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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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097 – Interview: Common Elder Law Issues When Helping Aging Parents

by Leslie Kernisan, MD MPH Leave a Comment

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Better Health While Aging
097 – Interview: Common Elder Law Issues When Helping Aging Parents
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In This Episode:

Dr. K talks with elder law and estate planning attorney, Mark Gilfix, JD, about common legal issues that come up when helping aging parents. He is a partner at Gilfix & La Poll Associates, a Bay Area law firm that helped pioneer elder law. They discuss:

  • What is elder law and how it differs from estate planning and trust law
  • Why a durable power of attorney (DPOA) is a vital elder law planning tool
  • How DPOAs come into play if there are memory issues or other capacity concerns
  • The role of attorneys in checking capacity when their clients complete legal documents
  • What happens if you contact an older parent’s attorney with concerns about memory or capacity
  • The risks of undue influence, financial exploitation, and family members having an agenda
  • What people can do if they are concerned about the validity of an older person’s legal transaction
  • Options when a potentially impaired older parent refuses to release DPOA documents to family
  • Why it’s best for families to communicate early and often
  • How elder law attorneys can help with long-term care planning
  • Tips on starting planning conversations with your family
[Read more…]

096 – Interview: Paying for Long-Term Care: 2019 Updates

by Leslie Kernisan, MD MPH Leave a Comment

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Better Health While Aging
096 – Interview: Paying for Long-Term Care: 2019 Updates
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In This Episode:

Dr. K talks with Howard Gleckman, senior fellow at the Urban Institute and an expert on how policy and tax issues affect older adults and their long-term care. He is also the author of Caring for Our Parents: Inspiring Stories of Families Seeking New Solutions to America’s Most Urgent Health Crisis. They discuss:

  • What is “long-term care” and who usually ends up paying for it
  • Why so many older adults end up needing some form of long-term care
  • That it’s Medicaid, not Medicare, that sometimes covers long-term care needs for older adults
  • What “triggers” need to occur for long- term care insurance policies to kick-in
  • Currently available options to pay for long-term care and “ongoing living assistance”
  • Why insurers have had difficulty offering affordable long-term care insurance
  • What happened to the federal long-term care program the CLASS act
  • How Washington State’s new public long-term care insurance plan is set up, and why it won’t help today’s older adults
  • The new Medicare rules that might enable Medicare Advantage plans to offer the “non-medical” services that can help older adults age in place
  • What are the benefits of Medicare Advantage care plans
  • What politicians are saying about this, and why we don’t hear more about long-term care issues
[Read more…]

095 – Interview: Hearing Aids & Other Hearing Loss Treatment Options

by Leslie Kernisan, MD MPH 6 Comments

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Better Health While Aging
095 – Interview: Hearing Aids & Other Hearing Loss Treatment Options
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In This Episode:

Dr. K talks about hearing aids and other ways to address hearing loss with Meg Wallhagen, PhD, Professor of Gerontological Nursing at UCSF’s School of Nursing. She is a nationally recognized expert on hearing loss and has been on the board of the Hearing Loss Association of America since 2010. This episode is Part 2 of a two-part series on hearing loss. They discuss:

  • Why people may be entitled to workplace accommodations to address hearing loss
  • What should take place during an initial audiology evaluation
  • How audiologists adjust and fit hearing aids, and what to expect from a good audiology provider
  • What to expect from using hearing aids
  • Common hearing aid options to consider, & how to choose a hearing aid
  • Why it’s good to get a hearing aid with a telecoil
  • Why the brain needs time to adjust to hearing aids & why it’s essential to use them regularly
  • Who shouldn’t get hearing aids
  • Why a “Pocket Talker” can be a good option for people with dementia
  • Other alternatives to hearing aids, such as special phones
  • Why it’s important to address hearing loss sooner rather than later
  • Other simple ways to improve communication with older adults with hearing loss
  • Recent developments in over-the-counter hearing aids and personal sound amplification products (PSAPs)
[Read more…]

