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Better Health While Aging

Practical information for aging health & family caregivers

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    • Preventing Falls in Aging Adults
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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.

Depression in Aging:
Diagnosis & Treatment When the Golden Years are Blue

by Nicole Didyk, MD

Most of us can relate to feeling sad or blue, sometimes for days at a time. It may be in response to a major life event like losing a job, a break-up, or as part of grief. These sad feelings can lead us to feel less interested in enjoyable activities, make us lose our appetite or disrupt sleep.

Although research shows that people often become happier as they age, sad feelings are also very natural and can be associated with some of the typical transitions and changes of aging.  But clinical depression, from a medical point of view, is something different, and should not be considered a normal part of getting older.

In this article, I’ll explain the most important things to know about late-life depression, including:

  • What’s different about depression in later life?
  • What are the symptoms of depression and how is clinical depression diagnosed (especially in an older person who may also have medical illnesses that can mimic depression symptoms)?
  • What does testing for depression look like?
  • What treatments are recommended for older adults with clinical depression?
  • What you can do if you’re worried that someone is depressed, and how to help someone with depression.

In an upcoming article, I’ll also cover the special considerations and challenges when it comes to diagnosing and treating depression in those living with dementia, which is a common scenario in my practice as a geriatrician.

Depression in Later Life

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles Tagged With: antidepressants, depression

How to Prevent Falls: 4 Proven Approaches To Ask Your Doctor About

by Leslie Kernisan, MD MPH

elderly woman falling

Worried about falls in an older parent or relative? If so, do you know if their doctor has considered the most useful fall prevention approaches?

Fall risk can be reduced, but it generally takes some thought and effort. That’s in part because most older adults have multiple factors making them vulnerable to falls.

In a related article on this site, I’ve explained that best fall prevention plans involve identifying an older person’s particular risks — especially risks related to health conditions — and trying to counter those.

So for instance, if an older person has diabetes and is having frequent moments of low blood sugar (also known as hypoglycemia), then to reduce falls, addressing the hypoglycemia is as important, if not more, as starting an exercise program.

In other words, I always recommend that aging adults and families learn to tailor their fall prevention plans. You want to focus on what are the most important modifiable risk factors for that individual person.

That said, over the years I’ve noticed that there are four approaches that I find myself using over and over again, in almost all my patients who have had repeated falls.

These four approaches are used often by geriatricians, but much less often by busy primary care doctors. Unless, that is, a proactive family asks about them.

My Four Most-Used Fall Prevention Approaches

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles Tagged With: fall prevention, falls

How You Can Help Someone Stop Ativan

by Leslie Kernisan, MD MPH

Ativan

Have you heard of Ativan (generic name lorazepam), and of the risks of benzodiazepines drugs in older adults? Is an older person you care for taking prescription medication for sleep, anxiety, or “nerves”?

Would you like an easy, practical tool to help someone stop a drug whose risks often outweigh the benefits?

If so, I have good news: a wonderful patient education tool has been created by a well-respected expert in geriatrics, Dr. Cara Tannenbaum. Best of all, a randomized trial has proved that this tool works.

As in, 62% older adults who received this tool — a brochure with a quiz followed by key information — discussed stopping the medication with a doctor or pharmacist, and 27% were successful in discontinuing their benzodiazepine. The brochure includes a handy illustrated guide on slowly and safely weaning a person off these habit-forming drugs.

This is big news because although experts widely agree that long-term benzodiazepine use should be avoided in older adults, getting doctors and patients to work together to stop has been tough. It is, after all, generally easier to start a tranquilizer than to stop it!

But through a patient education brochure, Dr. Tannenbaum’s team was able to make this tricky process much more doable for older adults, their families, and their doctors.

Why it’s important to try to stop lorazepam & other benzodiazepines

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles Tagged With: brain health, medication safety, medications, sleep

5 Things to Know about Aging Parents & Financial Decline

by Leslie Kernisan, MD MPH

Aging woman counting money

You probably already know that many older adults develop problems managing finances as they age.

