Helping Older Parents Articles

Wondering whether you should worry? Having trouble getting parents to accept help? Overwhelmed by challenges and concerns?

This part of the site is especially for you! It includes our hand-picked articles, tips, & resources for people helping older parents.

Blood pressure medications linked to serious falls: What you can do

by Leslie Kernisan, MD MPH

Have you had any concerns about an older person falling, or being at risk for a broken hip?

A new clinical research study relevant to millions of older adults was just featured in the news.

The study, completed by a team of geriatrics researchers at Yale, found that in older adults aged 70 or older, taking blood pressure medication was linked to a higher risk of serious falls. (Serious falls as in, falls that caused an ER visit for a fracture, a dislocated joint, or a brain bleed. Serious stuff indeed!)

So, if the person you care for has a diagnosis of hypertension, and if you’ve had any concerns regarding falls or near-falls, these study results should be of interest to you.

In this post, I’ll review the key results of this study. Then I’ll tell you what I think are the most important practical take-aways for family caregivers.

This post will also include some practical tips to help you minimize the risk of your loved one experiencing a serious fall.

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Delirium: How Caregivers Can Protect Alzheimer’s Patients

by Leslie Kernisan, MD MPH

This week’s Q & A call was about how to better manage health and healthcare issues, when you’re taking care of someone with a dementia such as Alzheimer’s.

Most of the caregivers’ questions were about delirium. This is the state of worse-than-usual confusion that people can develop when they are sick or under serious stress.

I love talking to Alzheimer’s caregivers about delirium, because this is a really common problem that family caregivers absolutely can do something about!

The key is to know that people with dementia are especially prone to get delirium when they fall ill (especially in the hospital). And then you’ll want to know the basics on how to spot this problem, and how to get the doctors to address it properly.

A fact I wish more caregivers of elders knew: delirium can be the only obvious sign of a potentially serious health problem, such as a heart attack, a urinary tract infection, or a pneumonia. (Especially when it comes to older people with Alzheimer’s, they often don’t voice focused complaints the way younger people do.)

The trouble is, even though delirium is very common in older adults, studies have shown that it’s often missed by doctors and nurses. This is a important problem in healthcare, for three key reasons:

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A common problem that speeds Alzheimer’s decline, and how to avoid it

by Leslie Kernisan, MD MPH

Earlier this week, while I was listening to a social work colleague (Mary Hulme of Moonstone Geriatrics) give a talk on dementia at the public library, the following question came up:

“How can one keep Alzheimer’s from getting worse?”

Now, Alzheimer’s disease — the most common underlying cause of dementia symptoms — does slowly get worse no matter what. (Given enough years, it will eventually damage the brain to the point of causing a slow death, which is why Alzheimer’s is a terminal disease.)

But on the other hand, we do know that some things tend to slow the progression of brain decline, whereas other things seem to speed up the decline. In other words, the actions we take — and don’t take — can influence a person’s dementia journey.

In my experience, people often have heard about things that might slow down decline (exercise is one of my favorites).

But it seems to me that people are often much less well-informed about the things that can speed up Alzheimer’s decline. This is too bad, because often it is possible to take actions to avoid or minimize things that might cause dementia to get worse faster.

So today I’m going to write about what I think is the most important of these potentially dementia-accelerating problems: delirium.

Delirium: What it is, why it matters

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Tools to Help with End-of-Life Planning

by Leslie Kernisan, MD MPH

Yesterday I did a webinar with Family Caregiver Alliance, on end-of-life issues for dementia caregivers.

(4/10/14: I have just uploaded this powerpoint to Slideshare, so you can see my slides here.)

As you can imagine, this is a big topic that can’t be covered comprehensively in an hour.

So, I focused the talk mainly on something that I often find myself wishing families had spent more time on: advance care planning. Specifically, I talked about how individuals and families can approach planning for future medical care, in the context of a diagnosis of Alzheimer’s or another form of dementia.

Why? Because in my own experience, the last stage of life for a person with dementia is often strongly influenced by what kind of planning did — or didn’t — happen earlier on.

