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Better Health While Aging

Practical information for aging health & family caregivers

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025 – Interview: Palliative Care to Live Well with Cancer

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging
Better Health While Aging
025 – Interview: Palliative Care to Live Well with Cancer
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In This Episode:

Dr. K talks with Amy Berman, RN, Senior Program Officer at the John A. Hartford Foundation, who has been benefitting from palliative care ever since she was diagnosed with Stage IV breast cancer in late 2010. They discuss:

  • Why palliative care is the best friend of the seriously ill, and doesn’t mean “giving up” care
  • How palliative care helps people align medical care with what’s most important to them
  • How palliative care has helped Amy maintain her quality of life, despite having incurable cancer
  • How palliative care complements — rather than replaces — usual treatments for cancer and other serious illnesses
  • The difference between palliative care and hospice
  • Why it’s worth looking for an oncologist who regularly partners with a palliative care team
  • Tips on accessing palliative care for yourself or your relatives
[Read more…]

024 – Interview: Better Cancer Screening While Aging

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging
Better Health While Aging
024 – Interview: Better Cancer Screening While Aging
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In This Episode:

Dr. K talks with Louise Walter, MD, an expert on cancer screening in older adults and the Chief of the Division of Geriatrics at the University of California San Francisco. They discuss:

  • Why it’s important to consider life-expectancy, before pursuing cancer screening
  • How doctors and others can better estimate life-expectancy
  • Why cancer screening can be harmful to some older adults
  • Why it’s important for older people to ask “How soon will this help me?”
  • Why screening for prostate cancer with the “PSA” test is often problematic
  • Dr. Walter’s top tips on making sure you get cancer screening services that are right for you
[Read more…]

023 – Anemia in Aging: 10 Common Causes & What to Ask

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging
Better Health While Aging
023 – Anemia in Aging: 10 Common Causes & What to Ask
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00:00 / 36:15
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In This Episode:

Dr. K explains what all older adults and families should know about anemia, a common health problem that is not always due to low iron levels. She covers:

  • How anemia is detected and diagnosed in aging adults
  • Symptoms of anemia
  • The most common causes of anemia, and the tests often used to check for them
  • How over-the-counter medications can cause anemia
  • What to ask the doctor
  • How to avoid common pitfalls related to the diagnosis of iron-deficiency anemia
  • How to get better follow-up, if you or your relative is diagnosed with anemia
[Read more…]

022 – QA: Helping a Paranoid Older Parent and Checking Safety

by Leslie Kernisan, MD MPH 4 Comments

Better Health While Aging
Better Health While Aging
022 – QA: Helping a Paranoid Older Parent and Checking Safety
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00:00 / 46:30
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In This Episode:

Dr. K responds to a reader’s question on assessing the safety of an older parent who has become paranoid and has started behaving differently. She covers:

  • Why delusions, hallucinations, and paranoid behavior are so common in older adults
  • The six “Ds” that cause paranoia and other forms of late-life psychosis
  • Why a medical evaluation to identify the causes of psychosis is so important
  • How to check on “levels of decline” and safety, using the Checking Older Parents Quick Start Guide
  • How to tell your parent’s doctor about the problems, even if your parent doesn’t want you to be involved
  • The best sources of useful advice and information, if you are concerned about a parent with signs of late-life psychosis
  • Tips on discussing these issues with a resistant parent
[Read more…]

021 – Vitamin B12 Deficiency: Risks, Diagnosis, & Treatment

by Leslie Kernisan, MD MPH 8 Comments

Better Health While Aging
Better Health While Aging
021 – Vitamin B12 Deficiency: Risks, Diagnosis, & Treatment
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In This Episode:

Dr. K explains what all older adults and family caregivers should know about the surprisingly common problem of vitamin B12 deficiency. She covers:

  • Common symptoms of low vitamin B12, such as anemia (low red blood cell count), neuropathy (nerve problems), and cognitive impairment
  • The role of vitamin B12 in the body
  • What causes pernicious anemia, which is a type of vitamin B12 deficiency
  • Which medications interfere with vitamin B12 absorption and can cause low levels
  • Other risk factors for having low vitamin B12
  • How to test for vitamin B12 deficiency, including when to test for methylmalonic acid
  • How this vitamin deficiency can be treated
[Read more…]

