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.

How to Choose the Safest Over-the-Counter Painkiller for Older Adults

by Leslie Kernisan, MD MPH

Depositphotos_13932212_m-2015-OTC-medication-compressor

Q: My 88-year old mother often complains of various aches and pains. What is the safest over-the-counter painkiller for her to take? Aren’t some of them bad for your liver and kidneys?

A: Frequent aches and pains are a common problem for older adults.

If your mother has been complaining, you’ll want to make sure she gets a careful evaluation from her doctor. After all, frequent pain can be a sign of an important underlying health problem that needs attention. You’re also more likely to help your mom reduce her pain if you can help her doctors identify the underlying causes of her pain.

That said, it’s a good idea to ask what over-the-counter (OTC) pain relievers are safest for older people.

That’s because improper use of OTC painkiller tablets is actually a major cause of harm to older adults.

So let me tell you what OTC pain relievers geriatricians usually consider the safest, and which very common group of painkillers can cause serious side-effects in aging adults. I’ve also made a Youtube video cover the topics mentioned in this article:

What’s the safest OTC painkiller for an aging parent?

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8 Things to Have the Doctor Check After an Aging Person Falls

by Leslie Kernisan, MD MPH

If you want to prevent dangerous falls in an aging adult, here’s one of the very best things you can do: be proactive about getting the right kind of medical assessment after a fall.

Why? There are three major reasons for this:

A fall can be a sign of a new and serious medical problem that needs treatment. For instance, an older person can be weakened and fall because of illnesses such as dehydration, or a serious urinary tract infection.
Older adults who have fallen are at higher risk for a future fall. Although it’s a good idea for any older person to be proactive about identifying and reducing fall risk factors, it’s vital to do this well after a fall.
Busy doctors may not be thorough unless caregivers are proactive about asking questions. Most doctors have the best intentions, but studies have shown that older patients often don’t get recommended care. By being politely proactive, you can make sure that certain things aren’t overlooked (such as medications that worsen balance).

All too often, a medical visit after a fall is mainly about addressing any injuries that the older person may have suffered.

Obviously, this is very important; one doesn’t want to miss a fracture or other serious injury in an older person.

However, if you want to help prevent future falls, it’s also important to make sure the doctors have checked on all the things that could have contributed to the fall.

This is really key to preventing falls in an aging adult. Even if you’re pretty sure the fall was just due to tripping and stumbling, a good evaluation can uncover issues that made those trips and stumbles more likely.

In this article, I’ll list eight key items that you can make sure the doctors check on, after an older person falls. This will help you make sure that you (or your older loved one) get a thorough work-up, and can reduce the chance of future serious falls.

This list is partly based on the American Geriatrics Society’s Clinical Practice Guidelines on Preventing Falls.

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5 Ways to Help Someone Age in Place

by Leslie Kernisan, MD MPH

People of all older ages often tell me they hope to age in place.

Meaning, they want to be able to remain in their home and community, even as time brings changes to life, health, and abilities.

These days, many older people do end up moving, often reluctantly. And this doesn’t have to be a bad thing; I find that after a period of adjustment, many aging adults enjoy their new homes and communities. But no one likes the thought that they might *have* to move, because it’s become too difficult or risky to remain in one’s preferred home.

Now, as for all things in life and health and aging, it’s impossible to guarantee the outcome we want. But, as in almost all things in life and health and aging, there’s plenty you can do to put the odds in your favor, when it comes to aging in place.

The key is to understand what often interferes with remaining in one’s home. Then you can think about how to anticipate, prevent, or work around many of those challenges to aging in place.

In this post, I’ll describe some of the common reasons that I see older adults struggling to age in place. Then I’ll share 5 specific things you can do, to help an older person better age in place.

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Deprescribing: How to Be on Less Medication for Healthier Aging

by Leslie Kernisan, MD MPH

Have you ever wondered whether you — or your older relative — might be taking too many medications?

You’re certainly right to ask yourself this. I consider this for all my own patients, and wish every doctor would.

