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.

Why Older People Fall & How to Reduce Fall Risk

by Leslie Kernisan, MD MPH 98 Comments

To be honest, people don’t usually ask me this.

Instead, they want to know things like “How do I keep my mother from falling?” or “What should I do? My grandfather’s been falling.”

After all, falls are a scary thing. Most people know that falls are dangerous for older adults.

The Center for Disease Control (CDC) reports that one in five falls causes a serious injury such as a broken bone or head injury. Fear of falling can also seriously affect an aging adult’s quality of life and sadly, can keep a person from being active and thriving.

So, many older adults and family caregivers are interested in fall prevention because the risks are so great. And the good news is that although it’s not possible to prevent all falls, it almost always IS possible to take actions that will reduce the chance of a bad fall.

If you want to learn more, you’re in the right place.

In this post, I’ll cover:

How understanding why aging adults fall can help you keep an older parent — or yourself — safer,
Why personalized fall prevention plans work better than relying on general fall prevention tips,
The four-step process I use to help older adults prevent falls,
A practical example showing you how to use these steps to avoid falls yourself.

First, understand why older people fall

There are many reasons that aging adults fall. Most older people will be falling due to their own unique combination of reasons.

So how, exactly, should YOU go about reducing fall risk?

Now, you can — and should — try to implement the general tips that are often listed in most fall prevention resources: exercise, medication review with the doctor, vision checks, and home safety reviews.

But if you really want to help an older loved one avoid falls, I recommend you learn to better understand why he or she, in particular, might fall.

Why? Because when you understanding the specific reasons an older person may be falling, you’ll then be able to:

Identify which fall prevention strategies are most likely to help the person you worry about,
Recognize risky situations, and take steps to avoid them,
Know which medical conditions — and which medications — to ask your doctors to look into,
Understand what may have caused a specific fall, which can help you avoid future falls.

In other words, learning why older people fall means that you’ll be able to figure out why YOUR older relative is likely to fall — and take steps to help them. [Read more…]

4 Medications FDA-Approved to Treat Alzheimer’s & Other Dementias:
How They Work & FAQs

by Leslie Kernisan, MD MPH 61 Comments

If someone in your family has been diagnosed with Alzheimer’s or another dementia, chances are that they’ve been prescribed one of the “memory medications.”

But were they told what to expect, and how to judge if the medication is worth continuing?

I’ve noticed that patients and families often aren’t told much about how well these medications generally work, and or how to determine if it’s likely to help in your situation.

So in this post, I’ll explain how the four medications in wide use work. I’ll also address some of the frequently asked questions that I hear from older adults and families.

If someone in your family is taking one of these medications or considering them, this will help you better understand the medication and what questions you might want to ask the doctors. It’s especially important to understand the pros and cons if finances or medication costs are a concern.

Note: This article is about those drugs that have been studied and approved to treat the cognitive decline related to dementia. This is not the same as treating behavioral symptoms (technically called “neuropsychiatric” symptoms) related to dementia, such as paranoia, agitation, hallucinations, aggression, sleep disturbances, wandering, and so forth. There are no drugs FDA-approved to treat the behavioral problems of dementia. The off-label use of psychiatric medications, such as Seroquel, in dementia is covered here: 5 Types of Medication Used to Treat Difficult Dementia Behaviors.)

Worried about the safety of a loved one with memory loss? I explain how to address driving and other safety issues here: How to Help Your Parent with Memory Loss Be Safer (Even if They’re Resisting).

4 Medications FDA-Approved to Treat Dementia

FDA-approved medications to treat Alzheimer’s and related dementias basically fall into two categories: [Read more…]

COVID & Aging Adults: 2022 Updates

by Leslie Kernisan, MD MPH 29 Comments

Since the COVID-19 pandemic emerged in early 2020, COVID has become one of the top causes of illness and death in the US, and has especially impacted aging adults, for both health and social reasons.

Older age is one of the top risk factors for severe COVID; it’s even a stronger risk factor than vaccination status. So this is an important issue for us to follow in geriatrics.

On this page, I’ll be posting updates related to COVID and older adults, for 2022. I’ll be focusing on important developments and what I think is most important for older adults and their families to know, to be safer and manage these COVID times we are living through.

I also have a section below on general COVID safety principles for older adults, which I am pretty sure will hold true throughout this year…even as the COVID situation evolves.

Latest Updates:

[Read more…]

How We Diagnose Dementia: The Practical Basics to Know

by Leslie Kernisan, MD MPH 102 Comments

“Doctor, do you diagnose dementia? Because I need someone who can diagnose dementia.”

A man asked me this question recently. He explained that his 86 year-old father, who lived in the Bay Area, had recently been widowed. Since then the father had sold his long-time home rather quickly, and was hardly returning his son’s calls.

The son wanted to know if I could make a housecall. Specifically, he wanted to know if his father has dementia, such as Alzheimer’s disease.

This is a reasonable concern to have, given the circumstances.

However, it’s not very likely that I — or any clinician — will be able to definitely diagnose dementia based a single in-person visit.

But I get this kind of request fairly frequently. So in this post I want to share what I often find myself explaining to families: the basics of clinical dementia diagnosis, what kind of information I’ll need to obtain, and how long the process can take.

Now, note that this post is not about the comprehensive approach used in multi-disciplinary memory clinics. Those clinics have extra time and staff, and are designed to provide an extra-detailed evaluation. This is especially useful for unusual cases, such as cognitive problems in people who are relatively young.

Instead, in this post I’ll be describing the pragmatic approach that I use in my clinical practice. It is adapted to real-world constraints, meaning it can be used in a primary care setting. (Although like many aspects of geriatrics, it’s challenging to fit this into a 15 minute visit.)

Does this older person have dementia, such as Alzheimer’s disease? To understand how I go about answering the question, let’s start by reviewing the basics of what it means to have dementia.