The Better Health While Aging Podcast

Get practical health tips from a geriatrician and other experts! We discuss common health problems that affect people over age 60, the best ways to prevent and manage those problems, and we also often address common concerns and dilemmas that come up with aging parents and other older loved ones.

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

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

00:00 / 43:22

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

053 – Interview: Addressing Loneliness in Aging

00:00 / 41:24

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

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

00:00 / 43:37

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

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

00:00 / 37:30

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

050 – Flu Shots for Older Adults: What to Know

00:00 / 40:53

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

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

[Read more…]

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

[Read more…]

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

[Read more…]

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…]

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