094 – Interview: Hearing Loss in Aging: Why It Matters & Getting Evaluated

by Leslie Kernisan, MD MPH 10 Comments

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Better Health While Aging
094 – Interview: Hearing Loss in Aging: Why It Matters & Getting Evaluated
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In This Episode:

Dr. K talks about how we can help older adults address hearing loss with Meg Wallhagen, PhD, Professor of Gerontological Nursing at UCSF’s School of Nursing. She is a nationally recognized expert on hearing loss and has been on the board of the Hearing Loss Association of America since 2010. This episode is Part 1 of a two-part series on hearing loss. They discuss:

  • Why hearing loss in aging usually causes distortion of sounds, and how that affects understanding speech (and grandchildren)
  • Why it usually doesn’t help to speak more loudly to someone with hearing loss
  • How hearing loss affects the health, wellbeing, and social relationships of older adults
  • Why older people often don’t want to address hearing loss
  • The problem of healthcare professionals overlooking hearing loss
  • How hearing loss affects brain function
  • Why it can become harder to successfully address hearing loss once it’s severe
  • How hearing loss should be evaluated and what happens during a hearing test
  • Why poor Medicare coverage of hearing loss often creates barriers to care
  • How Professor Wallhagen’s brochure can help older adults agree to address hearing loss
[Read more…]

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

by Leslie Kernisan, MD MPH Leave a Comment

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093 – Interview: Hiring In-Home Care for Aging in Place: What to Know
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In This Episode:

Dr. K talks with Michelle Allen, LCSW, about what families should know, when they want to obtain or hire in-home care to help an older person with aging in place. Michelle is an experienced social worker and geriatric care manager based in Atlanta, and is a featured expert providing guidance in Dr. K’s Helping Older Parents Membership Community. They discuss:

  • How geriatric social workers (and geriatric care managers) help older adults and families address aging issues
  • Why families and older adults usually seek out privately paid in-home care
  • Why most of the home care services older adults need to age in place are not covered by Medicare
  • What is “home health care,” and how to get Medicare to pay for certain medically skilled home services
  • What to know about hiring paid in-home caregivers
  • The pros and cons of hiring through an agency versus hiring an individual caregiver
  • Why families have to pay taxes, if they hire someone without going through an agency
  • Common mistakes that families make, when hiring in-home help to assist an older person
  • Why aging in place may not work out, and how to plan for other options
  • The benefits of working with “life care planning” elder law firms, which provide geriatric care coordinators such as Michelle
[Read more…]

092- Interview: Addressing Nighttime Urination & Insomnia in Aging

by Leslie Kernisan, MD MPH 20 Comments

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Better Health While Aging
092- Interview: Addressing Nighttime Urination & Insomnia in Aging
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In This Episode:

Dr. K talks with geriatrician Shachi Tyagi, MD, Assistant Professor of Medicine at the University of Pittsburg. Her research focuses on two common issues in older adults, insomnia and having to urinate at night (nocturia). They discuss:

  • Why nocturia becomes common as we age
  • Common health problems that may be related to nocturia
  • The relationship between nocturia and sleep problems
  • How nocturia should be assessed and how it can be managed
  • “Brief behavioral treatment” and other recommended insomnia treatments that can also improve nocturia
  • Why sleep medications should be avoided in aging
  • How to reduce the risk of nighttime falls related to nocturia
  • Options for addressing nocturia and sleep issues in dementia
  • Tips on tracking bladder and sleep symptoms, and how to get help from your health providers
[Read more…]

091 – Interview: Reducing the Risk of Power of Attorney Abuse

by Leslie Kernisan, MD MPH Leave a Comment

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Better Health While Aging
091 – Interview: Reducing the Risk of Power of Attorney Abuse
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In This Episode:

Dr. K speaks with senior attorney David Godfrey, JD, of the American Bar Association Commission on Law and Aging, about drafting better power of attorney documents so as to reduce the risk of abuse. David works closely with the National Center on Law and Elder Rights and authored an issue brief in 2018 that covers advance planning and how to avoid exploitation. They discuss:

