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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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079 – QA: Advice for Older Parents Frustrated by Their Family’s Concerns

by Leslie Kernisan, MD MPH 3 Comments

Better Health While Aging
Better Health While Aging
079 – QA: Advice for Older Parents Frustrated by Their Family's Concerns
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In This Episode:

Dr. K addresses an older parent’s concerns and frustrations regarding her son’s attempts to help her with her health, and their differing views on what she needs. She covers:

  • What to do if you’re an older parent frustrated by your adult child’s concerns for you
  • How to communicate better and help your family understand what matters most to you
  • Why it’s essential to address goals, priorities, and advance planning
  • Why everyone needs to think about acceptance and boundaries
  • The importance of fostering a stronger relationship and more connectedness
  • Why older adults should be very careful about entirely cutting off their adult children
  • How to negotiate a better way forward, and how to get help doing so
[Read more…]

078 – Interview: The Biology of Aging & Longevity

by Leslie Kernisan, MD MPH 2 Comments

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Better Health While Aging
078 – Interview: The Biology of Aging & Longevity
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In This Episode:

Dr. K talks with geriatrician and geroscientist John Newman, MD PhD,  about the biology of aging and his research on ketogenic diets and geriatric syndromes. Dr. Newman is an assistant professor at the Buck Institute for Research on Aging and in the Division of Geriatrics at UCSF. He also works on improving the hospital care of older adults. They discuss:

  • How aging biology research helps us understand fundamental aging processes that affect all animals
  • The complex relationship between aging and disease, and what is the geroscience hypothesis
  • Cellular hallmarks of aging, and biomarkers to assess physiological age
  • How we can assess someone’s physiological age
  • Why biomarkers of aging aren’t as useful as functional assessments of older people
  • How insulin, fasting, and other aspects of metabolism are related to aging
  • What Dr. Newman has learned from studying ketones and aging in mice
  • What is known about ketogenic diets in humans
  • What’s been shown to improve healthspan and lifespan (in mice)
  • Why metformin, a diabetes drug, is a “really good drug”
  • Why things that slow aging in the lab may not work in humans or under real-world conditions
[Read more…]

077 – Interview: Making Advance Care Planning Easier Through PREPARE

by Leslie Kernisan, MD MPH Leave a Comment

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Better Health While Aging
077 – Interview: Making Advance Care Planning Easier Through PREPARE
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In This Episode:

Dr. K talks with geriatrician Rebecca Sudore, MD, an expert in helping older adults address advance directives, end-of-life planning, and other aspects of advance care planning. Dr. Sudore is the creator of PREPARE, an easy-to-use online program designed to help older adults talk about what matters most with family members and health professionals. She is also a Professor in the UCSF Division of Geriatrics. They discuss:

  • Why Dr. Sudore created California’s first easy-to-read advance directive form in 2005
  • What families in focus groups told her, about making decisions for someone else
  • Why it’s important to address more than legal forms and end-of-life situations
  • Why older adults need to discuss what matters to them, with family and with their health providers
  • How PREPARE uses short videos and worksheets to help older adults think through what matters, and share their values with others
  • Her research proving that PREPARE does help older adults address planning
  • Why many older adults don’t address advance planning, and how we might change this
  • Advance care planning for Alzheimer’s and other dementias
  • Tips on getting reluctant older parents to talk about their wishes and address their planning
  • How to find an easy-to-use advance directive for all 50 states on the PREPARE website
[Read more…]

076 – Flu Shots for Older Adults: What to Know (2018 Update)

by Leslie Kernisan, MD MPH Leave a Comment

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Better Health While Aging
076 – Flu Shots for Older Adults: What to Know (2018 Update)
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In This Episode:

Dr. K explains what all older adults and family caregivers should know about annual vaccination against influenza. She also reports on the statistics from last year’s flu season. This episode covers:

  • What is influenza, and how many people are affected every year
  • Why older adults are at higher risk of harm from the flu
  • How the vaccine works
  • The two key ways you can protect yourself from the flu
  • How pneumococcal vaccination helps protect against flu complications
  • What to know about flu shots designed for older adults
  • Which influenza vaccine she thinks is best for most older adults
  • What to do if your older relative is unable or unwilling to get vaccinated
  • What to know about the intranasal flu vaccine available for people age 2-49
[Read more…]

075 – Preventing Falls: 4 Approaches to Ask Your Doctor About

by Leslie Kernisan, MD MPH Leave a Comment

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Better Health While Aging
075 – Preventing Falls: 4 Approaches to Ask Your Doctor About
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In This Episode:

Dr. K reviews her four most used fall prevention approaches, which are routine in geriatrics care but are often overlooked by busy primary care providers. She covers:

  • The three questions about falls that PCPs should be asking older adults
  • How the CDC’s STEADI fall prevention algorithm can help you understand what your health provider should be doing
  • Why medication review is an essential part of fall prevention
  • The importance of checking blood pressure sitting and standing
  • How a physical therapy evaluation can help
  • The recent research suggesting Tai Chi helps prevent falls
  • How to get a good home safety assessment done
  • Why Vitamin D is no longer recommended for fall prevention (but is still worth taking)
[Read more…]

