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Better Health While Aging

Practical information for aging health & family caregivers

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055 – Interview: Bill Thomas on Ageism & Innovations to Improve Aging

by Leslie Kernisan, MD MPH 4 Comments

Better Health While Aging
Better Health While Aging
055 – Interview: Bill Thomas on Ageism & Innovations to Improve Aging
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In This Episode:

Dr. K talks with geriatrician Bill Thomas, MD, founder of ChangingAging.org, the Eden Alternative, and the Green House Project. They discuss his recent efforts to counter ageism and his latest housing-related projects, including:

  • What is ageism and why is it so pervasive
  • The stories we tell ourselves about aging (including our own aging) and youth
  • Thinking about lifespan in terms of childhood, adulthood, and elderhood
  • Why it’s a problem for older adults to cling to “adulthood” as part of their identities
  • The words we use and why we might embrace the term “elder”
  • How having “too much house” is risky in aging, and how a Minka house might help
  • How Bill Thomas is planning for his own aging
  • His plan to pilot a “Multi-Ability, multiGenerational, Inclusive, Community” (“MAGIC”) in 2018
[Read more…]

054 – How to Make Difficult Decisions Easier:
Using Goals of Care & Weighing Benefits vs Burdens

by Leslie Kernisan, MD MPH 4 Comments

Better Health While Aging
Better Health While Aging
054 – How to Make Difficult Decisions Easier:
Using Goals of Care & Weighing Benefits vs Burdens
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In This Episode:

Dr. K discusses a reader’s dilemma concerning his resistant 96-year-old father, and explains how using two foundational concepts — goals of care, and weighing benefits versus burdens — can help families work through difficult decisions. (See here for the posted question and her written answer.) She covers:

  • How to think about whether an older relative may have lost decision-making capacity
  • The three key goals of medical care: helping people live longer, feel better, and function better
  • Why thinking through goals of care is foundational in geriatrics
  • Three common non-medical goals for older adults: autonomy, safety, and privacy
  • What to do when goals come into conflict
  • How to use a “benefits versus burdens” framework to think through dilemmas and difficult decisions
  • How the reader with the resistant 96-year-old father might think through his options
  • 4 suggestions to keep in mind when discussing difficult topics with an older relative
[Read more…]

053 – Interview: Addressing Loneliness in Aging

by Leslie Kernisan, MD MPH 4 Comments

Better Health While Aging
Better Health While Aging
053 – Interview: Addressing Loneliness in Aging
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In This Episode:

Dr. K talks with Carla Perissinotto, MD, Associate Chief for Geriatrics Clinical Programs at UCSF and a nationally known expert on loneliness in aging. Her landmark 2012 study found that loneliness is common among older adults, and is associated with greater declines while aging. They discuss:

  • What surprised her about her study findings
  • The difference between being alone, being lonely, and being socially isolated
  • How social contact and loneliness can impact health while aging
  • When to worry about someone who lives alone
  • Whether trying to age in place might increase the risk of social isolation
  • Different services and options that can help maintain social connections even when it’s hard to leave home
  • What to do if you’re worried about an older relative who might be lonely
  • How older adults might plan ahead to reduce their risk of loneliness and social isolation
  • How loneliness can put aging adults at risk for financial exploitation
  • Promising approaches to reducing loneliness in aging
[Read more…]

052 – Maintaining Mobility & Preventing Falls in Aging: Myths & Truths

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging
Better Health While Aging
052 – Maintaining Mobility & Preventing Falls in Aging: Myths & Truths
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00:00 / 43:37
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In This Episode:

Dr. K talks with Tiffany Shubert, PT PhD, a practicing physical therapist and a leading expert on exercise for fall prevention. They discuss the best ways to maintain mobility and prevent falls in aging, including:

  • Why walking is often not enough, when it comes to fall prevention
  • Why strong legs and good balance are crucial, and which exercises help develop this
  • How much exercise older adults should aim to do every week
  • How to figure out if an older person is tired due to doing too much versus not enough
  • The truths about chair exercises
  • The truth about water exercises
  • Whether canes prevent falls, and how they can be helpful
  • What to know about canes and walkers in dementia
  • How to find a high-quality exercise program that will build strength in aging
  • When trekking poles can be a good option to support safer mobility
  • What to know about yoga for fall prevention, and why tai chi might be a better choice

[Read more…]

051 – Interview: Innovations to Help Older Adults & Family Caregivers

by Leslie Kernisan, MD MPH 2 Comments

Better Health While Aging
Better Health While Aging
051 – Interview: Innovations to Help Older Adults & Family Caregivers
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00:00 / 37:30
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In This Episode:

Dr. K talks with Anne Tumlinson, an expert in long-term care and the founder of the caregiving organization Daughterhood.org. They discuss the upcoming Aging 2.0 Optimize Conference, promising innovations to help family caregivers and more. Their conversation addresses:

  • Which problems that come up the most in the Daughterhood.org community
  • Why it’s so hard for families to navigate the healthcare system
  • Promising age-friendly health innovations
  • Options for addressing aging in place and aging in the right place
  • Dr. Bill Thomas’s new Minka customizable house project
  • How transportation innovations can help older adults
  • The peer-to-peer aging health coaching being pioneered by AgeWell Global
  • What Anne learned from helping the Caregiver Action Network develop training to help families learn to make decisions
[Read more…]

050 – Flu Shots for Older Adults: What to Know

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging
Better Health While Aging
050 – Flu Shots for Older Adults: What to Know
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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 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
[Read more…]

049 – Better Primary Care for Older Adults:
the Oak Street Health Story

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging
Better Health While Aging
049 – Better Primary Care for Older Adults:
the Oak Street Health Story
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In This Episode:

Dr. K talks with Griffin Myers, MD, Chief Medical Officer of Oak Street Health, a Chicago-based network of primary care clinics designed to serve older adults. They discuss:

  • What makes Oak Street Health’s primary care different from usual primary care
  • Why every patient is assigned to a team and not just a doctor
  • How Oak Street Health uses patient relations managers, care managers, pharmacists, and other team members to address issues that many primary care providers don’t
  • The problems with fee-for-service in primary care, and the benefits of accountable care
  • How Oak Street Health is able to serve seniors of all income levels, without charging extra fees
  • How they help older adults avoid risky medications
  • Advice for innovators developing health technologies for aging adults
[Read more…]

048 – How Cerebral Small Vessel Disease Affects Most Aging Brains

by Leslie Kernisan, MD MPH 10 Comments

Better Health While Aging
Better Health While Aging
048 – How Cerebral Small Vessel Disease Affects Most Aging Brains
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In This Episode:

Dr. K explains what to know about cerebral small vessel disease (SVD), a very common brain condition linked to cognitive decline, balance and walking problems, dementia, and other significant health issues. She covers:

  • Common terms used by radiologists to describe this condition, such as “white matter disease,””small vessel ischemia,” and others
  • What is cerebral SVD
  • What are the symptoms that can be caused by this condition
  • Risk factors and other potential causes for cerebral SVD
  • How to treat and prevent cerebral SVD
  • Why it’s not usually a good idea to request an MRI to check for this condition
  • What to do if you’re concerned about cerebral SVD for yourself or an older loved one
[Read more…]

047 – Unintended Weight Loss in Aging

by Leslie Kernisan, MD MPH 2 Comments

Better Health While Aging
Better Health While Aging
047 – Unintended Weight Loss in Aging
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00:00 / 28:17
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In This Episode:

Dr. K explains what to know and what to do if you’re concerned about an older person who is losing weight. She covers:

  • Why unintended weight loss is an important red flag
  • Why it’s especially useful to monitor the weight of an older person who lives alone or is frail
  • The easiest ways to monitor an older person’s weight and nutritional status
  • When to worry about weight loss
  • The most common medical causes of unintended weight loss
  • How cognitive problems and/or mobility issues can cause weight loss or poor nutrition
  • When to consider appetite stimulants or supplements such as Boost or Ensure
  • Tips for family caregivers
[Read more…]

046 – Interview: Deprescribing & Reducing Risky Medications in Aging

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging
Better Health While Aging
046 – Interview: Deprescribing & Reducing Risky Medications in Aging
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00:00 / 48:48
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In This Episode:

Dr. K talks with geriatrician Dr. Cara Tannenbaum about deprescribing, empowering older adults, and how to get off unneeded or risky medications. Dr. Tannenbaum holds a Professorship in Medicine and Pharmacy at the University of Montreal and helped to found the Canadian Deprescribing Network. They discuss:

  • Why it’s so common for older people to be on medications that could be deprescribed
  • Why empower older adults to talk to their doctors about deprescribing
  • How Dr. Tannenbaum developed the EMPOWER brochure, which resulted in 25% of participants being able to stop sedative medications such as lorazepam
  • Common mistakes people make when they try to stop risky medications too quickly
  • Which medications are especially important for seniors to consider deprescribing
  • The six questions  you should regularly ask your doctors about your medications
[Read more…]
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