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Tools for Caregivers: How to Manage Tasks & To-dos

by Leslie Kernisan, MD MPH

This post is the fourth and final post in a series describing the four key types of tools that I recommended to caregivers at a retreat earlier this summer.

Just to recap, the key tools I recommended included a journal/notebook, a portable and up-to-date medication list, an organizer to keep copies of medical results (also known as a “personal health record”), and last but not least, a personal or family task organizer.

In this post, I’ll explain why I believe most caregivers can benefit from using some kind of task organizer in order to keep track of the to-dos related to an older person’s medical care. I’ve also tried some of the task management tools that are available, and will write about a few that caregivers may want to try.

Why I recommend task organizers to caregivers

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Tools for caregivers: Keeping & Organizing Medical Information

by Leslie Kernisan, MD MPH

This post is part 3 of a series describing the four key types of tools that I recommended to caregivers at a retreat earlier this summer:

Journal/notebook, for notes and symptom tracking (see this post for details)
Portable and up-to-date medication list (see this post for details)
Organizer to keep copies of medical results and medical records
Personal/family task organizer

In this post, I’ll explain why it’s important to keep copies of medical results and key medical records. I’ll then explain which kinds of medical information is most useful to keep, and I’ll describe a few ways that caregivers can do this.

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Tools for Caregivers: the Portable & Up-to-date Medication List

by Leslie Kernisan, MD MPH

At a recent retreat for family caregivers, I proposed four key tools that I recommend to caregivers who want to improve the healthcare of an older person:

Journal/notebook, for notes and symptom tracking (see last week‘s post for more details)
Portable and up-to-date medication list
Organizer to keep copies of medical results and medical records
Personal/family task organizer

In this post, I’ll explain why I always recommend caregivers make an effort to maintain a portable and up-to-date medication list. Then I’ll discuss some tech tools that caregivers can consider.

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Tools for Caregivers: How journals can help

by Leslie Kernisan, MD MPH

Last month, as I was preparing to present a talk at a Family Caregiver Alliance retreat, I spent some time looking into tech tools to recommend to caregivers.

As you might imagine, there are many apps and programs to consider, and I quickly realized that it wasn’t going to be possible to review everything that’s available.

So instead, I decided to start by thinking about my patients and families, and trying to identify a few key areas in which I’d seen tools and organizational strategies really help caregivers better manage an older person’s health needs.

I came up with four key categories of tools that I’ve recommended to families:

Journal/notebook, for notes and symptom tracking
Portable and up-to-date medication list
Organizer to keep copies of medical results and medical records
Personal/family task organizer

In this post, I explain how a journal can help caregivers with the medical parts of their caregiving. Then I’ll describe a few tech tools that caregivers might want to try.

[Read more…]

How to identify risky medications for older adults

by Leslie Kernisan, MD MPH

Many family caregivers know that medications can cause side-effects in older people, and may worry that perhaps their loved ones are being affected by medications.

It’s a very reasonable concern to have. Studies have shown that older adults, especially those taking multiple prescription medications, often experience potentially serious side-effects from their medications.

But having talked with many family caregivers over the years, I’ve found that even the savvy ones often haven’t heard of the “Beer’s List.”

What is the Beer’s List?

Technically known as the “American Geriatrics Society Updated Beers Criteria: Medications that Older Adults Should Avoid or Use with Caution,” this is a carefully reviewed list of medications that are “potentially inappropriate” for older adults, and includes many of the medications that we geriatricians tend to stop or reduce in our patients. (Seriously, identifying and reducing these medications is a big part of my clinical practice!)

Although mainly meant to be used as a reference by clinicians, the American Geriatrics Society(AGS) also provides the information in an easier-to-read format here.

What to do if you realize that you or a loved one is taking a potentially risky medication? Conveniently, AGS addresses this very issue and provides a handy online guide on “What to Do and What to Ask Your Healthcare Provider if a Medication You Take is Listed in the Beers Criteria for Potentially Inappropriate Medications to Use in Older Adults.”

If you’re a caregiver: Have you ever used the Beer’s list as a resource? Other ideas for how caregivers can be empowered to check on their loved one’s medications?

Helping Older Parents Articles

Delirium: What it is, why it matters

Why I recommend task organizers to caregivers

What is the Beer’s List?

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