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Better Health While Aging

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.

10 Things to Know About HIPAA & Access to a Relative’s Health Information

by Leslie Kernisan, MD MPH

Depositphotos_71539567_m-2015-HIPAA-compressor

Have you ever had questions about what might be going on with an older loved one’s health? But then you find that your older relative is unable — or unwilling — to let you in on the health details?

Or maybe you’ve wanted to talk to your parent’s doctor, but worried that doing so might be a HIPAA violation?

Such issues come up often for the family caregivers of aging adults. Common situations include:

  • An older parent who starts to act in ways that are strange or worrisome, such as becoming paranoid or delusional.
  • An older adult who seems to be physically or mentally declining, but seems reluctant to discuss the situation
  • A hospitalization or emergency room visit
  • A hospitalized older person becoming confused (this would be delirium) and becoming no longer able to explain to family what the doctors have said

In these situations, family caregivers often find themselves grappling with issues related to the HIPAA (Health Insurance Portability and Accountability Act) Privacy Rule.

Why all the grappling?

Well, although most people — and all clinicians — have heard of HIPAA, its rules and requirements are often misunderstood. So for instance, families may assume that it’s a HIPAA violation to report a relative’s worrisome behavior to the doctor, because their relative hasn’t given them permission to do so.

Even worse:  doctors and other clinicians sometimes refuse to disclose any information to families, and will incorrectly claim that it’s a HIPAA violation to do so. This can create extra confusion and stress for families, or can even sometimes put an older person at risk for harm.

If you’ve been concerned about an aging parent’s health, or are otherwise helping someone with their health concerns, then it can be very helpful to understand HIPAA better. HIPAA regulations will also govern your access to medical records and other important health information.

In fact, the American Bar Association includes “Know your rights of access to health information” among its Ten Legal Tips for Caregivers.

The detailed ins and outs of HIPAA can indeed be hard to fully understand. But, it’s not too hard to learn some practical basics, especially since the US Department of Health and Human Services (HHS) provides a Summary of the Privacy Rule here, and maintains a truly useful set of online FAQs about HIPAA here.

In this article, I’ll explain five useful key basics to help you understand HIPAA better, especially when it comes to getting information and medical records as a family caregiver.

I’ll also address five questions I’ve often heard family caregivers ask about HIPAA.

At the end, I’ll share some of my favorite online HIPAA resources, as well as some final tips to keep in mind.

5 Key Basics About HIPAA

[Read more…]

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

5 Things to Know about Aging Parents & Financial Decline

by Leslie Kernisan, MD MPH

Aging woman counting money

You probably already know that many older adults develop problems managing finances as they age.

Now how would you answer the questions below:

  • Has your aging parent planned for a decline in financial abilities?
  • Are you prepared to detect signs of a financial decline?
  • Do you know what to do if you do notice problems with finances?

Many people, even the ones who are caring and well-informed, will often answer “no” to these questions.

But this post will equip you to start answering yes. And I want you to be able to answer yes, because declines in the ability to manage finances are very common among older adults, and often causes serious health and life problems.

The trouble, of course, is that financial decline is uncomfortable for older adults and their families to think about. Managing money, after all, is one of the ways we maintain autonomy and control over our lives.

So nobody likes to confront the fact that our ability to manage money will — in all likelihood — someday decline. (Research suggests that even aging adults who don’t develop dementia often experience declines in financial ability.) And families are understandably squeamish about monitoring an older relative’s financial abilities.

Fortunately, a little education and guidance can make it much easier to be more proactive about this tough topic.

In this post, I’ll cover

  • Five warning signs of financial decline
  • Five important things to know about aging & finances
  • How to protect aging parents from financial problems
  • What to do if your aging parent is having trouble managing their finances

I’ll also cover some ways that geriatricians and other healthcare providers can help, both to reduce declines in financial ability and to properly evaluate them when they occur.

5 Warning Signs of Financial Decline

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles Tagged With: financial concerns, memory

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

by Leslie Kernisan, MD MPH

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…]

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

COVID Vaccination for Aging Adults:
What to Know & Do

by Leslie Kernisan, MD MPH

COVID is an important issue for older adults: they are more likely to be severely affected by COVID, and they represent most COVID deaths.

Luckily, COVID vaccines are effective and significantly reduce the risk of hospitalization and death in older adults. In particular, I want to offer science-based information to help with common questions, such as “Which COVID vaccine is better for seniors?” or “Which COVID vaccine for a 90-year-old?”

This page covers my older science-based updates on COVID vaccines.

For my latest update, see here: Covid & Aging Adults: Current Vaccines & Updates

 

[Read more…]

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

Coronavirus Update & Suggestions (7.16.20 Edition)

by Leslie Kernisan, MD MPH

Like many of you, I continue to follow the coronavirus situation closely, for personal and professional reasons.

Given the dismaying surge in COVID cases over the past several weeks, this week I devoted part of my twice-monthly Helping Older Parents members call to this topic, and I have decided to share this part of the call below.

