The Better Health While Aging Podcast

Better Health While Aging

086 - Interview: Creating Age-Friendly Health Systems at UCSF

00:00 / 1:02:55

In This Episode:

Dr. K talks with Dr. Stephanie Rogers, MD MPH, about creating Age-Friendly Health Systems at UCSF, and the specific programs they’ve developed to make hospitalization safer and better for older adults. They discuss:

What are Age-Friendly Health Systems, and why do older adults need them?
Why Age-Friendly Health Systems emphasize the “4 Ms”: mobility, mentation, medications, and what matters
How an Age-Friendly Health System differs from usual healthcare
Why hospitalization is often so risky for older people
What are Acute Care for Elders (ACE) units and how they help prevent problems such as falls, delirium, and loss of independence
How UCSF’s Hip Fracture Co-Management Service provides better care and improves recovery
UCSF’s Delirium Reduction Campaign, which uses a tool called “AWOL” to check every hospitalized patient for delirium
How delirium can be prevented, and what UCSF recommends that families do
How UCSF uses Patient and Family Advisory Councils to improve care
How to find an Age-Friendly Health System near you

085 – Understanding Lab Tests:
4 Common Blood Tests for Older Adults

Better Health While Aging

085 – Understanding Lab Tests:
4 Common Blood Tests for Older Adults

00:00 / 38:24

In This Episode:

Dr. K explains four “panels” of blood tests ordered for older adults, and what to keep in mind when blood tests are ordered. She covers:

What is a complete blood cell count (CBC)
What is a basic metabolic panel (also known as a basic electrolyte panel) and what is a comprehensive metabolic panel
What is a lipid panel
Common reasons that health providers order these panels, and what they can tell us about an older person’s health
Medications that often affect electrolytes
Why it’s important to request copies of your laboratory results
Key questions to ask, when lab tests are ordered or when you review abnormal results with your health provider

084 – Interview: Understanding White Matter Changes in the Aging Brain

by Leslie Kernisan, MD MPH 40 Comments

Better Health While Aging

084 – Interview: Understanding White Matter Changes in the Aging Brain

00:00 / 1:02:56

In This Episode:

Dr. K talks with neurologist Fanny Elahi, MD PhD, about cerebral small vessel disease and other issues related to white matter changes in the brain. Dr. Elahi sees patients and conducts research at UCSF’s Memory and Aging Center, and is an Assistant Professor of Neurology at UCSF. They discuss:

What is the white matter in the brain, and why it often changes or is damaged with aging
The relationship between white matter changes and cerebral small vessel disease
How white matter changes can be thought of as a form of “scarring” in brain
Why these brain changes can affect memory, thinking, and/or falls
What we know about the prevention and treatment of these changes
How white matter changes relate to vascular dementia, Alzheimer’s and other causes of dementia
How the UCSF Memory and Aging Center evaluates white matter changes
What is vascular parkinsonism
What to consider for younger people with white matter changes on MRI
Her recommendations on maintaining the brain and its blood vessels
Ongoing research projects at UCSF and elsewhere that listeners may be able to participate in

083 – Interview: Disrupting Dementia and Creating Dementia-Friendly Communities

Better Health While Aging

083 – Interview: Disrupting Dementia and Creating Dementia-Friendly Communities

00:00 / 1:00:19

In This Episode:

Dr. K talks with Kavan Peterson, editor and co-founder (with Dr. Bill Thomas) of ChangingAging.org. He is also the Chief Operation Officer for the Minka House Project. They discuss:

How Kavan met Bill Thomas and why they founded ChangingAging.org
How approaches to aging have improved over the past decade
Why the ChangingAging Tour emphasizes listening sessions, and the top two concerns they hear about
Why multi-generational interaction is so important
Why ChangingAging decided to focus on disrupting dementia
The Village of Hope project and the creation of dementia-friendly communities
How technological innovations can help care for aging adults
What’s next for ChangingAging, Minka and MAGIC in 2019
How and why you should get involved in creating age-friendly communities

082- Interview: Bill Thomas on Housing & Communities as Engines of Independence in Aging

Better Health While Aging

082- Interview: Bill Thomas on Housing & Communities as Engines of Independence in Aging

00:00 / 1:05:11

In This Episode:

Dr. K talks with geriatrician Bill Thomas, MD, founder of ChangingAging.org. They discuss his recent efforts to “escape from the gerosphere” and focus on aging as late-life development, by changing our stories about aging and fostering better housing and communities. They cover:

What are the general misconceptions and assumptions of aging
Changing the narrative from “aging problems” to “later life development”
Why housing and communities are engines of independence and are essential to better aging
Why we should focus on creating MAGIC: Multi-Ability, multi-Generational, Inclusive Communities
What to say to older adults who want to live in homes that aren’t serving them well
Why you should consider whether your home is “future-proofed”
What is a Minka house
Changing Aging’s current projects innovating with Minka and MAGIC
How and why we should address ableism and ageism, including within ourselves
Co-housing and other options for older adults interested in better places to live and grow older

081 – Interview: How to Plan Ahead for Your Later Years

Better Health While Aging

081 – Interview: How to Plan Ahead for Your Later Years

00:00 / 51:57

In This Episode:

Dr. K talks with family caregiving expert Carol Levine, Director of the Families and Health Care Project at the United Hospital Fund of New York about her new book, “Navigating Your Later Years for Dummies.” They discuss:

How to be proactive about your current and future age-related needs
Why it’s vital to start by taking a personal inventory of your preferences and resources
How your financial situation affects your housing and care options in later life
Why it’s especially helpful to discuss your finances and your living will with family
Pros and cons of aging in your own long-time home
Why it’s important to know that Medicare doesn’t cover most long-term care services
Planning tips for those aging alone or without family support
The value of aging within a community and maintaining a support network
How Carol has talked with her own children & planned for her own aging
How to avoid getting overwhelmed by the process

080 – Interview: Smartwatches as Medical Alert Devices
(What to Know & How to Choose)

Better Health While Aging

080 – Interview: Smartwatches as Medical Alert Devices
(What to Know & How to Choose)

00:00 / 1:01:31

In This Episode:

Dr. K talks with Richard Caro, PhD, a co-founder of Tech-Enhanced Life, who recently spent a few weeks carefully testing and reviewing four types of smartwatches that can serve as medical alert devices in the event of a fall or other personal health emergency. They discuss:

The Tech-Enhanced Life approach to evaluating innovations and newer technologies
The problem with existing medical alert devices
What key things to consider, when choosing a personal emergency response system (PERS) device and service
Why Richard and Dr. K recommend automatic fall-detection in a medical alert device
Which four smartwatch devices Richard selected for further testing
The difference between the Apple Watch 3 and 4, when it comes to using them as a medical alert
Why most medical alert services charge a monthly fee
How these newer smartwatch devices compare to more traditional PERS devices
The benefits of being able to “practice” summoning help
Richard’s preferred combo of medical alert features that no smartwatch offers (yet)
What to keep in mind if considering a medical alert for someone with dementia

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

by Leslie Kernisan, MD MPH 3 Comments

Better Health While Aging

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

00:00 / 30:14

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

078 – Interview: The Biology of Aging & Longevity

Better Health While Aging

078 – Interview: The Biology of Aging & Longevity

00:00 / 1:18:57

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

077 – Interview: Making Advance Care Planning Easier Through PREPARE

Better Health While Aging

077 – Interview: Making Advance Care Planning Easier Through PREPARE

00:00 / 51:20

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