Better Health While Aging

Practical information for aging health & family caregivers

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.

COVID & Aging Adults: 2024- 2025 Updates

by

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. 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.

 

Covid & Aging Adults: COVID News 2024-2025

COVID fall vaccine update October 1, 2024

Here is my most recent video update, from October 1, 2024:

In this video, I talk about the impact of COVID on older adults so far this year, and I explain the available vaccines for the three respiratory viruses likely to be very active this fall and winter: COVID, influenza, and RSV.

[Read more…]

Flu Shots for Older Adults During COVID Times: What to Know & Do for 2024

by

It’s that time of the year: fall, which I think of as flu vaccination time.

I always think getting a flu vaccine is a good idea for most older adults. In these COVID pandemic times, I think it’s even more important.  So I agree with the Centers for Disease Control (CDC), which is urging that people get vaccinated against influenza early in the fall (before the end of October 2024).

Now, vaccination against seasonal influenza can seem like 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 stronger flu vaccines that are now recommended for older adults.

This year, I agree with the CDC that it’s important for people to get their seasonal flu shot, and if you are an older adult, I recommend getting one of the three flu vaccines specifically recommended for older adults. (See below for more on these!)

Note: If you are age 65 or older and it’s been more than 2 months since your last COVID booster, you may be able to get your COVID fall booster shot at the same time. (For more on the fall 2024 COVID booster, see COVID & Aging Adults: 2024-2025 Updates)

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, this will be our fifth winter dealing with COVID-19 as well. (Plus there is now RSV!) As of September 2024, we still have 500-900 people dying of COVID every week, most of whom are people over age 65. 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, it’s likely that COVID will get worse again this winter.

So this year, it’s important to do what you can to reduce respiratory illness, to protect yourself, and to protect others. And getting vaccinated against influenza is one of the things we can do.

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 & the CDC’s new recommendations specifically for older adults
  • What’s new and resources for the 2024-2025 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
  • Whether it’s more important to get a flu shot or a COVID vaccination (or a booster)

[Read more…]

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

by

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 your loved one just tripped and stumbled, 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 your loved one has had 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. 

 

[Read more…]

Hiring In-Home Caregivers for Aging in Place: What to Know

by

This article is by Michelle Allen, LCSW. Michelle is an experienced social worker and geriatric care manager based in Atlanta and is a featured expert providing guidance in our Helping Older Parents programs. 

At some point, you may need to have someone help your older parent – or perhaps you – with care in the home.

So, what do you do when you need some more hands to help with housekeeping, meal preparation, dressing, transportation, medication management, etc.? How do you find qualified, reliable, kind, and trustworthy people?

About two-thirds of all help comes from unpaid caregivers — such as daughters, sons, and friends — and about one-third of all help comes from paid caregivers.

It is easy to understand how you get a family member or friend to help — you usually just ask. But hiring a paid in home caregiver can be a bit more daunting.

In this article, I’ll explain what you need to know, to better understand your options and get the care that is needed.

Home Care vs. Home Health

[Read more…]

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

by

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?

[Read more…]

Q&A: What to do if your aging parent becomes rude & resistant

by

Aging Parent with Adult Child

Q: My loving, Jewish mother is 92 and has turned into a rude, abusive foul-mouthed woman who I no longer recognize.

She’s in relatively good health and amazingly lives in the same house I grew up in. She has an aide during the day. She won’t leave the house, treats the aide poorly and last weekend cursed out my very patient spouse. We’ve been getting 5 calls a day such as ” I’m having a heart attack; no one will tell me whether recycling comes today”! 

I know she has early signs of dementia. Her cardiologist tells me not to take it to heart and this is not the same woman who raised me.  She won’t go to the JCC adult programs, complains about being lonely at night, yet hangs up on me when I tell her we can get an aide at night or sell the home and let her live in a facility with women her age, etc. She threatens to call the Police if someone comes to her home at night. I have a POA but don’t want to rob her of her independence at 92. I try to tell her to speak nicely to the aides, myself, my spouse, but she says ” I don’t remember or I must have reacted to something someone did or said.”

I feel guilty as I’m not spending as much time with her as I would like, but it’s a matter of survival. Jewish guilt is thrown about with impunity and I can’t tell whether she’s being manipulative and obsessing over bullshit ( “oh my God the outside light may burn out tonight” ) or she really can’t control herself. Her aide  is a lovely human being but my mom orders her around like a slave.  Who is this woman? I’m torn, anguishing over what to do and am doing nothing but try to correct her inappropriate behavior and language. I wanted to take her to a geriatric psychiatrist but she refused to go. Medication to calm her down is dangerous per the MD as she could fall, etc. 

What should I do? I’m at my wits end. 

Dr. K’s answer:

Wow, difficult situation but unfortunately not uncommon.

You say your mother has early signs of dementia, and it is true that “personality changes” can be due to an underlying type of dementia, such as fronto-temporal dementia or Alzheimer’s, especially if a family notices other changes in memory or thinking abilities.

But it doesn’t sound like your mother’s been clinically evaluated for dementia, and you don’t say whether this has been brought up with her primary care doctor.

How to Get Signs of Dementia (or Personality Changes) Evaluated

[Read more…]

Q&A: What to Do About Unintentional Weight Loss

by

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 unexplained 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, unintentional 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 unexplained 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…]

5 Ways to Help Someone Age in Place

by

Aging Farmer

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.

[Read more…]

Deprescribing: How to Be on Less Medication for Healthier Aging

by

medications elderly should avoid

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:

[Read more…]

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

by

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…]

Disclaimer

The material on this site, including any exchanges in the comments section of the blog, is for informational and educational purposes only.

Any comments Dr. Kernisan may make regarding an individual’s story or comments should not be construed as establishing a physician-patient relationship between Dr. Kernisan and a caregiver, or care recipient.

None of Dr. Kernisan’s website or group information should be considered a substitute for individualized medical assessment, diagnosis, or treatment.

Please see the full Disclaimer for more information.

Please also carefully read our Terms & Conditions of Use, before using this site.

Creative Commons License
This work by Leslie Kernisan MD & Better Health While Aging LLC is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Based on a work at BetterHealthWhileAging.net.

Privacy Policy & Disclosures

Your privacy is very important to us. Your information will never be sold to anyone, whether you browse the site, sign up for email updates, or register for an event.

Pleae read our complete Privacy Policy for more information and for Dr. Kernisan's financial disclosures.