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Practical information for aging health & family caregivers

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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.

Medicare: The ABCDs to Know & Tips for Open Enrollment

by Michelle Allen, LCSW 12 Comments

Every year, Medicare has an open enrollment period: October 15 – December 7.

During this time, Medicare beneficiaries can do the following:

  • Switch from Original Medicare to Medicare Advantage, or vice versa;
  • Switch from one Medicare Advantage plan to another;
  • Change Medicare Part D (prescription drug) plan; or
  • Enroll in a Medicare Part D (a late enrollment penalty may apply).

Medicare health and drug plans can make changes each year—things like cost, coverage, and what providers and pharmacies are in their networks.  It is important for Medicare beneficiaries to review their current plans, options, and needs for the next year. Many beneficiaries fail to take any action during open enrollment; Medicare is not a “set it and forget it” insurance plan.

Before you can start deciding if and what to change about your Medicare benefits, you have to understand the basics of Medicare.

In this article, I’ll review the basics of Medicare Parts A, B, C and D. Then, I’ll share some tips on navigating the Medicare Open Enrollment period and how to get help, if you’re considering making a switch or if you need help affording the Medicare premiums. [Read more…]

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

Urinary Incontinence in Aging:
What to know when you can’t wait to go

by Nicole Didyk, MD 12 Comments

“I know where every bathroom is at the mall, and my wife rolls her eyes every time I have to visit one when we just arrived – even after I went before leaving the house!  What can I expect?  Most old guys are in the same boat!”

If you opened this article, you probably relate to the quote above, and you’re not unlike millions of other older adults.

Incontinence doesn’t always mean wetting yourself. It can involve urgent needs to use the toilet, frequent bathroom trips, or losing tiny amounts of urine with certain activities. 

Incontinence is more than inconvenient, it can be life-altering, leading to early retirement or social withdrawal, depression, and loss of independent function. Important incontinence stats include:

  • 1 in 3 older women and 1 in 12 older men have lower urinary tract symptoms that can include incontinence
  • Urinary incontinence cost the US economy $66 billion in 2012
  • 6-10% of nursing home admissions are due to urinary incontinence
  • Only 22% of men with urinary incontinence seek help for the problem, as compared to 45% of women

For this reason, in geriatrics, we often ask our patients about incontinence.

I recently had the opportunity to talk to Dr. Adrian Wagg, a Geriatrician-Internist and international expert in urinary incontinence.  You can listen to this interview, and find out how to download a transcript of it here.   In this article, I’ll share some of his insights about the management of incontinence in older adults, and why it remains undertreated too often.

In particular, I’ll cover:

  • How urinary function changes with age
  • Types and causes of urinary incontinence in both men and women
  • What to do if you’re experiencing urinary incontinence and want help
  • How to help manage urinary incontinence in an older person you’re caring for

What happens to the Urinary System with Aging?

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog Tagged With: incontinence, overactive bladder, prostate, urinary incontinence, UTI

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

by Leslie Kernisan, MD MPH 28 Comments

elderly woman fallingWorried 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.

Get Your Free Fall Prevention Resource Guide! A handy short PDF to help you quickly find the key online resources mentioned in this article. Click here to download.

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…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles Tagged With: fall prevention, falls

Flu Shots for Older Adults During COVID Times: What to Know & Do for 2020

by Leslie Kernisan, MD MPH 136 Comments

Usually, I update this article in October, which I think of as flu vaccination time.

But this is 2020 and things are different, so I am writing this in September. In particular, due to COVID-19, the Centers for Disease Control (CDC) is urging that people get vaccinated against influenza early in the fall (before the end of October 2020).

Vaccination against seasonal influenza has always been a bit of a tricky topic. 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?

And now that we have COVID-19 to contend with, vaccination for seasonal influenza might feel even more confusing for people. 

Don’t let yourself be confused. In this article, I will share with you what I know about influenza vaccination and what I’ve learned about influenza in COVID times. I also have updates on the newest high-dose vaccines available for older adults.

But let me share the bottom line with you right now. In general, I have always supported the CDC’s usual recommendation that everyone over the age of 6 months should get their seasonal flu shot.

This year, I agree with the CDC that it’s especially important for people to get their seasonal flu shot, as soon as you can, and if you are an older adult, I recommend getting one of the higher-dose vaccines.

In “normal” pre-COVID times, the Centers for Disease Control (CDC) estimates that every year, influenza affects 9-45 million Americans, causes 140,000-810,100 hospitalizations, and results in 12,000-61,000 deaths. In most years, influenza vaccination does help reduce hospitalizations and deaths (I go into details below).

And now this fall, we will also have COVID-19 to contend with. As of September 2020, at least 190,000 Americans have died of this disease. We don’t know for sure what will happen this fall, but since COVID seems to spread more when people are indoors and in proximity to the exhalations of others, COVID is likely to get worse this fall.

So this year, more than ever, it’s important to do what you can to reduce respiratory illness, to protect yourself, and to protect others. We don’t yet have a COVID vaccine, but we do have influenza vaccines.

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.

Here’s what I’ll cover in this article:

  • The basics of influenza and vaccination against the flu
  • What we know about influenza and COVID-19
  • What to know about flu shots for older adults
  • What’s new and resources for the 2020-2021 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

(Prefer to listen to my key points about flu shots for aging adults? Click here to jump down to my subtitled audio with searchable transcript!)

[Read more…]

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

Q&A: What to Do About Unintentional Weight Loss

by Leslie Kernisan, MD MPH 95 Comments

Q: My 88-year-old father lives in his own home about 100 miles from us. He’s been living alone since my mother died five years ago. I thought he looked rather thin last time we saw him. I’m starting to feel worried about his nutrition. Should I be concerned? Would you recommend he start drinking a supplement such as Boost or Ensure?

A: This question comes up a lot for families. It is indeed very common for older adults to experience unintentional weight loss at some point in late-life.

The brief answer is that yes, you should be concerned. But I wouldn’t recommend you jump to purchasing Boost or Ensure.

Now, in most cases, some nutritional supplementation is in order. But before focusing on this, you should first get help figuring out why your father is losing weight.

For doctors, unintended weight loss is a major red flag when it comes to the health of an older person.

So in geriatrics, we usually recommend that an older person — or their caregivers — monitor weight regularly. This enables us to spot weight loss sooner rather than later.

Once we’ve spotted unintentional weight loss, the next step is to figure out what might be causing it. And then we’re in a better position to recommend a treatment plan, which might well include a nutritional supplement.

In this post, I’ll go over each of these steps in more detail.

Why you should monitor for unintentional weight loss

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles, Q&A Tagged With: weight loss

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