Better Health While Aging

146 – Atrial Fibrillation in Older Adults: Watchman, Medications & Other Treatment Options Oct 11, 2024

In This Episode:

Dr. K talks about atrial fibrillation (afib) with Cara Pellegrini, MD, a specialist in cardiac electrophysiology and an expert on the Watchman device and other ways to treat this common heart arrhythmia. They cover:

What is afib & what causes it?
What are the symptoms of afib & how is it diagnosed?
How is afib treated?
What to know about blood-thinners for afib
Treating afib in frail older adults
Atrial fibrillation & stroke risk
Watchman for afib & stroke prevention
Who should consider Watchman?
Afib in dementia
How lifestyle changes can powerfully affect afib
What to ask doctors about afib

Related episode:

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

Related Resources:

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145 – COVID & Fall 2024 Vaccines Update Oct 04, 2024

In This Episode:

Dr. K provides an update on COVID so far this year, and explains the available vaccines for the three respiratory viruses likely to be very active this fall and winter: COVID, influenza, and RSV. She also addresses other ways to protect oneself this winter.
She covers:

2024 vaccines for older adults
COVID so far in 2024
Why COVID remains worse than flu
COVID vaccines for 2024-25
Flu vaccines for 2024
What to know about RSV vaccine
How to stay healthier this winter

Note: For the masks Dr. K recommends, you can get the 3M V-flex here https://amzn.to/3OxrsRY, and the Powecom KN95 here https://amzn.to/3W9frXf

These are Amazon affiliate links, so any purchases will help support Better Health While Aging, thank you!

Related Resources:

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143 – Unsafe Driving in Aging: What to Know & Do Aug 23, 2024

In This Episode:

Dr. K explains what to know and what to do if you’re concerned about unsafe driving in an older adult, including when driving should stop and what to know if you’re dealing with Alzheimer’s or a related type of dementia. She covers:

How aging impacts driving abilities
Common causes of unsafe driving in older adults
How to make driving safer in aging
Driving warning signs to look out for
How Alzheimer’s/dementia affects driving
When it’s time to stop driving
What to do if someone won’t stop driving
How to get help if you’re concerned
Her approach to driving in aging and in dementia

Related episode:

124 – Does Your Aging Parent Need Help? What to check & how to talk about it

Related Resources:

The Hartford: Warning Signs for Driving
NHTSA: Older Drivers Traffic Safety Facts (2022)
American Academy of Neurology: Practice Parameter update: Evaluation and management of driving risk in dementia

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142 – Vitamin D: Why Less is More in Aging Jul 30, 2024

In This Episode:

Dr. K explains why the best dose of vitamin D for older adults is lower than you might think. She explains why vitamin D is important and how the latest research suggests that high doses of vitamin D might actually be risky for older adults. This episode covers:

What is vitamin D
What is an optimal level of vitamin D
When to test vitamin D levels
What is vitamin D deficiency
Official vitamin D intake recommendations
Key vitamin D research findings
Vitamin D and fall prevention
The vitamin D dose she recommends for older adults

Related episode:

138 – How to Promote Brain Health & Memory in Aging

Related Resources:

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141 – 4 Most Common Types of Dementia in Aging May 08, 2024

In This Episode:

Dr. K goes beyond Alzheimer’s and explains what older adults and families should know about the most common types of dementia in older adults. She covers:

The 4 most common types of dementia in older adults
How doctors diagnose the specific type of dementia
Mixed dementia and less common causes of dementia
The most common early symptoms of Alzheimer’s dementia, vascular dementia, and Lewy body dementia
Which types of dementia might be treatable
Newer types of dementia pathology, such as LATE, hippocampal sclerosis, and cerebral amyloid angiopathy
Dr. K’s approach to dementia type

Related episode:

139 – How to Treat Mild Cognitive Impairment

Related Resources:

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140 – How to Exercise to Age Well Apr 17, 2024

In This Episode:

Dr. K explains how exercise helps older adults maintain strength and independence, and covers the four types of exercise all older adults should be doing regularly. She also discusses why walking isn’t enough, how to avoid injuries and special situations in geriatrics, such as exercising when an older person is frail or has Alzheimer’s. This episode covers:

The benefits of exercise in aging
Is walking good exercise?
Strength training in aging
Aerobic exercise in aging
Balance exercises for seniors
Flexibility exercises in aging
Best exercises for fall prevention
How to start and maintain an exercise routine
Managing risks of exercise and avoiding injuries
Exercise to counter frailty and sarcopenia
Exercise when there’s Alzheimer’s or dementia
Getting someone else to exercise
The role of protein and strength training

Related episodes: How to Improve Brain Health in Aging

138 – How to Promote Brain Health & Memory in Aging

005 – Interview: Otago & Proven Exercises for Fall Prevention

Related Resources:

4 Types of Exercise in Later Life: How to maintain strength, balance, & independence in aging
Videos Illustrating Otago Exercises for Fall Prevention
National Council on Aging: Evidence-Based Falls Prevention Programs
National Institute on Aging: Four Types of Exercise Can Improve Your Health and Physical Ability
Nutrition Needs for Older Adults: Protein

Other references and resources:

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139 – How to Treat Mild Cognitive Impairment Apr 02, 2024

In This Episode:

Dr. Kernisan explains what all older adults and families should know about the treatment of mild cognitive impairment (MCI), a common memory condition that affects 20-25% of older adults. She discusses scientifically tested approaches to treating and managing MCI and improving brain health, including the role of medications, supplements, treating hearing loss, exercise and more. In this episode, she covers:

What is MCI
How MCI is related to Alzheimer’s and dementia
What to do if you suspect MCI
Scientifically proven approaches to treating and managing MCI
What to know about the “Bredesen protocol” for MCI
What to know about Leqembi and anti-amyloid treatments for Alzheimer’s
How Dr. K treats MCI
Common MCI pitfalls to avoid

Related episode:

Related Resources:

Useful references and resources:

Scholarly resources:

Critiques of the Bredesen protocol:

Can we trust The End of Alzheimer’s?
Bredesen Protocol offers false hope of reversing Alzheimer’s disease
Scholarly description of the Bredesen protocol: Precision Medicine Approach to Alzheimer’s Disease: Successful Pilot Project (note: ages of included patients were 50-76, with MoCA at least 19)

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138 – How to Promote Brain Health & Memory in Aging Mar 14, 2024

In This Episode:

Leslie Kernisan, MD MPH, explains the best ways to boost brain health in aging, to help memory and thinking, as well as to prevent cognitive decline. Learn which approaches geriatricians find most effective, plus which vitamins and supplements are likely to help. Dr. K also covers emotional well-being in aging, and how this affects cognitive health.
Topics discussed:

Helping older adults maintain brain health and memory
Why promote your brain health
The difference between normal and abnormal brain changes with aging
FAQ: How to know what’s happening in your brain
Why emotional well-being matters
3 key ways to boost brain health
How to be positive about your aging
What’s good for brain health
What’s bad for brain health
If you’re worried about someone else’s brain

Related episode:

073 – Anticholinergic Medications & Protecting Brain Health

Related Resources:

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137 – Aging Life Care (and Geriatric Care Managers) Explained: Who They Are & How They Help Jan 13, 2024

In This Episode:

Geriatrician Leslie Kernisan, MD MPH, teams up with her trusted geriatric care manager colleague Michelle Allen, LCSW, to explain how Aging Life Care Professionals (also known as geriatric care managers) can help older adults and their families. They cover:

Why geriatricians love geriatric care managers
Aging Life Care Professionals vs Geriatric Care Managers
What is an Aging Life Care Professional & how do they help
How to find an Aging Life Care Professional
What is a certified or professional geriatric care manager?
Other types of eldercare experts
How to hire an Aging Life Care Professional

Related episode:

135 – How to Pay for Elder Care

Related Resources:

Providing Elder Care: Covering the Cost of Home Care, Assisted Living & Other Options
Hiring In-Home Caregivers for Aging in Place
Find an Aging Life Care Expert
Learn more about getting help from Dr. K & Michelle here: Helping Older Parents Online Courses & Programs.