020 – How to Diagnose & Treat Mild Cognitive Impairment

by Leslie Kernisan, MD MPH 2 Comments

Better Health While Aging
Better Health While Aging
020 – How to Diagnose & Treat Mild Cognitive Impairment
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00:00 / 37:17
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In This Episode:

Dr. K responds to a reader who wants to know what works best for treating mild cognitive impairment. She covers:

  • How mild cognitive impairment (MCI) is defined and diagnosed
  • Whether having difficulty connecting names and faces is a sign of MCI
  • What a clinical evaluation for MCI should cover
  • The research on medications, exercise, and other approaches to treating MCI
  • What to know before taking a dementia medication such as donepezil (brand name Aricept) for MCI
  • 9 ways to promote brain health
[Read more…]

019 – Interview: How Foundations Are Improving Health & Aging

by Leslie Kernisan, MD MPH Leave a Comment

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Better Health While Aging
019 – Interview: How Foundations Are Improving Health & Aging
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In This Episode:

Dr. K talks with Chris Langston, PhD, former Program Director at the John A. Hartford Foundation and an expert on leveraging philanthropy to improve the health and healthcare of older Americans. They discuss:

  • How charitable foundations influence geriatrics research and education
  • The Hartford Foundation’s work assessing quality of care for older adults, and how older adults perceive that care
  • How the Hartford Foundation helped develop a “collaborative care” model for better treatment of depression in older adults
  • Why redesigning the way the average doctor works may be more important than providing more opportunities for doctors to acquire geriatrics knowledge
  • The benefits of “Acute Care for Elders” (ACE) units
  • How the evolution of geriatrics might be similar to — and different from — pediatrics
  • How society views aging and how we might tackle ageism
[Read more…]

018 – High Blood Pressure Treatment in Older Adults: Research Findings & Practical Tips

by Leslie Kernisan, MD MPH 2 Comments

Better Health While Aging
Better Health While Aging
018 – High Blood Pressure Treatment in Older Adults: Research Findings & Practical Tips
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00:00 / 00:57:00
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In This Episode:

Dr. K addresses the question “What should my blood pressure be?” for older adults. In this episode she covers:

  • Why an expert group recommended a higher blood pressure (BP) treatment goal for older adults in late 2013
  • Whether the newer blood pressure research (known as the SPRINT trial) means you should change your blood pressure treatment
  • Why the usual ways of measuring BP in the doctor’s office are flawed, and how to better measure BP
  • Why she recommends a certain BP goal for most older adults, and how seniors can decide if they want to aim for a lower BP goal
[Read more…]

017 – Interview: Paying for Long-Term Care & Other Family Caregiving Challenges

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging
Better Health While Aging
017 – Interview: Paying for Long-Term Care & Other Family Caregiving Challenges
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In This Episode:

Dr. K talks with Anne Tumlinson, an expert in long-term care financing and the founder of Daughterhood.org. They discuss:

  • What is “long-term care” for older adults, and how is it usually paid for?
  • What are ADLs and IADLs, and how do they relate to nursing home eligibility?
  • The conditions under which Medicaid (not Medicare!) pays for long-term care
  • The current role of long-term care insurance and how this type of insurance could be improved
  • Why Anne started Daughterhood.org in response to seeing friends struggling with helping their parents and paying for care
  • The two big family caregiver problems that Anne hears about over and over again: how do I pay for this and how do I deal with my siblings?
  • The guilt, shame, and grief that family caregivers — especially women — often experience when helping older parents
  • Anne’s tips for family caregivers who are struggling to pay for care or to cope
[Read more…]

016 – 3 Reasons You Should Have a Home Blood Pressure Monitor

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging
Better Health While Aging
016 – 3 Reasons You Should Have a Home Blood Pressure Monitor
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In This Episode:

Dr. K explains why most older adults should have a home blood pressure monitor. She covers:

  • 3 key ways that a home blood pressure (BP) monitor often helps older adults get better healthcare
  • Why it’s essential to always record pulse along with BP
  • What is orthostatic hypotension, how it relates to falls, and which medications often cause it
  • What kinds of health problems can cause a heart rate that is much higher than usual
  • How a home BP monitor can help when you call a medical telephone advice line
  • What to ask the doctor after a BP medication has been changed
  • How often to check blood pressure, if you have a home BP monitor
  • How to choose a home blood pressure monitor to buy
  • Which Omron home blood pressure monitor she recommends and why
[Read more…]
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