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.

13 Recommended Resources for National Family Caregivers Month

by Leslie Kernisan, MD MPH 7 Comments

This month — November — is National Family Caregivers Month.

If you’ve been in any way assisting another adult with managing health concerns or life tasks, you qualify as one of the estimated 40 million family caregivers in the US.

Such help often starts out with small things, such as helping an older relative get to appointments or assisting with grocery shopping.

But it’s also fairly common for families to end up providing quite a lot of care. A 2015 report found that on average, family caregivers provided 24.4 hours of assistance per week, and 23% of caregivers were clocking 41 hours or more.

Many people find themselves eventually struggling with the caregiving. Most of us haven’t prepared or been trained to do this, and many people are unsure of where to get information, help, or support.

So in this article, I’ll share some of my favorite resources to make family caregiving a little easier. [Read more…]

End of Life Planning Made Easy Through PREPARE

by Team BHWA 8 Comments

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

Many older adults have never gotten around to addressing these issues, and of those who have, many 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.

But if you wanted to get started addressing this, you may have run into a few common hitches. The forms are often in legalese and hard to understand. And people often are sure just how to go about “making their wishes known.”

Fortunately, geriatrician Rebecca Sudore, MD, noticed this problem early in her career, and decided to do something about it.

Over the past 15 years, she developed and tested California’s first easy-to-read advance directive, then designed PREPARE, an easy online video program created to help older adults address advance care planning.

In a recent podcast episode, she and Dr. Kernisan discussed PREPARE, advance care planning, and how to make it easier for older adults to address what matters most to them when it comes to end-of-life planning.

This article will share some highlights and key points from their conversation, including:

The easy-to-read advance directives (and where you can get one)
Why advance care planning needs to include more than completing forms
How the PREPARE program helps older adults talk about what matters most
How to use PREPARE resources to help yourself or your loved ones talk about what matters and complete your planning

[Read more…]

Flu Shots for Older Adults: What to Know & Do for 2018-2019

by Leslie Kernisan, MD MPH 65 Comments

It’s October, which means it’s that time of the year again: flu vaccination time!

Back when I worked in a primary care clinic, this is when we made a big push to offer the seasonal flu shot to all of our patients. (And we got ourselves immunized, as well.)

Not all of our patients agreed. Many older adults are skeptical of the need to get a yearly vaccination against influenza. They aren’t sure it will help. Or they think that the vaccination will actually give them a mild case of the flu. Or they just don’t like needles.

Or maybe they aren’t sure which type of seasonal flu shot to get: the regular one or one of the newer “stronger” versions, designed for older adults?

I’m never surprised when people bring up these questions. Vaccination for seasonal influenza can indeed be a confusing topic.

But it’s certainly important to consider. Depending on the year, the Centers for Disease Control (CDC) estimates that every year, influenza affects 9-60 million Americans, causes 140,000-710,100 hospitalizations, and results in 12,000-56,000 deaths.

Influenza is more severe in some years than others. In fact, the CDC recently announced that the 2017-2018 season was particularly severe, with an estimated 80,000 deaths related to the flu.

Now, most people get better without needing hospitalization, but some people get very sick. Older adults are especially likely to get dangerously ill from catching the flu.

So I agree with the CDC’s recommendation: everyone over the age of 6 months should get their seasonal flu shot.

In fact, I’m about to go get mine. As a healthy woman in her 40s, I’m not that concerned about getting dangerously ill from influenza. Instead, I get my annual flu shot because I want to minimize my chance of getting sick and perhaps exposing my older patients to influenza.

This month, you’ll probably be encouraged to get vaccinated too. So in this article, I’ll address some key things to know about influenza and the flu shot, along with some common questions and concerns. Here’s what I’ll cover:

The basics of influenza and vaccination against the flu
What to know about flu shots for older adults
What’s new and resources for the 2018-2019 flu season
Which influenza vaccination is probably best for most older adults
What to do if your older parent or relative is unwilling or unable to get vaccinated

[Read more…]

How to Prevent Falls: 4 Proven Approaches To Ask Your Doctor About

by Leslie Kernisan, MD MPH 15 Comments

elderly woman falling Worried about falls in an older parent or relative? If so, do you know if their doctor has considered the most useful prevention approaches?

Fall risk can be reduced, but it generally takes some thought and effort. That’s in part because most older adults have multiple factors making them vulnerable to falls.

In a related article on this site, I’ve explained that best fall prevention plans involve identifying an older person’s particular risks — especially risks related to health conditions — and trying to counter those.

So for instance, if an older person has diabetes and is having frequent moments of low blood sugar (also known as hypoglycemia), then to reduce falls, addressing the hypoglycemia is as important, if not more, as starting an exercise program.

In other words, I always recommend that aging adults and families learn to tailor their fall prevention plans. You want to focus on what are the most important modifiable risk factors for that individual person.

That said, over the years I’ve noticed that there are four approaches that I find myself using over and over again, in almost all my patients who have had repeated falls.

These four approaches are used often by geriatricians, but much less often by busy primary care doctors. Unless, that is, a proactive family asks about them.

My Four Most-Used Fall Prevention Approaches

[Read more…]

6 Ways that Memory & Thinking Change with Normal Aging (& What to Do About This)

by Leslie Kernisan, MD MPH 34 Comments

brain changes with aging It’s annoying but unfortunately true: most parts of the body work less well as one gets older and older.

This is even true of the brain, which is part of why it becomes more common to experience a “tip of the tongue” moment as one gets older.

Such age-related changes in how the brain manages memory, thinking, and other mental processes are called “cognitive aging.”

Understanding how aging changes cognition is important. It can help you understand what to anticipate when it comes to your own aging. It can also help families better understand the changes they’re noticing in an older person, and whether those are out of the ordinary or not.

Since I’ve often written about changes in thinking that are abnormal and concerning in older adults, I thought it might be helpful for me to write an article outlining what is normal and to be expected.

Specifically, I’ll cover:

How cognitive aging differs from other diseases and conditions that affect memory and thinking
6 ways that memory and thinking change with aging
The difference between crystallized and fluid intelligence
How to tell cognitive aging apart from more worrisome changes
Practical takeaways and what you can do

[Read more…]

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