Episode Archive - Page 15 of 19 - Better Health While Aging

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

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging

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

00:00 / 1:04:36

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

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048 – How Cerebral Small Vessel Disease Affects Most Aging Brains

by Leslie Kernisan, MD MPH 10 Comments

Better Health While Aging

048 – How Cerebral Small Vessel Disease Affects Most Aging Brains

00:00 / 40:55

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

047 – Unintended Weight Loss in Aging

00:00 / 28:17

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

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046 – Interview: Deprescribing & Reducing Risky Medications in Aging

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging

046 – Interview: Deprescribing & Reducing Risky Medications in Aging

00:00 / 48:48

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

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045 – HIPAA: Key Basics & 5 FAQs for Family Caregivers

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging

045 – HIPAA: Key Basics & 5 FAQs for Family Caregivers

00:00 / 42:49

In This Episode:

Dr. K explains what all family caregivers should know about the HIPAA Privacy Rule, and your options for getting doctors to share information about an older relative’s health. She covers:

Why it’s so common for families to need health information from a relative’s doctors
What is the HIPAA Privacy Rule
When are doctors allowed to disclose health information to family members and others
When are doctors required to disclose health information
What is a HIPAA release or authorization, and when is it necessary?
Options for communicating with doctors despite an older person’s objections or refusal
When to consider an older person’s decision-making capacity
How a durable power of attorney for healthcare can enable a family member to obtain information
Practical tips for family caregivers

[Read more…]

044 – Hospice Medications & What to do if You’re Concerned

by Leslie Kernisan, MD MPH 4 Comments

Better Health While Aging

044 – Hospice Medications & What to do if You're Concerned

00:00 / 40:02

In This Episode:

Dr. K addresses a reader’s concerns about the morphine and lorazepam (brand name Ativan) that were given to her relatives with dementia, while on hospice. She covers:

Common end of life symptoms, and which symptoms are common in people with advanced Alzheimer’s
How morphine is usually used at the end of life, to manage problems such as pain and shortness of breath
Why it’s usually possible to use morphine to control symptoms without “hastening” death
Why it’s unclear that lorazepam should be used as often as it is, in hospice care
How to choose a good hospice provider
How to be proactive, to avoid problems and misunderstandings with the hospice team
What you can do, if you’re concerned about the care a loved one is receiving while on hospice

[Read more…]

043 – How Hospice Helps at the End of Life, & Hospice for Alzheimer’s

by Leslie Kernisan, MD MPH 4 Comments

Better Health While Aging

043 – How Hospice Helps at the End of Life, & Hospice for Alzheimer's

00:00 / 38:00

In This Episode:

Dr. K explains the basics of hospice care, with a special focus on hospice for people with Alzheimer’s disease and related dementias. She covers:

The difference — and relationship — between hospice and palliative care
What kind of services and benefits you can get through hospice
How hospice eligibility is determined by Medicare
The difference between severe Alzheimer’s disease and “terminal” Alzheimer’s
How to know when someone with Alzheimer’s might be eligible for hospice
Why some people with dementia “recover” and may be discharged from hospice
Common misconceptions people have about palliative care and hospice
Why hospice is a good choice for most patients and families facing the end of life

[Read more…]

042 – Why Healthcare is Flawed & How to Improve It:
The Work of Dr. Lawrence Weed

by Leslie Kernisan, MD MPH 10 Comments

Better Health While Aging

042 – Why Healthcare is Flawed & How to Improve It:
The Work of Dr. Lawrence Weed

00:00 / 46:55

In This Episode:

The patient must have a copy of his own record. He must be involved with organizing and recording the variables so that the course of his own data on disease and treatment will slowly reveal to him what the best care for him should be.” — Dr. Lawrence Weed, “Your Health Care and How to Manage It” (1975)

Dr. K discusses the flaws of healthcare and how medicine could be improved, per the insights of visionary healthcare reformer Dr. Lawrence Weed, who died earlier this month at age 93. She covers:

What is optimal medical care, and why doctors often fail to provide it to their patients
Why usual medical care — which relies mainly on doctors using their own internal knowledge and mental processes — leads to disorderly healthcare and frequent errors in diagnosis and management
Dr. Weed’s seminal insight that “Any system of care that depends on the personal knowledge and analytic capabilities of physicians cannot be trusted.“
Why Dr. Weed believed that healthcare professionals should use “knowledge couplers” and other more reliable tools to guide the process of evaluation and diagnosis, instead of relying on their own mental processes
Dr. Weed’s belief that the patient should be much more involved in his or her care, and that doctors should help patients make choices, rather than choose for them
Why Dr. Weed advocated for a better medical record, and why he wanted patients to have access to it
Dr. Weed’s lifelong advocacy for a healthcare system that would be orderly and reliable for evaluation, diagnosis, and documentation, but then would be flexible and individualized when it comes to treatment for individual patients
Tips on how older adults and their families can get better care from their doctors, and support the improvements that Dr. Weed envisioned

[Read more…]

041 – UTIs and Urine Bacteria in Aging:
How to get the right diagnosis & avoid unneeded antibiotics

by Leslie Kernisan, MD MPH 4 Comments

Better Health While Aging

041 – UTIs and Urine Bacteria in Aging:
How to get the right diagnosis & avoid unneeded antibiotics

00:00 / 32:44

In This Episode:

Dr. K explains why having bacteria in one’s urine does NOT mean one has a urinary tract infection (UTI) that requires antibiotics. In fact, as people get older, they may have bacteria in the urine but no UTI symptoms or other signs of infection. This condition, called “asymptomatic bacteriuria” is common, and is often inappropriately treated with antibiotics. In this episode:

How to know if one has asymptomatic bacteriuria versus a UTI that warrants antibiotics
Why having asymptomatic bacteriuria becomes more common as people become older
Why the Infectious Disease Society of America and others have repeatedly urged doctors to NOT treat asymptomatic bacteriuria
The challenge of correctly diagnosing UTIs in people with dementia
How one can be harmed by using antibiotics to try to eliminate bacteria in the bladder
What to do if you’re worried about urine bacteria — or a possible UTI — in an older person

[Read more…]

040 – Dehydration in Older Adults:
How to Prevent It, Detect It, & Treat It

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging

040 – Dehydration in Older Adults:
How to Prevent It, Detect It, & Treat It

00:00 / 45:48

In This Episode:

Dr. K explains how to prevent, detect, and treat dehydration in aging adults. She covers:

What is dehydration and what causes it
Why older adults are at higher risk for dehydration
How dehydration can be correctly diagnosed
Why several commonly-used tests for dehydration are often inaccurate in older adults
Symptoms of dehydration
Health consequences that may be associated with mild versus more severe dehydration
How dehydration can be treated
How to prevent dehydration, including how to help older adults stay hydrated
What to known about dehydration and possible urinary tract infections
Tips for family caregivers who are concerned about an older person’s hydration

[Read more…]

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