In part, this is because over the years, I’ve had countless older adults express their worries and frustrations, related to their prescription drugs. These include:

The hassle of having so many pills to take
Worries about side-effects
Frustration with medication costs
Wondering whether a given medication is the “right” one for you, or for your condition
The sneaky feeling that some of those medications don’t seem to help much
The hassle of coordinating a long medication list among multiple doctors

Needless to say, all of this is not so good for quality of life while aging.

And unlike some things that people worry about, these concerns are all actually justified, given what geriatricians know about older adults and medications.

So if you’ve ever experienced the above worries — or if you (or your older relative) are taking more than five medications — then I want to make sure you know about a process that can improve or resolve all those problems that older adults have with their medications.

It’s called deprescribing, and it’s really essential to optimizing the health of an older person.

In this article, I’ll cover what every older adult and family caregiver should know about it:

What is deprescribing?
Why is deprescribing especially important for older adults?
How does deprescribing work?
What medications are most important for older adults to consider deprescribing?
How can older adults and family caregivers get doctors to address deprescribing?

This way, you’ll have a better shot at what everyone wants when it comes to medication:

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Atrial Fibrillation in Aging:
What to Know & How to Treat

by Leslie Kernisan, MD MPH

The human heart is often described as a pump, but there’s much more to it: it also has a special electrical system that regulates and coordinates heartbeats.

Abnormal heartbeats are called arrhythmias, and probably the most common one is atrial fibrillation, a condition that affects millions of older adults and plays a major role in stroke, disability, and hospitalization.

Some people with atrial fibrillation come to medical attention because they feel unwell—short of breath, fatigued, or aware that their heart is racing. Others feel fine and are surprised when a clinician — or maybe even their smartwatch — tells them they have an irregular heartbeat. Families are often left trying to understand a diagnosis that sounds ominous and a set of treatment options that can feel confusing or even frightening.

To help clarify what matters most, I spoke with cardiologist and electrophysiologist Cara Pellegrini, MD, about atrial fibrillation in aging. Here’s what to know, including what atrial fibrillation is, why it matters, and how to think through treatment and stroke prevention—especially when frailty, falls, or cognitive impairment are part of the picture.

Dr. Kernisan: What exactly is atrial fibrillation?

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Beyond Alzheimer’s:
Common Types of Dementia in Aging

by Leslie Kernisan, MD MPH

Are you dealing with a diagnosis of dementia?

If so, you might be wondering what type of dementia you are dealing with. Or, perhaps you’ve heard someone say it’s important to find out what type of dementia it is.

It’s true that there certainly are different types of dementia, and it’s often said that the most common one is Alzheimer’s disease.

But actually, especially as people get to be age 80 or older, by far the most common type of dementia is mixed dementia. Meaning, the dementia symptoms are caused by a mix of types.

If you are dealing with memory loss or other forms of cognitive decline, it’s a good idea to know the basics about the different types of dementia.

In this article, I’ll cover:

What is dementia and what’s the difference between Alzheimer’s and dementia
The most common types of dementia in older adults
When it might be important to find out what type of dementia it is
My usual approach to using dementia type to help patients

You can also watch my video covering Common Types of Dementia in Aging:

What is dementia?

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Top 10 Checklist for Better Health & Aging in 2026

by Leslie Kernisan, MD MPH

Do you find yourself taking stock and setting goals around the time of New Year’s?

It is indeed an excellent time to reflect on the past year.

And although one can set goals at any time of year, the start of the calendar year is a time that seems to inspire many people to think about their health and how to thrive over the coming year.

If better health while aging is important to you, here are my top ten suggestions for the coming year.

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9 Types of Issues to Address When Helping Older Parents

by Leslie Kernisan, MD MPH

Most older adults don’t need much help from others.

In fact, many of them are quite busy assisting others and otherwise contributing to their families, communities, and/or workplaces.

But of course, many older people eventually do need some help from others, especially if they live into their 80s, 90s, or beyond. After all, only a minority of people transition from being fully independent to deceased, with no intervening period of needing assistance.

(Wondering how to get an older person to accept help? That’s covered here: 6 Steps to Take When Aging Parents Need Help – Even if They’re Resisting.)

When an older person does start to need help, it tends to be close family members — assuming the person has family — that step in: spouses, adult children, siblings, nephews or nieces, grandchildren, and so forth. In fact, family members are by far the number one source of “long-term care supports and services” for older adults.