Now how would you answer the questions below:

  • Has your aging parent planned for a decline in financial abilities?
  • Are you prepared to detect signs of a financial decline?
  • Do you know what to do if you do notice problems with finances?

Many people, even the ones who are caring and well-informed, will often answer “no” to these questions.

But this post will equip you to start answering yes. And I want you to be able to answer yes, because declines in the ability to manage finances are very common among older adults, and often causes serious health and life problems.

The trouble, of course, is that financial decline is uncomfortable for older adults and their families to think about. Managing money, after all, is one of the ways we maintain autonomy and control over our lives.

So nobody likes to confront the fact that our ability to manage money will — in all likelihood — someday decline. (Research suggests that even aging adults who don’t develop dementia often experience declines in financial ability.) And families are understandably squeamish about monitoring an older relative’s financial abilities.

Fortunately, a little education and guidance can make it much easier to be more proactive about this tough topic.

In this post, I’ll cover

  • Five warning signs of financial decline
  • Five important things to know about aging & finances
  • How to protect aging parents from financial problems
  • What to do if your aging parent is having trouble managing their finances

I’ll also cover some ways that geriatricians and other healthcare providers can help, both to reduce declines in financial ability and to properly evaluate them when they occur.

5 Warning Signs of Financial Decline

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles Tagged With: financial concerns, memory

6 Steps to Take When Aging Parents Need Help – Even if They’re Resisting

by Leslie Kernisan, MD MPH

getting aging mother to accept help

Have you noticed worrisome changes in your aging parent?

Maybe they’ve been mostly okay but now you’re seeing problems with memory, such as forgetfulness or asking the same questions repeatedly. Or maybe you’ve noticed trouble with driving, keeping up the house, managing stairs, or paying bills. 

Some aging parents simply begin to seem more withdrawn. Others start leveling accusations at others, claiming someone took or moved something, or acting paranoid.

For many adult children, these changes lead to mounting questions. What’s wrong? What’s happening? Is it safe for Mom to keep driving? Should Dad live alone much longer?

I think of this as the “uh-oh” stage. It’s a transition no one looks forward to, and most haven’t prepared for: the time when you might have to start helping your aging parent.

And for many, it comes with an added challenge:  Most aging parents don’t welcome much help from their adult children. They may see it as interference, or an invasion of privacy.

Some parents might even refuse to accept that they’re having difficulties, despite issues that feel glaringly obvious—and concerning—to you.

By the time you’re noticing changes and have safety concerns, it’s quite possible that you’re right: that your parent does need help of some kind. So how should you best get involved, especially if your attempts to do so have gone poorly in the past?

Well, it’s certainly not easy. These situations are complicated from a medical and eldercare perspective, plus they tend to bring up difficult emotions for older parents and adult children alike.

But I do believe that it’s crucial for families to get involved. It’s not likely to be easy. But it can be easier, if you’re able to learn the better ways to do so—and also what to stop doing.

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles, Managing relationships

COVID Vaccination for Aging Adults:
What to Know & Do

by Leslie Kernisan, MD MPH

COVID is an important issue for older adults: they are more likely to be severely affected by COVID, and they represent most COVID deaths.

Luckily, COVID vaccines are effective and significantly reduce the risk of hospitalization and death in older adults. In particular, I want to offer science-based information to help with common questions, such as “Which COVID vaccine is better for seniors?” or “Which COVID vaccine for a 90-year-old?”

This page covers my older science-based updates on COVID vaccines.

For my latest update, see here: Covid & Aging Adults: Current Vaccines & Updates

 

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles

Coronavirus Info: What to Expect Regarding Hospitalization (3.27.20)

by Leslie Kernisan, MD MPH

Like many of you, I’ve been following the recent coronavirus developments closely.

In March, I devoted my twice-monthly Helping Older Parents members calls to this topic.

