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.

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…]

039 – Interview: Creating Age-Friendly Health Systems

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging

039 – Interview: Creating Age-Friendly Health Systems

00:00 / 38:07

In This Episode:

Dr. K talks with Amy Berman, RN, about a major new initiative to create “age-friendly health systems.” Amy is a Senior Program Officer at the John A. Hartford Foundation (JAHF), which focuses on improving the health of older adults. They discuss:

Four goals of an age-friendly health system
The four “Ms” that an age-friendly health system should address: what matters, mentation, mobility, and medications
Why delirium prevention is such an important part of addressing mentation
How the age-friendly health systems initiative builds on proven models of better care for older adults
How JAHF and its partners are planning to develop and expand age-friendly health systems
How older adults and families can find age-friendly care
10 benefits you can expect from age-friendly health systems

[Read more…]

038 – FAQs On “Incompetence” & Losing Decision Capacity

by Leslie Kernisan, MD MPH 2 Comments

Better Health While Aging

038 – FAQs On "Incompetence" & Losing Decision Capacity

00:00 / 41:09

In This Episode:

Dr. K addresses frequently asked questions about older adults and decisional capacity. She also provides practical advice on what you can do if you’re concerned that an older person is making “bad” decisions. She covers:

What does the term “capacity” mean when it comes to decision-making?
What is the difference between incapacity and incompetence?
How is capacity determined?
Does capacity have to be determined by legal professionals? Is it a “legal decision” whether someone has capacity?
Do I have to have a legal or clinical determination of incapacity for a specific decision before I override the decision of an older person with dementia?
Do I need a legal or clinical determination of incapacity before I take the car keys away from an older parent who has dementia and is an unsafe driver?
Is neuropsychological testing required to assess capacity?
What to do if you’re worried about an older person’s capacity, or actions

Related episodes:

013 – Interview: Solving Hard Problems in Helping Aging Parents
037 – Interview: Using Powers of Attorney to Help Older Adults

Related Resources:

Incompetence & Losing Capacity: Answers to 7 FAQs
American Bar Association Ten Legal Tips for Caregivers
Assessment of Capacity in Older Adults (American Bar Association/American Psychological Association)
Respect for Autonomy (Alzheimer’s Association)
Driving and Dementia (Alzheimer’s Association)

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037 – Interview: Using Powers of Attorney to Help Older Adults

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging

037 – Interview: Using Powers of Attorney to Help Older Adults

00:00 / 44:55

In This Episode:

Dr. K talks with elder law attorney Harry Margolis, founder of Margolis & Bloom LLP and ElderLawAnswers.com. They discuss common questions related to the durable general power of attorney as a tool to help older adults, including:

Why durable general power of attorney (POA) documents can be very helpful to older adults
What can be done if an older person objects to the actions of his or her agent
How to use transparency and communication to minimize family conflicts
Whether POA documents should be effective immediately or only upon incapacity
Why it’s important to put family care agreements in writing
What you can do if you’re concerned the POA is abusing his or her power as an older person’s agent
The pros and cons of appointing two people to be your agent on a POA
Why trusts can work better than a POA
What can be done when a POA tries to prevent other family members from visiting

[Read more…]

036 – Interview: Minimizing Family Conflicts & Supporting Aging Parents

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging

036 – Interview: Minimizing Family Conflicts & Supporting Aging Parents

00:00 / 1:07:32

In This Episode:

Dr. K talks with Janet Benvenuti, a family caregiving expert who is the founder of Circle of Life Partners and the author of “Don’t Give Up on Me: Supporting Aging Parents Successfully.” They discuss:

Janet’s experience becoming responsible for her parents’ financial affairs and medical care
How Janet and her siblings negotiated caregiving roles and conflicts
An exercise to help you map out your family’s resources to build a caregiving team
Why Janet wishes her family had done more advance planning related to housing
The role of personal care agreements and compensation in family caregiving
Janet’s tips on how boomers can set up a game plan for their own aging
How to use Janet’s book to help your family plan for aging

[Read more…]

035 – Interview: Aging in the Right Place

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging

035 – Interview: Aging in the Right Place

00:00 / 58:32

In This Episode:

Dr. K talks with Stephen Golant, PhD, Professor of Geography at the University of Florida and the author of “Aging in the Right Place.” Dr. Golant has a doctorate in social gerontology and social geography, and is a well-known expert on the housing and long-term care needs of older adults. They discuss:

What is environmental gerontology, and why environment is so important to aging adults
How one’s housing, neighborhood, and community affect one’s ability to age well
Why older adults like to remain in their own homes
The problems many older adults encounter when they try to age in place, and what it means to “age in the right place”
A definition of successful aging
Why we shouldn’t reflexively promote aging in place, and what to encourage instead
How to determine where is the right place to age, and which questions older people should ask themselves
Why it may be better for seniors to live in a neighborhood of people their own age
Dr. Golant’s plan for where to live as he ages

[Read more…]

034 – Preventing Falls: 10 Types of Medication to Reconsider

by Leslie Kernisan, MD MPH 1 Comment

Better Health While Aging

034 – Preventing Falls: 10 Types of Medication to Reconsider

00:00 / 38:13

In This Episode:

Dr. K explains ten types of medications that may be associated with falls in aging adults. These are the medications that experts including the Center for Disease Control (CDC) recommend that doctors address during a medication review for fall prevention. This episode covers:

The four actions the CDC recommends that older adults do, to prevent falls
Why it’s so common for older adults to be on medications that may increase the risk for falls
What doctors are supposed to do, if an older person is taking one of these medications
Generic and brand names of the more commonly used medications that may be linked to falls
Tips on what to ask your doctor, if you or your older relative are taking any of these medications

[Read more…]

033 – Safer Treatments for Insomnia in Aging

by Leslie Kernisan, MD MPH 4 Comments

Better Health While Aging

033 – Safer Treatments for Insomnia in Aging

00:00 / 25:20

In This Episode:

Dr. K explains how to safely treat insomnia in older adults, and why most seniors should avoid sleeping pills. She covers:

Why it’s essential to identify the cause(s) of sleep problems, before starting or continuing to use sleeping pills
Why over-the-counter or prescription sleep aids, such as diphenhydramine, benzodiazepines, and “z-drugs” such as zolpidem, are bad for memory and balance
Three proven insomnia treatments that are effective and safer than pills
Where to find cognitive-behavioral treatment for insomnia online
Approaches to treating sleep problems in people with Alzheimer’s and other dementias

[Read more…]

032 – 5 Top Causes of Sleep Problems in Aging

by Leslie Kernisan, MD MPH 2 Comments

Better Health While Aging

032 – 5 Top Causes of Sleep Problems in Aging

00:00 / 25:20

In This Episode:

Dr. K explains the most common causes of insomnia and other sleep problems in older adults, and how to get them correctly diagnosed. She covers:

How sleep changes with normal aging
Common physical health and mental health problems that can affect sleep
What types of medications are especially associated with sleep difficulties
What to know about sleep apnea and sleep-related breathing disorders
Restless leg syndrome and periodic limb movements of sleep
What to do if you’re concerned about insomnia

[Read more…]

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