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136 – 8 Things Doctors Should Check After a Fall Nov 29, 2023

In This Episode:

Geriatrician Leslie Kernisan, MD MPH, explains 8 things health providers should check after an older person falls, to prevent future dangerous falls in aging. In this episode:

Why it’s vital to be proactive after a fall
Why you should learn the 8 things Dr. K checks after a fall
Why checking BP sitting and standing is so important
The most useful blood tests to consider
Medications that can worsen falls
How to check gait and balance
Additional referrals to consider

Related episode:

034 – Preventing Falls: 10 Types of Medication to Reconsider

Related Resources:

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135 – How to Pay for Elder Care Oct 31, 2023

In This Episode:

Geriatrician Dr. Leslie Kernisan, MD MPH, teams up with experienced geriatric care manager Michelle Allen, LCSW, to discuss a common FAQ: how to pay for elder care. They cover

What types of help do elders usually need
What are the options for eldercare?
How much does eldercare cost?
How to pay for eldercare?
What to know about long-term care insurance
How Medicaid pays for eldercare

Related episode:

096 – Interview: Paying for Long-Term Care: 2019 Updates

Related Resources:

Hiring In-Home Caregivers for Aging in Place- What to Know: https://betterhealthwhileaging.net/hiring-home-care-for-aging-in-place/
Caring for an aging parent? Learn about Dr. K’s Helping Older Parents programs here: https://betterhealthwhileaging.net/helping-older-parents/

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134 – COVID & Aging August 2023 Update: Staying Safe, Boosters & More Aug 15, 2023

Dr. K discusses the latest COVID news for August 2023, including the recent rise in COVID cases, whether to get boosted again now or later, what we know about the upcoming fall COVID vaccine, and more.

In this episode:

What to know about the new COVID wave
Update on the EG.5 subvariant
Whether vaccines work against the newest variants
Update on the upcoming 2023 COVID vaccine booster
Answers to FAQs
- Should you get boosted again now or wait?
Symptoms of COVID & what to do if you catch it
What will really help us live with COVID

Note: For the masks Dr. K recommends, you can get the 3M V-flex here https://amzn.to/3OxrsRY, and the Powecom KN95 here https://amzn.to/3W9frXf

These are Amazon affiliate links, so any purchases will help support Better Health While Aging, thank you!

Related Episodes:

133 – COVID Summer 2023 News Update for Aging Adults

Related Resources:

BHWA:
- COVID & Aging Adults: 2023 & 2022 Updates
- COVID Vaccination for Aging Adults: What to Know & Do
To track COVID data:
- Wastewater:
  - Biobot.io wastewater tracker
  - CDC Wastewater Surveillance
- CDC Covid Data Tracker
- CDC Weekly hospitalizations
- CDC Weekly deaths
- CDC Nursing Home Covid-19 Data Dashboard
CDC & FDA information referenced in this update:
From medical journals and research groups:
From news and other media:
- NPR: Coronavirus FAQ: Is it wiser to get a booster now or wait for the new fall booster? (8/11/23)
- NBC news: What’s your current risk of getting long Covid? (March 2023)
For masking, ventilation COVID transmission information:
- Masks Dr. K uses:
- Project N95
- Twitter resources
  - @joeyfox85
  - @masknerd

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133 – COVID Summer 2023 News Update for Aging Adults Jun 07, 2023

Dr. K discusses the latest COVID news for Summer 2023, including the current COVID situation in the US, how to get COVID data now that the public health emergency has ended, updates on COVID boosters, how to know if you still should take precautions, and more.

In this episode:

What’s changed since February
Updates on the COVID bivalent booster
What’s happening now with COVID
How to decide if you should worry about COVID
What are the risks of catching COVID now?
How to avoid catching COVID this summer
COVID booster FAQs
COVID symptoms now
What to do if you catch COVID & how to get Paxlovid

Note: For the masks Dr. K recommends, you can get 3M Aura here https://amzn.to/3PJJyRO, the 3M V-flex here https://amzn.to/3OxrsRY, and the Powecom KN95 here https://amzn.to/3W9frXf

These are Amazon affiliate links, so any purchases will help support Better Health While Aging, thank you!