Here is a video commentary I recorded on 3.27.20.  Although the statistics about COVID numbers in the US quickly fell out of date, I am leaving this video available as the information on what to expect regarding hospitalization should be relevant for quite a while. This video covers:

  • What I’d recently learned about the clinical course of COVID
  • If you think you (or your older relative) might be sick with coronavirus
  • What to know about hospitalization for this, and how a “surge” situation might affect that
  • Options for care at home, including palliative care
  • My recommendations on planning ahead and then hoping for the best.

Also, in the video, I forgot to mention that one of my favorite clinical sources is currently making its coronavirus topic free to the public: Uptodate.com: Coronavirus disease 2019 (COVID-19).

The video is below, or get the audio-only through the podcast here.
(For those who have asked about transcripts: I wish I could but right now we are too short on funding; transcripts cost $1.25/minute to produce plus more time to format and finalize.)


Please stay as safe as you can, and take care!

Related resources:

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles, Useful Links

How to Make Hospitalization Better & Safer in Aging

by Leslie Kernisan, MD MPH

Dr. Stephanie Rogers UCSF Inpatient Geriatrics

As you may know, hospitalization is actually somewhat risky for older adults.

This is sometimes surprising to older adults and families. After all, hospitals are supposed to be places where people who are ill or injured can get the medical supervision and services that they need, to recover and be restored to health.

Well, it’s certainly true that hospitalization is often the only way for a person to obtain more substantial care from nurses and doctors. (There actually is an alternative called Hospital at Home, but it’s not widely available.)

If you’ve broken a hip, or have developed really significant shortness of breath from pneumonia, or otherwise are too unwell to be safely treated in the outpatient setting, hospitalization is often necessary. And since aging increases one’s vulnerability to a variety of health problems, older adults get hospitalized at higher rates than younger people do.

The problem, however, is that although hospitalization is intended to help patients, we’ve also realized that it tends to stress the body and mind in many ways. This is hard on every patient, but especially affects older adults. For instance:

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles

13 Recommended Resources for National Family Caregivers Month

by Leslie Kernisan, MD MPH

This month — November — is National Family Caregivers Month.

If you’ve been in any way assisting another adult with managing health concerns or life tasks, you qualify as one of the estimated 40 million family caregivers in the US.

Such help often starts out with small things, such as helping an older relative get to appointments or assisting with grocery shopping.

But it’s also fairly common for families to end up providing quite a lot of care. A 2015 report found that on average, family caregivers provided 24.4 hours of assistance per week, and 23% of caregivers were clocking 41 hours or more.

Many people find themselves eventually struggling with the caregiving. Most of us haven’t prepared or been trained to do this, and many people are unsure of where to get information, help, or support.

So in this article, I’ll share some of my favorite resources to make family caregiving a little easier.

[Read more…]

Filed Under: Geriatrics For Caregivers Blog, Helping Older Parents Articles, Useful Links

End of Life Planning Made Easy Through PREPARE

by Team BHWA

Living wills. Advance directives. Powers of attorney for healthcare. Making your wishes known.

Many older adults have never gotten around to addressing these issues, and of those who have, many are overdue for a review.

After all, this is not something where you should “set-it-and-forget-it.” Especially not if you completed the paperwork with a lawyer years ago, and have experienced changes in your health since then.

But if you wanted to get started addressing this, you may have run into a few common hitches. The forms are often in legalese and hard to understand. And people often are sure just how to go about “making their wishes known.”

Fortunately, geriatrician Rebecca Sudore, MD, noticed this problem early in her career, and decided to do something about it.

Over the past 15 years, she developed and tested California’s first easy-to-read advance directive, then designed PREPARE, an easy online video program created to help older adults address advance care planning.

In a recent podcast episode, she and Dr. Kernisan discussed PREPARE, advance care planning, and how to make it easier for older adults to address what matters most to them when it comes to end-of-life planning.

This article will share some highlights and key points from their conversation, including:

  • The easy-to-read advance directives (and where you can get one)
  • Why advance care planning needs to include more than completing forms
  • How the PREPARE program helps older adults talk about what matters most
  • How to use PREPARE resources to help yourself or your loved ones talk about what matters and complete your planning
[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles

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