Practical information for aging health & family caregivers
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.
Want to keep your brain — or the brain of someone you love — as healthy as possible?
Then it’s essential to know which commonly used medications affect brain function.
In this article, I’ll go into details regarding a type of medication that I wish all older adults knew about: anticholinergic drugs.
Everyone wants to get the right medical care. But doctors are often lacking key medical information at the time they see you (or, your aging relative).
The solution: setting up and using a personal health record (PHR).
This is a big step up from what many people do, which is to create an “in-case-of-emergency” packet. Such medical information packets usually include a list of medications, chronic conditions, and allergies, along with the names of next-of-kin and perhaps a POLST form.
I’ve reviewed such medical information packets, and they are certainly better than nothing. But in general, they don’t help older adults avoid these very common — and potentially serious — problems with their medical care:
Fortunately, Â even a very basic and low-tech PHR can help you avoid the problems listed above, and will improve your personal health information management.
At a minimum, you’ll save yourself hassle and the extra appointments that get scheduled because the doctor didn’t have the needed medical information the first time around. You’ll also spare yourself the discomfort and expense of enduring duplicate testing.
More importantly, properly maintaining and using a personal health record (PHR) will go a long way to ensuring that you get better, safer medical care. It can also help you avoid potentially life-threatening medical mishaps.
The key is to learn what medical information to put into this PHR, and how to use it effectively for care coordination.  This post will tell you what you need to know, to set up and use a PHR.
Here’s a situation that comes up for many people: you move in later life.
Or maybe it’s your older mother — or father, or other older relative — who’s moving to a new town, perhaps to be closer to you, or otherwise be somewhere more conducive to aging in place.
Such a move means that you’ll need to establish care with a new primary care provider.
For most older adults, establishing a good working relationship with a new health provider is a challenge. If nothing else, it can take some time to feel that each party knows and understands the other.
But it’s also in many cases a terrific opportunity to review a person’s health and healthcare. Provided, of course, that everyone involved makes an effort, and has good information to work with.
In this post, I’ll share my list of the most useful medical records and health information that you should bring to that first visit with the new primary care provider.
Do you have to bring this information? Of course not. In my own experience, most people bring nothing more than a medication list, if that. And they leave it to the new doctors to request health information from the previous doctors, which often arrives well after that first new patient visit.
But this is a problem,  because it makes it quite difficult for that first visit to be truly useful.
Sure, the doctor can interview you, and do a physical exam. Yet for many older adults, that interview and exam is often much more productive if a doctor can combine it with a review of the most useful health information.
I myself used to see a fair number of new older patients, when I was a primary care geriatrician at the Over 60 Health Center. Those first visits often felt like fumbling around in a dark room, feeling the walls and furniture and trying to get a sense of the overall layout.
But occasionally, a new patient would come with useful health information in hand. This generally made a big difference in how quickly we could ensure that our new patient was getting the right medical care from us, and from other involved doctors.
So if you want to have the best start possible with a new doctor — or help your aging parent do so — you’ll need to do a little advance preparation. This often requires some time and energy. But it will pay off, by ensuring that the new doctor has the information he or she needs, to provide you with good healthcare.
Also, if you are in that season of life where you’re starting to be more involved with your aging parent’s health (or think perhaps you should be), this is a great opportunity to learn more about your parent’s health.
Here’s my list of what I ask patients and families to bring to me, in order to make that new patient visit most useful.
In this article, I’ll address a real mainstay of modern medicine: laboratory tests that require drawing blood.
This is sometimes referred to as “checking labs,” “doing bloodwork,” or even “checking blood.”
Most older adults have been through this. For instance, it’s pretty much impossible to be hospitalized without having bloodwork done, and it’s part of most emergency room care. Such testing is also often done as part of an annual exam, or “complete physical.”
Last but not least, blood testing is usually — although not always — very helpful when it comes to evaluating many common complaints that affect aging adults.
Fatigued and experiencing low energy? We should perhaps check for anemia and thyroid problems, among other things.
Confused and delirious? Bloodwork can help us check on an older person’s electrolytes (they can be thrown off by a medication side-effect, as well as by other causes). Blood tests can also provide us with information related to infection, kidney function, and much more. I also go into these details in my Youtube video:
In another article, I’ve explained the key reasons that I recommend older adults and their caregivers have a blood pressure (BP) monitor at home.