Related Episodes:

132 – COVID 2023 News Update for Aging Adults (2.23.23 Edition)

Related Resources:

BHWA:
- COVID & Aging Adults: 2023 & 2022 Updates
- COVID Vaccination for Aging Adults: What to Know & Do
To track COVID data:
- CDC Covid Data Tracker
- CDC Weekly hospitalizations
- CDC Weekly deaths
- CDC Nursing Home Covid-19 Data Dashboard
- Wastewater:
  - CDC Wastewater Surveillance
  - Biobot.io wastewater tracker
CDC & FDA information referenced in this update:
From medical journals and research groups:
From news and other media:
- Your Local Epidemiologist: End of Public Health Emergency: A shift in data
- For masking, ventilation COVID transmission information:
  - - Masks Dr. K uses:
      - 3M V-flex N95
      - 3M Aura N95
      - Powecom KN95
  - - Project N95
  - - Twitter resources
      - @joeyfox85
      - @masknerd

132 – COVID 2023 News Update for Aging Adults (2.23.23 Edition) Feb 24, 2023

Dr. K discusses the latest COVID news for 2023, including what’s most important for aging adults and their families to know for the spring. She also covers the problem of doctors inappropriately not prescribing Paxlovid (the best treatment if an older adult does catch COVID), and how to advocate to get it successfully.

In this episode:

The current COVID & flu situation (cases & hospitalizations)
About the new Covid variant XBB.1.5
What the public health emergency ending will mean for you
How to know if you need to worry about COVID
What to know about COVID reinfections
If you’re high risk and need to avoid catching COVID
Update on the bivalent COVID booster
When can you get your next COVID booster?
Update on masks to prevent COVID
COVID symptoms in 2023
The best treatment for COVID (Paxlovid) & an FDA checklist that can help you get it
Summary of what to know for COVID in Spring 2023

Note: For the masks Dr. K recommends, you can get 3M Aura here https://amzn.to/3PJJyRO, the 3M V-flex here https://amzn.to/3OxrsRY, and the Powecom KN95 here https://amzn.to/3W9frXf

These are Amazon affiliate links, so any purchases will help support Better Health While Aging, thank you!

Related Episodes:

131 – COVID Update for Aging Adults (12.8.22 Edition)

Related Resources:

BHWA:
- COVID & Aging Adults: 2023 & 2022 Updates
- COVID Vaccination for Aging Adults: What to Know & Do
To track COVID data:
CDC & FDA information referenced in this update:
From medical journals and research groups:
From news and other media:
For masking, ventilation COVID transmission information:
- Masks Dr. K uses:
- Project N95
- Twitter resources
  - @joeyfox85
  - @masknerd

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131 – COVID Update for Aging Adults (12.8.22 Edition) Dec 09, 2022

Dr. K discusses what aging adults & families should know about COVID and flu this winter.

She covers:

The currently increasing rates of COVID & flu
What to know about the new Omicron subvariants BQ.1 and BQ.1.1
How well the fall COVID bivalent booster is working so far
How to avoid getting sick and how to gather safely
When to mask and how to do so effectively
Why use a HEPA air purifier at home and how to choose one
How to detect COVID now
How to treat COVID
Her top recommendations for staying safe during winter gatherings

Note: you can get the CO2 monitor Dr. K refers to here: https://amzn.to/3yhDtq8.

For the masks Dr. K is using, you can get 3M Aura here https://amzn.to/3PJJyRO, the 3M V-flex here https://amzn.to/3OxrsRY, and the Powecom KN95 here https://amzn.to/3W9frXf

Dr. K’s HEPA air purifier is here https://amzn.to/3Y96crN

These are Amazon affiliate links, so any purchases will help support Better Health While Aging, thank you!

Related Episodes:

130 – COVID Booster Update for Aging Adults (9.7.22 Edition)

Related Resources:

BHWA:
- COVID & Aging Adults: 2022 Updates
- COVID Vaccination for Aging Adults: What to Know & Do
To track COVID data:
CDC Datasets in this update:
From medical journals and research groups:
From news and other media:
- ‘Indoor pandemic’: An engineer on how to clean the air you breathe
For masking, ventilation COVID transmission information:
- Masks Dr. K uses:
- Project N95
- Twitter resources
- CDC Interactive ventilation tool
- CleanAirCrew.org Portable Air Cleaner Buying Guide
  - Air Cleaners dataset
- The Corsi-Rosenthal Box: DIY Box Fan Air Filter for COVID-19 and Wildfire Smoke

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130 – COVID Booster Update for Aging Adults (9.7.22 Edition) Sep 08, 2022

Dr. K discusses what aging adults & families should know about the new fall COVID boosters, the latest Omicron variants, and more. Plus who died of COVID this summer and how to know if you’re at high risk of severe COVID.

