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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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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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:

What is dementia?

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Constipation is not a glamorous topic, but it’s certainly important, especially in older adults.

As anyone who has experienced occasional — or even chronic — constipation can tell you, it can really put a damper on quality of life and well-being.

Constipation can also cause more substantial problems, such as:

• Severe abdominal pain, which can lead to emergency room visits
• Hemorrhoids, which can bleed or be painful
• Increased irritability, agitation, or even aggression, in people with Alzheimer’s disease or other forms of dementia
• Stress and/or pain that can contribute to delirium (a state of new or worse confusion that often happens when older adults are hospitalized)
• Fecal incontinence, which can be caused or worsened by having a hard lump of stool lodged in the lower bowel
• Avoidance of needed pain medication, due to fear of constipation
• Worsening of urinary leaks

Fortunately, it’s usually possible to help older adults effectively manage and prevent constipation. This helps maintain well-being and quality of life, and can also improve difficult behaviors related to dementia.

The trouble is that constipation is often either overlooked or sub-optimally managed by busy healthcare providers who aren’t trained in geriatrics. They are often focused on more “serious” health issues. Also, since many laxatives are available over-the-counter (OTC), some providers may assume that people will treat themselves if necessary.

Personally, I don’t like this hands-off approach to constipation. Although several useful laxatives, such as polyethylene glycol (brand name Miralax)  are indeed available OTC, I’ve found that the average person doesn’t know enough to correctly choose among them.

Also, although in geriatrics we often do end up recommending or prescribing laxatives, it’s vital to start by figuring out what is likely to be causing — or worsening — an older person’s constipation.

For instance, many medications can make constipation worse, so we usually make an attempt to identify and perhaps deprescribe those.

In short, if you’re an older adult, or if you’re helping an older loved one with health issues, it’s worthwhile to learn the basics of how constipation should be evaluated and managed. This way, you’ll be better equipped to get help from your health providers, and if it seems advisable, choose among OTC laxative options.

Here’s what I’ll cover in this article:

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