To very briefly recap:
In this post, I’ll share some tips on choosing and using a home BP monitor.
And don’t worry: I won’t tell you that you have to plan on checking every day for the rest of your lives. Although there are times when it’s great to check daily — like the week after a change in medication — the most important thing is to have a good BP monitor at home and know how to use it at least occasionally.Â
I also share some more guidance and advice in my Youtube video on high blood pressure here:Â
Have you been worried about an older person’s memory or thinking abilities?
Maybe your parent has seemed more confused recently. Or you may have noticed that your aging spouse is repeating herself, or struggling to do things that didn’t use to pose much of a problem.
Or you may have noticed false accusations, or irrational worries getting out of control.
These are very common concerns, and they often lead to questions such as:
The answer to the last question is this: if you are worried about memory or thinking, then you should seek out some kind of medical evaluation.
That’s because when families worry about an older person’s cognitive abilities, there often are some underlying health issues affecting the mind’s function.
Those need to be detected, and treated if at all possible. So, you’ll need to request help from a health professional, and in this article, I’ll explain what that initial help should consist of. This way you’ll know what to expect, and what the doctor might ask you about.
Technically, these kinds of problems are called “cognitive impairment.” This is a broad term that means some kind of problem or difficulty with one’s memory, thinking, concentration, and other functions of the conscious brain, beyond what might be expected due to normal “cognitive aging.”
(For more on “cognitive aging” and what types of changes are considered normal aging, see this article: 6 Ways that Memory & Thinking Change with Normal Aging, & What to Do About This.)
Cognitive impairment — which is also called “cognitive decline” — can come on suddenly or gradually, and can be temporary or more permanent. It may or may not keep getting slowly worse; it all depends on the underlying cause or causes.
In this article, I’ll share with you the more common causes of cognitive impairment in older adults.
I’ll then share a list of 10 things that should generally be done, during a preliminary medical evaluation for cognitive decline in an older adult.
You can also watch a subtitled video version of this information below.
What should you do if an older person complains of insomnia, or is not sleeping well at night?
Experts do believe that “normal aging” brings on some changes to sleep. (See this post for more on how sleep changes with aging.) Basically, older adults tend to get sleepy earlier in the evening, and tend to sleep less deeply than when they were younger.
So it’s probably not realistic to expect that as you get older, you’ll sleep as long or as soundly as when you were younger.
That said, although aging by itself does change sleep, it’s also quite common for older adults to develop health problems that can cause sleep disturbances. So if you’re older and aren’t sleeping well, you’ll want to make sure you’ve been checked for these. Figuring out what’s going on is always the first step in being able to improve things.
And remember, getting enough good quality sleep helps maintain brain health, physical health, and mood.
In this article, I’ll cover the top causes of sleep problems in older adults. I’ll also tell you about what approaches have been proven to work, to help treat insomnia and sleep problems in older adults.
Last but not least, if you (or your older relative) have experienced the very common combination of waking up to pee at night and difficulty sleeping, I highly recommend listening to this podcast episode, which features a geriatrician who is an expert on this: 092- Interview: Addressing Nighttime Urination & Insomnia in Aging.
If I had to recommend one key piece of healthcare equipment that older adults & caregivers should have at home, it would be this: a good home blood pressure (BP) monitor.
Why? Because BP measurements (and pulse measurements, which machines check at the same time) are an incredibly useful tool when it comes to assessing and optimizing an older person’s health and well-being. This is true even for those older people who aren’t being treated for hypertension (chronic high BP).
As I’d love for more older adults and families to understand how home BP monitors can help them, in this article I’ll explain how home BP monitors can be helpful specifically for older adults. (And then see my related article here: Choosing & Using a Home Blood Pressure Monitor, & What to Ask the Doctor .)
Today we’re covering a touchstone resource for geriatricians: the “Beers List” of medications that older adults should avoid or use with caution.
(Technically, it’s called “The AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults.” I personally think of it as the list of “risky medications” for older adults.)
If you want to know which medications older adults should be careful about, this is the list!
This list gets updated every few years, so the Beers Criteria published in May 2023 is about as up-to-date as you can get for this type of guideline document.Â
You should know that experts in geriatrics and in medication safety go through a very careful process of reviewing the research on medications, and of updating this list of medications that older adults should avoid or use with caution.
So in this article, here’s what I’ll be sharing with you:
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.