She covers:

The current COVID situation & variants in the US
Newer variants overseas that might evade immunity
What’s in the new bivalent fall COVID booster
How the fall booster was developed and tested
Why there has been debate about the fall COVID booster
Data review: who died of COVID this past summer?
The data on the benefit of boosters so far
Dr. K’s predictions regarding benefits of the fall COVID booster
When to get your fall COVID booster
Do you need a booster if you’ve had Omicron?
Summary of Dr. K’s COVID booster recommendations, including which booster, if you have a choice
What to know about Paxlovid and what to do if you catch COVID

Related Episodes:

129 – COVID Update for Aging Adults (7.21.22 Edition)

Related Resources:

BHWA:
- COVID & Aging Adults: 2022 Updates
- COVID Vaccination for Aging Adults: What to Know & Do
To track COVID data:
Fall COVID booster resources:
- CDC ACIP Meeting Slides from September 1, 2022
  - For human and mice data on Omicron booster: Moderna slides, Pfizer slides
CDC Datasets in this update:
- Rates of COVID-19 Cases or Deaths by Age Group and Vaccination Status
- Rates of COVID-19 Cases or Deaths by Age Group and Vaccination Status and Second Booster Dose
From medical journals and research groups:
From news and other media:
- Omicron boosters: Do I need one, and if so, when? (NPR 9/5/22)
- India and China first to authorize inhaled COVID vaccines (CBS 9/6/22)
For masking, ventilation COVID transmission information:
- Masks Dr. K uses:
  - 3M V-flex N95
  - 3M Aura N95
- Project N95
- Twitter resources
  - @masknerd
- CDC Interactive ventilation tool
- The Corsi-Rosenthal Box: DIY Box Fan Air Filter for COVID-19 and Wildfire Smoke

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129 – COVID Update for Aging Adults (7.21.22 Edition) Jul 22, 2022

Dr. K discusses the high COVID levels, the related risks for aging adults, what to know about Omicron BA.5, the data on boosters, and the most effective ways to take sensible precautions.

She covers:

The current COVID situation and how high cases really are
What to know about COVID hospitalization numbers
Whether COVID vaccines are still working
The data on first and second boosters
How the new Novavax COVID vaccine works
How to test for COVID
How long to isolate if you get COVID
What to know about Paxlovid and relapsing after Paxlovid
What masks she recommends
How to take reasonable precautions

Note: you can get the CO2 monitor Dr. K refers to on Amazon here: https://amzn.to/3yhDtq8. The masks that Dr. K is currently using include 3M V-flex N95, and 3M Aura N95. These are affiliate links, so any purchases will help support Better Health While Aging, at no extra cost to you.

Related Episodes:

128 – COVID Update for Aging Adults (5.5.22 Edition)

Related Resources:

BHWA:
- COVID & Aging Adults: 2022 Updates
- COVID Vaccination for Aging Adults: What to Know & Do
To track COVID data:
FDA:
For masking, ventilation COVID transmission information:
- Masks Dr. K uses:
  - 3M V-flex N95
  - 3M Aura N95
- Project N95
- Twitter resources
  - @kprather88, @linseymarr, @masknerd
- CDC Interactive ventilation tool
- The Corsi-Rosenthal Box: DIY Box Fan Air Filter for COVID-19 and Wildfire Smoke
From medical journals and research groups:
- Effectiveness of a second BNT162b2 booster vaccine against hospitalization and death from COVID-19 in adults aged over 60 years (Nature, April 2022)
- Effectiveness of 2, 3, and 4 COVID-19 mRNA Vaccine Doses Among Immunocompetent Adults During Periods when SARS-CoV-2 Omicron BA.1 and BA.2/BA.2.12.1 Sublineages Predominated — VISION Network, 10 States, December 2021–June 2022 (CDC, 7/15/22)
- Hospitalization and Emergency Department Encounters for COVID-19 After Paxlovid Treatment — California, December 2021–May 2022 (CDC 6/21/22)
- Self-reported long COVID after infection with the Omicron variant in the UK (UK ONS 7/18/22)
- SARS-CoV-2 transmission on planes, by “Your Local Epidemiologist” Katelyn Jetelina, PhD
- UK Health Security Agency COVID-19 vaccine weekly surveillance reports
- COVID-19 Rebound After Paxlovid Treatment (CDC 5/24/22)
- Newest Omicron subvariants can evade boosters, antibody therapies (UMN CIDRAP, 7/6/22)
  - covers bebtelovimab, the only monoclonal antibody treatment still effective against BA.5
From news and other media:
- What you need to know about the Novavax vaccine (Johns Hopkins Univ, 6/16/22)
- New COVID Vaccine for Fall? What to Know About the FDA’s Plans (CNET 7/15/22)
- FDA says COVID boosters for the fall must target newer omicron types (NPR 6/30/22)
Twitter sources that helped with this update:
- Dr. Eric Topol (good for all kinds of COVID data and info)
  - Graphic for PCR and rapid tests here

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128 – COVID Update for Aging Adults (5.5.22 Edition) May 06, 2022

Dr. K discusses the current rise in COVID cases, the related risks for aging adults, what to know about the newest Omicron variants, and the most effective ways to take sensible precautions.

She covers:

Where we are at with COVID now, and the impact on aging adults
About the Omicron variants BA.2 and BA.2.12.1
What’s changed (& hasn’t) with COVID
The latest on COVID vaccine efficacy during Omicron
What to know about first and second boosters
The latest on how COVID is being transmitted
What to do for masking to be effective
Ventilation & checking CO2 levels
Does rapid testing still work?
What to know if you catch COVID
Whether to mask on airplanes & answers to other FAQs
Her top recommendations for taking reasonable precautions right now

Note: you can get the CO2 monitor Dr. K refers to on Amazon here: https://amzn.to/3yhDtq8. This is an affiliate link, so any purchases will help support Better Health While Aging, at no extra cost to you.

Related Episodes:

127 – COVID Update for Aging Adults (2.24.22 Edition)

Related Resources:

BHWA:
- COVID & Aging Adults: 2022 Updates
- COVID Vaccination for Aging Adults: What to Know & Do
To track COVID data:
CDC:
- COVID variant proportion tracker
FDA: Paxlovid EUA Fact Sheet for Healthcare Providers
For masking, ventilation COVID transmission information:
- CIDRAP: What can masks do? Part 1: The science behind COVID-19 protection
- Project N95
- Twitter resources
  - @kprather88, @linseymarr, @masknerd
- CDC Interactive ventilation tool
- The Corsi-Rosenthal Box: DIY Box Fan Air Filter for COVID-19 and Wildfire Smoke
From medical journals and research groups:
- SARS-CoV-2 transmission on planes, by “Your Local Epidemiologist” Katelyn Jetelina, PhD
- UK Health Security Agency COVID-19 vaccine weekly surveillance reports
  - Effectiveness of 3 doses of COVID-19 vaccines against symptomatic COVID-19 and hospitalisation in adults aged 65 years and older (UK HSA)
- Efficacy of a Fourth Dose of Covid-19 mRNA Vaccine against Omicron (NEJM 3/16/22)
- Protection by a Fourth Dose of BNT162b2 against Omicron in Israel (NEJM 4/5/22)
From news and other media:
- Another rare virus puzzle: They got sick, got treated, got covid again (WaPo 4/27/22, about Paxlovid relapses)
- If you’ve had omicron before, are you safe from infection by the new variants? (NPR 5/4/22)
Twitter sources that helped with this update:
- Dr. Eric Topol (good for all kinds of COVID data and info)
  - Graphic for PCR and rapid tests here
- Dr. Bob Wachter (good for SF data and thinking through risk for 60 year olds)
  - Good thread on whether it’s currently worth trying to avoid COVID here

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127 – COVID Update for Aging Adults (2.24.22 Edition) Feb 25, 2022

In This Episode:

Dr. K discusses the ebbing of the Omicron surge, what to know about the “stealth” Omicron BA.2 (it has taken over in Denmark and is growing here), how to “live with COVID” safely, and more.