  • What is a general durable power of attorney (POA) and why every person should complete one
  • Common reasons why older adults may need someone else to transact business for them, such as temporary or permanent incapacity
  • Why court intervention may be necessary if an older person does not have a POA
  • How POAs can be used for financial exploitation, and how drafting protections in the POA document can reduce the risk of abuse
  • 6 key precautions to take, when drafting a general durable power of attorney
  • How requiring third party accounting can reduce family conflict
  • Why it’s a good idea to require a second signature for major transactions
  • The benefits of granting the power to revoke the POA to a third party
  • How older adults can find affordable legal assistance, for help drafting a POA
  • Options for older adults who have no close family available to serve as an agent
  • Resources to help guide agents to manage power of attorney duties
[Read more…]

090 – More on Avoiding Risky Medications & on Using the 2019 AGS Beers Criteria

by Leslie Kernisan, MD MPH 2 Comments

Better Health While Aging
Better Health While Aging
090 – More on Avoiding Risky Medications & on Using the 2019 AGS Beers Criteria
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In This Episode:

Dr. K provides more information on what’s included in the 2019 update of the American Geriatrics Society AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults, with a focus on which drugs she thinks are most important to avoid. She also addresses which medications are associated with falls, cognitive impairment, and other key conditions. She covers:

  • How the 2019 Beers Criteria is organized
  • Options for accessing the 2019 update
  • Which medications should be avoided in people with memory problems, per the Beers Criteria
  • Which drugs to avoid or use with caution if you have a history of falls or fractures
  • Other common risky medications to be aware of
  • What to know about opioid painkillers and the 2019 Beers Criteria
  • 5 things you can do to be proactive about medications safety in aging
  • Where to find consumer brochures that can help you discuss deprescribing for the most common risky medications
[Read more…]

089 – Giving Yourself (And Your Family) a Gift on National Healthcare Decisions Day

by Leslie Kernisan, MD MPH Leave a Comment

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Better Health While Aging
089 – Giving Yourself (And Your Family) a Gift on National Healthcare Decisions Day
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00:00 / 39:14
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In This Episode:

Dr. K shares a personal story and explains why it’s so important to take the time to talk with others and make plans to provide others with guidance, since most of us will at some point be unable to make our own healthcare decisions. She covers:

  • The importance of National Healthcare Decisions Day
  • What “advance care planning” means, and why it’s more than completing legal forms
  • Four key steps in advance care planning
  • Why it’s essential to have conversations with others, including with healthcare providers and with family
  • Two free online tools you can use to guide you through reflection, conversations, and completing paperwork
  • Five common pitfalls to avoid if possible
  • Five questions you can ask yourself, every April when it’s National Healthcare Decisions Day
[Read more…]

088 – Interview: Avoiding Inappropriate Prescribing in Aging & What to Know About the Beers Criteria

by Leslie Kernisan, MD MPH 5 Comments

Better Health While Aging
Better Health While Aging
088 – Interview: Avoiding Inappropriate Prescribing in Aging & What to Know About the Beers Criteria
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00:00 / 47:31
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In This Episode:

Dr. K talks with geriatrician Dr. Michael Steinman, Professor of Medicine at UCSF and an expert on medication safety in older adults. He recently served on the expert panel that authored the American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults, which lists medications that older adults should avoid or use with caution. They discuss:

  • What is “inappropriate prescribing” and why it affects an estimated 50% of older adults
  • How ageism can affect medication prescribing
  • How inertia, hospitalizations, and other factors lead to medications “accumulating”
  • Why it’s not safe to assume that all your medications are being prescribed for a good reason
  • How to be proactive about asking your health providers to review whether all medications are still necessary and appropriate
  • What is the Beer’s Criteria list and how does the Expert Panel decide what should be on it
  • Why older adults become more vulnerable to medications as they age
  • Some key Beers Criteria medications older adults should know about
  • What you can do if you’re taking a medication on the Beer’s Criteria list
  • How pharmacists can help, and other tips on ensuring safer medication use in aging
[Read more…]
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