074 – Interview: How the Village Model Supports Aging in Place & Community

by Leslie Kernisan, MD MPH Leave a Comment

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Better Health While Aging
074 – Interview: How the Village Model Supports Aging in Place & Community
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In This Episode:

Dr. K talks with UC Berkeley Professor Andrew Scharlach about his work studying the Village Model and other approaches to supporting aging in place. He is an expert on creating aging-friendly communities and formerly directed Berkeley’s Center for the Advanced Study of Aging Services.  They discuss:

  • What is a Village and what’s usually included in the Village model
  • How Villages differ from Naturally Occurring Retirement Communities (NORCs)
  • The grassroots history of the first Village and the growth of the Village model
  • Why aging in community may be a better goal than aging in place
  • Why Professor Scharlach and his colleagues decided to study Villages, and what they’ve learned so far
  • How Villages appear to benefit their members
  • How the goals and ambitions of Villages have evolved over time
  • How Villages manage funding and other challenges
  • Whether Villages are a good fit for people who are frail or declining
  • Whether Villages really do prevent unwanted relocations
[Read more…]

073 – Anticholinergic Medications & Protecting Brain Health

by Leslie Kernisan, MD MPH Leave a Comment

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Better Health While Aging
073 – Anticholinergic Medications & Protecting Brain Health
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In This Episode:

Dr. K explains what older adults and families should know about anticholinergic medications and their negative impact on brain health. Many commonly used over-the-counter and prescription medications are anticholinergic, and on the Beer’s List of Medications Older Adults Should Avoid or Use With Caution. She covers:

  • What it means for a medication to be anticholinergic
  • The evidence linking anticholinergics with confusion, delirium, and dementia
  • Seven commonly used types of medication that are quite anticholinergic
  • Why it’s important to minimize anticholinergics if you’re worried about memory or have been diagnosed dementia
  • How you can determine whether you or your parent’s medications are anticholinergic
  • What to do, if you or an older person you care for is taking an anticholinergic medication
[Read more…]

072 – Cognitive Aging: How Memory & Thinking Change as One Gets Older

by Leslie Kernisan, MD MPH 2 Comments

Better Health While Aging
Better Health While Aging
072 – Cognitive Aging: How Memory & Thinking Change as One Gets Older
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In This Episode:

Dr. K explains how memory and thinking change as one gets older, due to normal cognitive aging. She covers:

  • How cognitive aging is different from a neurodegenerative process such as Alzheimer’s disease
  • 6 ways that memory, other mental processes, and emotional processing change with aging
  • Why certain mental tasks become harder in late life
  • The difference between fluid and crystallized intelligence
  • Worrisome signs that should not be attributed to normal cognitive aging
  • Practical ways to maintain better brain function, and to compensate for normal age-related changes
[Read more…]

071 – Interview: How Estimating Life Expectancy Helps Older Adults Get Better Care

by Leslie Kernisan, MD MPH Leave a Comment

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Better Health While Aging
071 – Interview: How Estimating Life Expectancy Helps Older Adults Get Better Care
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00:00 / 1:06:44
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In This Episode:

Dr. K talks with Sei Lee, MD, an expert on prognosis and using estimated life expectancy to improve medical care for older adults. Dr. Lee is an Associate Professor in the UCSF Division of Geriatrics. They discuss:

  • What the term “prognosis” means, especially when it comes to older adults
  • Why a person’s likely life expectancy should be used to tailor medical care
  • How the answers to simple questions can be used to predict mortality
  • Why even a good life expectancy calculator can’t make exact predictions for a specific person
  • Common forms of medical care that may not be worth doing, if life expectancy is limited
  • Why it’s important to reconsider intensive diabetes treatment
  • How the Eprognosis.org website can help people learn whether cancer screening is still likely to benefit them
  • The challenges of discussing prognosis and life expectancy with older adults
  • Examples of how we can better focus medical care on “what matters the most”
[Read more…]

070 – Interview: Addressing & Preventing Financial Exploitation in Aging

by Leslie Kernisan, MD MPH 6 Comments

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Better Health While Aging
070 – Interview: Addressing & Preventing Financial Exploitation in Aging
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00:00 / 1:14:38
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In This Episode:

Dr. K talks with attorney Candace Heisler, JD, an expert on addressing financial exploitation and other forms of elder abuse. Ms. Heisler served as assistant district attorney for the City and County of San Francisco for over 25 years, and remains active in training various professionals to address elder abuse. They discuss:

  • What it means to financially exploit an older person
  • The role of trust and relationships in facilitating financial exploitation
  • Why it can be hard to determine whether financial abuse has occurred
  • What to do if you suspect that an older relative has been financially exploited
  • The role of Adult Protective Services in investigating worrisome situations
  • The difference between pursuing a criminal case versus a civil case
  • What is “undue influence” and how it’s related to financial abuse
  • Steps older adults can take to reduce their risk of being financially exploited
  • How to reduce the risk of that a power of attorney might be misused
[Read more…]
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