, here’s what I’ll be sharing with you:

[Read more…]

Addressing Medical, Legal, & Financial Advance Care Planning:
The Healthy Aging Checklist Part 6

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Power of attorney

This is the sixth and final post covering the Healthy Aging Checklist, a set of six core activities that will help any older adult maintain the best possible health while aging.

They are:

In this post, I’ll address the last item on the list: advance planning for medical, legal, and financial issues. This includes power of attorney documents, plus much more.

This is a big topic, and it’s not possible to cover everything you could or should do in a single article. You would need a book for that — I suggest three down below — plus it’s best to work with qualified professionals (healthcare providers, eldercare attorneys, and financial planners) before completing any legally binding paperwork.

But every day as I work, I see older adults and families whose health and well-being is being affected by the consequences of their planning — or lack of planning, as the case often is.

So in this post, I will share some practical information that should make it easier for you to address planning that covers some common age-related challenges:

  • The three key steps involved in all advance planning for aging
  • 5 common problems every older adult and family should consider planning for
  • 5 key steps for advanced planning in healthcare, and where to get a good free medical power of attorney (POA)
  • 4 key steps for advance planning for legal and financial issues, and what to know about general POAs
  • Tips for adult children, including what to do if you’re concerned about mental capacity or undue influence

[Read more…]

27 Recommended Preventive Health Services for Older Adults: the Healthy Aging Checklist Part 5

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Aging Parents To Do List

This is the fifth in a series of posts covering the Healthy Aging Checklist, which is my list of six fundamental activities that will help any older adult maintain the best possible health while aging.

 

 

They are:

In this post, I’ll cover recommended preventive health screening guidelines and other prevention services for older adults. These are based on the recommendations of the U.S. Preventive Services Task Force (USPSTF) and also on Medicare’s coverage of preventive health services.

By my count, based on the USPSTF and Medicare guidelines, there are currently 27 preventive health services that older adults should consider. I have a summary list here, and then detailed information on each service starting here.

Get Your Free Preventive Health Cheatsheet! The 27 proven preventive health services for older adults, in a handy PDF checklist that you can print or save. Includes details on who should get each service, and helpful links. Click here now.

But before you read about them, let’s go over the basics of how health screening and other preventive health services work, including why they can sometimes be harmful, or sometimes fall out of favor.

This way, when you review the list of preventive services to consider, you’ll better understand which services are likely to help, and why certain services may not be a good fit for you or your parent.

Understanding Preventive Health Services

Preventive health services essentially fall into three categories:

[Read more…]

How to Age Better by Optimizing Chronic Conditions:
The Healthy Aging Checklist Part 4

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Doctor & Older Woman

This is the fourth in a series of posts covering the Healthy Aging Checklist.

Again, the Healthy Aging Checklist summarizes the six fundamental activities I recommend when asked what to do to maintain the best possible health while aging. They are:

In this post, I’ll cover the fourth item: learning to optimize the management of any chronic conditions.

Now, people are often very interested in “prevention” and in “staying healthy.” But far fewer people seem to be interested in making sure that they and their doctors are doing the right things for any chronic conditions they already have, and — equally importantly — avoiding the wrong things.

This is a serious oversight, because most of the “aging” problems that older adults eventually develop are due to chronic health conditions that have progressed or caused complications.

So optimizing the care of chronic conditions is very important for the prevention of future health deterioration. And it’s also vital to helping older adults feel and function their best in the here and now.

According to Medicare, over two-thirds of beneficiaries have two or more chronic conditions. Here’s a figure from the Medicare Chronic Conditions Chartbook, showing what percentage of older adults are affected by the 15 most common chronic conditions:

Prevalence of Chronic Conditions Medicare 2012 Chartbookjpg_Page1

I can’t emphasize this enough: these chronic conditions often are the key drivers, when it comes to an older person’s symptoms, health crises, health declines, and the eventual development of disabilities.