This video covers:

  • The coronavirus situation today
  • Are we better at preventing COVID?
  • Are we better at treating COVID?
  • Current COVID treatments available in the hospital
  • My take on hospitalization for frail older adults with COVID
  • Useful resources and my recommendations for this summer

The video is below, or get the audio-only through the podcast here.
(For those who have asked about transcripts: I wish I could but right now we are too short on funding; transcripts cost $1.25/minute to produce plus more time to format and finalize.)


Please stay as safe as you can, and take care!

Related resources:

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog

Coronavirus Info: What to Expect Regarding Hospitalization (3.27.20)

by Leslie Kernisan, MD MPH

Like many of you, I’ve been following the recent coronavirus developments closely.

In March, I devoted my twice-monthly Helping Older Parents members calls to this topic.

Here is a video commentary I recorded on 3.27.20.  Although the statistics about COVID numbers in the US quickly fell out of date, I am leaving this video available as the information on what to expect regarding hospitalization should be relevant for quite a while. This video covers:

  • What I’d recently learned about the clinical course of COVID
  • If you think you (or your older relative) might be sick with coronavirus
  • What to know about hospitalization for this, and how a “surge” situation might affect that
  • Options for care at home, including palliative care
  • My recommendations on planning ahead and then hoping for the best.

Also, in the video, I forgot to mention that one of my favorite clinical sources is currently making its coronavirus topic free to the public: Uptodate.com: Coronavirus disease 2019 (COVID-19).

The video is below, or get the audio-only through the podcast here.
(For those who have asked about transcripts: I wish I could but right now we are too short on funding; transcripts cost $1.25/minute to produce plus more time to format and finalize.)


Please stay as safe as you can, and take care!

Related resources:

[Read more…]

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

5 Easy Ways to Connect with a Different Generation (& Why it Matters)

by Leslie Kernisan, MD MPH

When is the last time you had a really meaningful conversation with someone from a different generation? And who was it with?

Was it with a grandchild? A niece? Your own parent? A neighbor? Or maybe even the person standing next to you in line at the store?

While these types of connections happen every day across the United States, they probably aren’t happening enough. 

And that’s a shame, given that research suggests these intergenerational connections are actually really valuable to people of all ages.  

For instance, in 2018, the AARP conducted a national survey of grandparents to learn more about this intergenerational relationship and what it means to older adults. Almost 90% of grandparents reported their relationship with their grandchildren is good for their mental well-being. 

However, the survey also found that distance was the number one barrier to seeing grandchildren more often, with over half of grandparents reporting they have at least one grandchild who lives more than 200 miles away.  Sixty-one percent of grandparents reported wanting more information about connecting with their grandchildren and staying relevant in their lives. 

I first heard about these findings at a conference last summer, when I met Kerry Byrne, PhD, a fellow aging and family caregiving expert who has developed a special interest in intergenerational connections, and in the grandparent-grandchild relationship in particular.

Partly due to her own experience living abroad and trying to keep her children close to their grandparents, in 2019 she founded The Long Distance Grandparent, a website dedicated to helping grandparents and grandchildren connected, even if they live far from each other.

I find this topic of intergenerational connections fascinating. Among other things, it has a role in countering ageism!

So I invited Kerry to join me on the podcast, to talk about how older adults can stay more connected to people of different generations, whether that’s with grandchildren or with people outside their family.

If you are a grandparent yourself, or just want to learn more about why intergeneration connections matter and how you can foster them in your own life, I hope you’ll take a listen to the podcast, or read through the transcript.

Both are available on the show notes page, which you can find here: 102 – Interview: The Importance of Grandparents & Intergenerational Connections

5 Practical Ways to Have More Intergenerational Connections

Here are five specific things Kerry suggests that older adults can do, to foster more intergenerational connections:

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Managing relationships

How to Make Hospitalization Better & Safer in Aging

by Leslie Kernisan, MD MPH

Dr. Stephanie Rogers UCSF Inpatient Geriatrics

As you may know, hospitalization is actually somewhat risky for older adults.

This is sometimes surprising to older adults and families. After all, hospitals are supposed to be places where people who are ill or injured can get the medical supervision and services that they need, to recover and be restored to health.

Well, it’s certainly true that hospitalization is often the only way for a person to obtain more substantial care from nurses and doctors. (There actually is an alternative called Hospital at Home, but it’s not widely available.)

If you’ve broken a hip, or have developed really significant shortness of breath from pneumonia, or otherwise are too unwell to be safely treated in the outpatient setting, hospitalization is often necessary. And since aging increases one’s vulnerability to a variety of health problems, older adults get hospitalized at higher rates than younger people do.

The problem, however, is that although hospitalization is intended to help patients, we’ve also realized that it tends to stress the body and mind in many ways. This is hard on every patient, but especially affects older adults. For instance:

[Read more…]

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

13 Recommended Resources for National Family Caregivers Month

by Leslie Kernisan, MD MPH

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…]

Filed Under: Geriatrics For Caregivers Blog, Helping Older Parents Articles, Useful Links

End of Life Planning Made Easy Through PREPARE

by Team BHWA

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…]

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

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