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.

Flu Shots for Older Adults: What to Know & Do for 2018-2019

by Leslie Kernisan, MD MPH 49 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. In fact, the CDC recently announced that the 2017-2018 season was particularly severe, with an estimated 80,000 deaths related to the flu.

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 2018-2019 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…]

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

by Leslie Kernisan, MD MPH 13 Comments

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 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…]

9 Types of Issues to Address When Helping Older Parents

by Leslie Kernisan, MD MPH 14 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…]

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

by Leslie Kernisan, MD MPH 32 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…]

Financial Exploitation in Aging: What to Know & What to Do

by Leslie Kernisan, MD MPH 5 Comments

Here’s an upsetting situation that comes up a lot, and may have come up for you: is someone financially taking advantage of Mom or Dad?

It’s a pretty legitimate concern to have. To begin with, most people know that there are plenty of “scammers” out there, phoning or mailing older adults with deceptive information designed to hoodwink them out of some of their savings.

But there’s actually another form of exploitation that may be more common, and is often harder for families to address.

That would be exploitation perpetrated by a someone the older person knows and has a personal relationship with.

Sometimes the person suspected of exploitation is relatively new to the older person’s life, such as a new romantic interest, friend, or paid caregiver.

In other cases, family members become concerned that someone in the family – such as one of the older person’s children – is beginning to take financial advantage of things.

Exploitation in the context of personal relationships is often especially tricky for families to address. The older person may be quite attached to – or otherwise feel dependent on – the person that others perceive as suspicious or problematic. Or there may be concerns about stirring up family dramas and conflicts, by voicing concerns about a sibling or another relative.

People are often unsure of what exactly constitutes illegal activity, and what can be done if they are concerned about financial exploitation.

So in this article, I’ll cover the key things you should know, so that you can better evaluate and address a worrisome situation, should one arise.

Specifically, in this article I’ll explain: [Read more…]

Helping Older Parents

My Four Most-Used Fall Prevention Approaches

Disclaimer