Furthermore, I’m sorry to say this but here goes: you should not assume that doctors will provide you with optimal care for chronic conditions. Experts have estimated that patients get only about half of recommended healthcare. A large body of healthcare quality research has repeatedly documented that it is very common for older adults to receive healthcare that varies from “wrong” (e.g. totally counter to guidelines with no documented justification for this) to “sub-optimal” (which means it’s not very deficient but could and should be better).

Later in this article, I will go into more detail on why doctors often provide sub-optimal care, and what you can do about it.

But first, let’s review what’s at stake and why it’s worthwhile to make sure you optimize the healthcare of an older adult’s chronic conditions. I’ll then finish by providing some practical tips to help you be proactive so you can optimize the care of chronic conditions, for healthier aging.

8 Ways Chronic Conditions Harm the Health & Well-being of Older Adults

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5 Questions to Ask Yourself on National Healthcare Decisions Day

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Since 2008, April 16th has been designated as “National Healthcare Decisions Day” (NHDD).

It’s an initiative meant to “inspire, educate and empower the public and providers about the importance of advance care planning.”

In other words, National Healthcare Decisions Day is meant to get you to think about things like advance directives, living wills, powers of attorney for healthcare.

This means planning for your future…a future time during which you might be ill and others — most likely your family — will have to make decisions about your healthcare.

It’s basically a great opportunity to address end-of-life planning, and equip your family to know what they should do during a medical emergency.

This is not a particularly unlikely scenario. Between the present-at-all-ages possibility of being in a bad accident and the increased likelihood of illness as one gets older, you’d actually have to be quite lucky — or unlucky, depending on how you see it — to reach the end of your life without anyone else ever having to make a medical decision on your behalf.

Still, studies and surveys generally find that many of us have not yet taken the needed steps to “make our wishes known.”

And even among those who have “made their wishes known,” there’s usually more to it than they realize, and they often have skipped an important piece of the process.

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6 Common Medication Problems in Aging, & What You Can Do

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Too many pills?If you’re helping an older person with health and healthcare, chances are that person is taking at least a few prescription medications, if not several.

Do you ever wonder if he or she is on the right medications? Do you worry about side-effects and interactions?

These are sensible concerns to have. Many older adults end up experiencing “polypharmacy,” which means taking more than 5 medications concurrently.

And although medications do often help maintain health and wellbeing, studies have repeatedly shown that lots of older adults end up suffering from problems related to medication.

Polypharmacy, predictably, increases the risk of problems.  (Polypharmacy is usually defined as taking five or more medications concurrently.) But even older adults taking one to three daily medications can encounter problems.

So I want to share a list of common ways that medications affect the health and wellbeing of aging adults. I’ll then explain what you can do, to minimize these problems.

Six Common Medication-Related Problems in Aging Adults

Here are the most common problems that I see: [Read more…]

3 Ways to Prevent Injury From a Fall
(Plus 3 Ways That Don’t Work as Well as You’d Think)

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elderly person falling hip fracture

Worried about falls in an older person?

You’re right to be concerned, especially if the older person has already experienced a fall. Research suggests that falling once doubles your chance of falling again.

And falls, as everyone knows, can cause life-changing injuries. The Centers for Disease Control (CDC) reports that:

  • One out of five falls causes a serious injury such as broken bones or a head injury
  • Each year at least 300,000 older people are hospitalized for hip fractures
  • More than 95% of hip fractures are caused by falling, usually by falling sideways
  • Falls are the most common cause of traumatic brain injuries

For these reasons and more, preventing falls is a major focus of preventive care for older adults, and is a big part of what we do in geriatrics. (Learn more about how we do this in this article: Why Older People Fall & How to Reduce Fall Risk.)

But if we want to protect older people from the potentially devastating consequences of falls, it’s not enough to help them reduce falls.

We also need to think about how we can reduce the likelihood of injury from a fall.

In this article, I’ll share with you three approaches that can help reduce fall-related injuries.

Then I’ll address two other approaches that are sometimes tried, but are less likely to help.

3 ways to prevent fractures and other injuries related to falls 

[Read more…]

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