She covers:

Why current COVID numbers are better but still not low enough
What we’ve learned about vaccines & boosters during the Omicron surge
What we can learn from Denmark lifting all COVID restrictions
How to compare US COVID data to that of other countries, and why our outcomes are worse
What to know about the Omicron sister variant BA.2
What it would mean for COVID to be “endemic”
The ideal approach to living with COVID
Wastewater & other ways to monitor COVID in your local area
What older adults can do to keep themselves and their families safer

Note: The CDC released updated guidance re COVID and assessing local COVID-19 community levels on 2/25/22. Dr. K has posted written comments regarding this on her 2022 COVID article: COVID & Aging Adults: 2022 Updates.

Related Episodes:

126 – Update: COVID Vaccination in Aging (1.6.22 Edition)

Related Resources:

BHWA:
- COVID & Aging Adults: 2022 Updates
- COVID Vaccination for Aging Adults: What to Know & Do
To track COVID data:
CDC:
- COVID variant proportion tracker
FDA: Paxlovid EUA Fact Sheet for Healthcare Providers
Twitter threads referenced in update:
- Kristian Andersen on Danish COVID outcomes since restrictions were lifted
- Bob Wachter on estimating the COVID risk of attending a party
  - Photo summarizing his math here
From medical journals and research groups:
From news and other media:
Twitter sources that helped with this update:
- Dr. Eric Topol (good for all kinds of COVID data and info)
  - Graphic for PCR and rapid tests here
- Zeynep Tufecki (smart takes on COVID & more)
- Dr. Ashish Jha (good for pithy common-sense takes on COVID)

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126 – Update: COVID Vaccination in Aging (1.6.22 Edition) Jan 07, 2022

In This Episode:

This episode covers the latest on the ongoing Omicron surge, including whether it’s milder in older adults, what’s we’ve learned about rapid testing for Omicron, what to know about the current hospital situation, how to stay safer during the surge, and more.

The episode also addresses these FAQs:

But isn’t Omicron supposedly “milder”?
Do COVID tests (PCR and rapid) work against Omicron?
Do the COVID vaccines still “work”, and will they work against Omicron?
Are the COVID vaccines effective in older adults?
Why get vaccinated/boosted if you’re just going to get COVID anyway?
What about those new COVID treatments?
Shouldn’t we just “let it rip”?
And if I test positive for COVID?
Is it safe to ….

Related Episodes:

125 – Update: COVID Vaccination in Aging (12.16.21 Edition)

Related Resources:

BHWA:
- COVID & Aging Adults: 2022 Updates
- COVID Vaccination for Aging Adults: What to Know & Do
CDC:
- COVID 19 Quarantine and Isolation
- Nursing Home Covid-19 Data Dashboard
FDA: Paxlovid EUA Fact Sheet for Healthcare Providers
From medical journals and research groups:
- Imperial College London Omicron severity report (Dec 22, 2021)
From news and other media:
- NY Times COVID Tracker
- The C.D.C. Is Hoping You’ll Figure Covid Out on Your Own (Zeynep Tufecki, Jan 5, 2022)
- Emerging Data Raise Questions About Antigen Tests and Nasal Swabs (Jan 5, 2022)
- CDC recommits to isolation and quarantine guidelines without tests (Jan 4, 2022)
- Pfizer Investor Presentation (covers Paxlovid and more) (Dec 17, 2021)
Twitter sources that helped with this update:
- Dr. Eric Topol (good for all kinds of COVID data and info)
  - Graphic for PCR and rapid tests here
- Dr. Michael Mina (good for understanding COVID tests & more)
- John Burn-Murdoch (good for COVID data stories, mostly UK but some US)
- Zeynep Tufecki (smart takes on COVID & more)
- Dr. Ashish Jha (good for pithy common-sense takes on COVID)

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125 – Update: COVID Vaccination in Aging (12.16.21 Edition) Dec 17, 2021

In This Episode:

This update covers Omicron, COVID boosters, plus how to search the CDC data to see just how well vaccines have worked, even in older adults. I also show the data demonstrating that vaccinated people age 80+ are still at higher risk of serious COVID than unvaccinated people under age 50; this is why fully vaccinated older adults should take precautions during the current surge!