Sometimes providing this eldercare support can be fairly straightforward: a little help with transportation, or arranging for some assistance with shopping or household chores.

But in other cases, family members find themselves having to take on quite a lot. This is often due to health issues affecting the older person’s ability to remain independent and manage various aspects of life.

Some situations that commonly bring this on include:

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Cerebral Small Vessel Disease:
What to Know & What to Do

by Leslie Kernisan, MD MPH

Signs of cerebral small vessel disease. From Inzitari et al, BMJ. 2009 Jul 6;339:b2477. doi: 10.1136/bmj.b2477

This article is about the most common aging brain problem that you may have never heard of.

While leading a fall prevention workshop a few years ago, I mentioned that an older person’s walking and balance problems might well be related to the presence of “small vessel ischemic changes” in the brain, which are very common in aging adults. (This is also called “white matter disease.”)

This led to an immediate flurry of follow-up questions. What exactly are these changes, people wanted to know. Do they happen to every older adult? Is this the same as vascular dementia? And how they can best help their parents with cognitive decline?

Well, these types of brain lesions don’t happen to every older person, but they do happen to the vast majority of them. In fact, one study of older adults aged 60-90 found that 95% of them showed signs of these changes on brain MRI.

In other words, if your older parent ever gets an MRI of the head, he or she will probably show some signs of these changes.

So this is a condition that older adults and families should know about. Furthermore, these changes have been associated with problems of consequence to older adults, including:

Cognitive decline,
Problems with walking or balance,
Strokes,
Vascular dementia.

Now, perhaps the best technical term for what I’m referring to is “cerebral small vessel disease.” But many other synonyms are used by the medical community — especially in radiology reports. They include:

White matter disease
Small vessel ischemic disease
Brain lesions
Periventricular white matter changes
Perivascular chronic ischemic white matter disease of aging
Chronic microvascular changes, chronic microvascular ischemic changes
Chronic microvascular ischemia
White matter hyperintensities
Age-related white matter changes
Leukoaraiosis

In this post, I will explain what all older adults and their families should know about this extremely common condition related to the brain health of older adults.

In particular, I’ll address the following frequently asked questions:

What is cerebral small vessel disease (SVD)?
What are the symptoms of cerebral SVD?
How is cerebral small vessel disease related to vascular dementia and cerebrovascular accidents?
What causes cerebral SVD?
How can cerebral SVD be treated or prevented?
Should you request an MRI if you’re concerned about cerebral SVD?

I will also address what you can do, if you are concerned about cerebral SVD for yourself or an older loved one.

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Q&A: What You Can Do if You’re Worried About “Incompetence”

by Leslie Kernisan, MD MPH

Q: My 87-year-old father lives alone. His house has become increasingly dirty, but he refuses to get help, even though I’m sure he needs it. I’m worried that he’s becoming incompetent and in need of elder care, but he doesn’t want to go see the doctor. What can I do?

A: This situation does come up a fair bit with aging parents and relatives. I’m sorry to say there usually are no easy solutions. But there definitely are things you can and should do, and it’s better to act sooner rather than later.

Let’s review what you can do. I’ll also explain what I’ve learned about “incompetence” over the years, and how doctors usually play a role in the evaluation of such older adults.

Then, I’ll share some thoughts on how older people and families can plan ahead, to avoid facing this kind of dilemma. And then last but not least, I share a few thoughts on taking care of yourself as you go through this.

The usual concern, for a person of this age, is that the person may have developed memory loss, or a dementia such as Alzheimer’s disease.

This is a pretty reasonable worry, since an estimated 30% of people aged 85+ have dementia. (Wondering about dementia vs Alzheimer’s? Here’s where I explain dementia and how it’s related to Alzheimer’s.)

And of course, if your older parent seems to be doing worse than before, when it comes to activities that require mental organization (such as keeping a house reasonably clean), that further increases the chance that some kind of brain deterioration is causing problems.

But, we should never start by jumping to the conclusion that someone has developed dementia and needs elder care.

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Helping Older Parents Articles

What’s the safest OTC painkiller for an aging parent?

Dr. Kernisan: What exactly is atrial fibrillation?

What is dementia?

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