The Geriatrics For Caregivers Blog

Learn practical ways to improve the health and wellbeing of older adults!

Written especially for family caregivers of older adults, but useful for all who want to learn how geriatricians help aging adults.

Leg Swelling in Aging: What to Know & What to Do

by Nicole Didyk, MD 6 Comments

Swelling in the lower legs – known as “lower extremity edema” in medical terms – is a problem that often affects older adults.

The good news is that most of the time, it’s annoying, but not terribly dangerous. However, in other cases, swelling in the feet, ankles, or lower legs can be the sign of a new health problem, or a worsening chronic condition.

And, even if it’s “benign” and not related to a dangerous health condition, edema can be a major risk factor for skin breakdown and reduced mobility in aging adults.

Since leg swelling becomes so common as people get older, in this article we’ll demystify leg edema and cover the most important things that older adults and families should know about this condition. In particular, we’ll cover:

How does edema happen?
Common causes of swollen ankles or legs in aging adults
Medications that can cause leg swelling as a side-effect
How leg swelling should be medically evaluated
How to prevent and treat leg swelling
What to know BEFORE going on a “water pill”

[Read more…]

6 Steps to Take When Aging Parents Need Help – Even if They’re Resisting

by Leslie Kernisan, MD MPH 4 Comments

getting aging mother to accept help Have you noticed worrisome changes in your aging parent?

Maybe they’ve been mostly okay but now you’re seeing problems with memory, such as forgetfulness or asking the same questions repeatedly. Or maybe you’ve noticed trouble with driving, keeping up the house, managing stairs, or paying bills.

Some aging parents simply begin to seem more withdrawn. Others start leveling accusations at others, claiming someone took or moved something, or acting paranoid.

For many adult children, these changes lead to mounting questions. What’s wrong? What’s happening? Is it safe for Mom to keep driving? Should Dad live alone much longer?

I think of this as the “uh-oh” stage. It’s a transition no one looks forward to, and most haven’t prepared for: the time when you might have to start helping your aging parent.

And for many, it comes with an added challenge: Most aging parents don’t welcome much help from their adult children. They may see it as interference, or an invasion of privacy.

Some parents might even refuse to accept that they’re having difficulties, despite issues that feel glaringly obvious—and concerning—to you.

By the time you’re noticing changes and have safety concerns, it’s quite possible that you’re right: that your parent does need help of some kind. So how should you best get involved, especially if your attempts to do so have gone poorly in the past?

Well, it’s certainly not easy. These situations are complicated from a medical and eldercare perspective, plus they tend to bring up difficult emotions for older parents and adult children alike.

But I do believe that it’s crucial for families to get involved. It’s not likely to be easy. But it can be easier, if you’re able to learn the better ways to do so—and also what to stop doing. [Read more…]

Q&A: What You Can Do if You’re Worried About “Incompetence”

by Leslie Kernisan, MD MPH 50 Comments

Q: My 87 year old father lives alone. His house has become increasingly dirty, but he refuses to get help, even though I’m sure he needs it. I’m worried that he’s becoming incompetent, but he doesn’t want to go see the doctor. What can I do?

A: This situation does come up a fair bit with aging parents and relatives. I’m sorry to say there usually are no easy solutions. But there are definitely things you can and should do, and it’s better to act sooner rather than later.

Let’s review what you can do. I’ll also explain what I’ve learned about “incompetence” over the years, and how doctors usually play a role in the evaluation of such older adults.

Then, I’ll share some thoughts on how older people and families can plan ahead, to avoid facing this kind of dilemma. And then last but not least, I share a few thoughts on taking care of yourself as you go through this.

What’s probably going on with your father

[Read more…]

COVID Vaccination for Aging Adults:
What to Know & Do

by Leslie Kernisan, MD MPH 40 Comments

At last, at last. After an excruciating year of coronavirus pandemic, an amazing milestone has been reached: COVID vaccination has begun!

On December 11, 2020, the FDA granted an emergency use authorization (EUA) to Pfizer’s COVID-19 vaccine. Moderna was granted a similar EUA on December 18, 2020. So now, it’s possible to vaccinate people who are not part of a trial studying the new vaccine.

Of course, it doesn’t mean that everything will be back to normal within the next few weeks. But vaccination is what will enable us to eventually pull out of the danger and disruption the pandemic is causing.

Although it’s exciting to see COVID vaccination start to take place in the U.S., it also raises a lot of questions for people.

In this article, I’ll summarize what I think is most important for older adults and families to know about coronavirus vaccination.

In particular, I want to address the question of efficacy (does it work?) and safety (is it dangerous?), specifically for older adults.

So I’ve recorded a short video presentation about how I assess whether the COVID vaccine (or other treatment) is effective in older adults, especially those over age 85 and those in nursing homes. I also have summarized some key vaccine information below.

In this video, I review the data for Pfizer’s vaccine, and I show you how you can assess the data on older adults when the data for upcoming vaccines is released. [Read more…]

Top 10 Checklist for Better Health & Aging in 2021

by Leslie Kernisan, MD MPH 39 Comments

Do you find yourself taking stock and setting goals around the time of New Year’s?

It is indeed an excellent time to reflect on the past year. (And wow, quite a lot to reflect on for 2020!)

And although one can set goals at any time of year, the start of the calendar year is a time that seems to inspire many people to think about their health and how to thrive over the coming year.

If better health while aging is important to you, here are my top ten suggestions for the coming year. [Read more…]

The Geriatrics For Caregivers Blog

What’s probably going on with your father

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