Helping Older Parents

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.

Deprescribing: How to Be on Less Medication for Healthier Aging

by Leslie Kernisan, MD MPH 37 Comments

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 medications. 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…]

Flu Shots for Older Adults: What to Know & Do for 2019-2020

by Leslie Kernisan, MD MPH 85 Comments

It’s October, which means it’s that time of the year again: flu vaccination time!

Back when I worked in a primary care clinic, this is when we made a big push to offer the seasonal flu shot to all of our patients. (And we got ourselves immunized, as well.)

Not all of our patients agreed. 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?

I’m never surprised when people bring up these questions. Vaccination for seasonal influenza can indeed be a confusing topic.

But it’s certainly important to consider. Depending on the year, the Centers for Disease Control (CDC) estimates that every year, influenza affects 9-60 million Americans, causes 140,000-710,100 hospitalizations, and results in 12,000-56,000 deaths.

Influenza is more severe in some years than others. For instance, the 2017-2018 season was particularly severe, with an estimated 80,000 deaths related to the flu. The 2018-2019 season wasn’t as bad, but still had a real impact: the CDC estimates that there were 37.4 million to 42.9 million flu illnesses last year, causing an estimated 36,400 – 61,200 flu deaths.

Now, most people get better without needing hospitalization, but some people get very sick. Older adults are especially likely to get dangerously ill from catching the flu.

So I agree with the CDC’s recommendation: everyone over the age of 6 months should get their seasonal flu shot.

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.

This month, you’ll probably be encouraged to get vaccinated too. So in this article, I’ll address some key things to know about influenza and the flu shot, along with some common questions and concerns. Here’s what I’ll cover:

The basics of influenza and vaccination against the flu
What to know about flu shots for older adults
What’s new and resources for the 2019-2020 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

[Read more…]

9 Types of Issues to Address When Helping Older Parents

by Leslie Kernisan, MD MPH 33 Comments

Aging Parents To Do List 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.

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 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: [Read more…]

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

by Leslie Kernisan, MD MPH 12 Comments

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 Membership.

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 paid caregivers 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…]

6 Ways that Memory & Thinking Change with Normal Aging (& What to Do About This)

by Leslie Kernisan, MD MPH 55 Comments

brain changes with aging It’s annoying but unfortunately true: most parts of the body work less well as one gets older and older.

This is even true of the brain, which is part of why it becomes more common to experience a “tip of the tongue” moment as one gets older.

Such age-related changes in how the brain manages memory, thinking, and other mental processes are called “cognitive aging.”

Understanding how aging changes cognition is important. It can help you understand what to anticipate when it comes to your own aging. It can also help families better understand the changes they’re noticing in an older person, and whether those are out of the ordinary or not.

Since I’ve often written about changes in thinking that are abnormal and concerning in older adults, I thought it might be helpful for me to write an article outlining what is normal and to be expected.

Specifically, I’ll cover:

How cognitive aging differs from other diseases and conditions that affect memory and thinking
6 ways that memory and thinking change with aging
The difference between crystallized and fluid intelligence
How to tell cognitive aging apart from more worrisome changes
Practical takeaways and what you can do

[Read more…]

Helping Older Parents

Home Care vs. Home Health

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