(View the show notes page to watch my subtitled talk and my slides.)

This episode includes:

What do we know about Omicron so far, and will the vaccines remain protective
Should I get vaccinated against COVID?
Should my 90-year-old mother get the COVID vaccine?
How well does the vaccine work in older adults? How to use CDC data to see how well it works in different age groups
Should I worry that the vaccine might harm me (or my frail older parent)?
Who should get a COVID booster and why?
How to stay safer during the holidays.

Related Episodes:

123 – Update: COVID Vaccination in Aging (10.28.21 Edition)

Related Resources:

BHWA:
- COVID Vaccination for Aging Adults: What to Know & Do
CDC:
- CDC COVID Data Tracker
  - County view (to check your local transmission rates)
  - Rates of COVID-19 Cases and Deaths by Vaccination Status
  - Rates of laboratory-confirmed COVID-19 hospitalizations by vaccination status
- Nursing Home Covid-19 Data Dashboard
- COVID-19 Vaccine Booster Shots
- Selected Adverse Events Reported after COVID-19 Vaccination
- SARS-CoV-2 B.1.1.529 (Omicron) Variant — United States, December 1–8, 2021 (report on first Omicron cases in US)
- COVID-19 Vaccine Booster Dose Safety (from 11/19/21 CDC COVID-19 Vaccine Task Force Meeting)
From medical journals:
- Preliminary findings from study after Christmas party in Oslo (Norwegian Institute of Public Health)
- Protection of BNT162b2 Vaccine Booster against Covid-19 in Israel (NEJM Oct 2021)
From news and other media:
- Omicron: What We Know About the New Coronavirus Variant (NY Times Dec 2021)
- As U.S. Nears 800,000 Virus Deaths, 1 of Every 100 Older Americans Has Perished (NY Times 12/13/21)
- For COVID-19, age matters as much as vaccination status (9/27/21)
- I’m fully vaccinated and I also had COVID. Do I need a booster? (NPR Nov 2021)
- COVID-19 preventable mortality and leading cause of death ranking (Kaiser Family Foundation analysis, Dec 2021)

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124 – Does Your Aging Parent Need Help? What to check & how to talk about it Nov 19, 2021

In This Episode:

Dr. K explains what to do if you’ve become worried about your aging parent, and are trying to figure out if they need help, or are unsure of what to do next. She covers:

What mental changes are normal as people get older, and what’s not normal
The three types of problems you’ll want to check for
Specific signs to check for, to detect possible memory or thinking problems
How to tell if your parent needs more help around the house or with their daily life
The safety red flags I usually check for
A more respectful and effective way to talk to your aging parent about how things are going
What to stop doing and what to do instead, to reduce conflicts

Related Resources:

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123 – Update: COVID Vaccination in Aging (10.28.21 Edition) Oct 29, 2021

In This Episode:

This video update covers COVID boosters, recent research on the efficacy of COVID vaccination in older adults over the last six months, why we are seeing breakthrough infections, and more. I also cover my recommendations for how aging adults and their families can be safer during the holidays, and using rapid antigen tests.

(View the show notes page to watch my subtitled talk and my slides.)

This episode includes:

The current COVID situation in US
What recent research shows, when it comes to how well the vaccines work over time and in older age groups
What to know about COVID boosters and who should get them
How to stay safe during the holidays
What to know about rapid antigen tests
My latest recommendations for older adult & families

Related Episodes:

122 – Update: COVID Vaccination in Aging (9.9.21 Edition)

Related Resources:

BHWA:
- COVID Vaccination for Aging Adults: What to Know & Do
CDC:
- CDC COVID Data Tracker (to check your local transmission rates)
- CDC: When You’ve Been Fully Vaccinated
- Nursing Home Covid-19 Data Dashboard
- Rates of COVID-19 Cases and Deaths by Vaccination Status
- CDC: Comparative Effectiveness of Moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson) Vaccines in Preventing COVID-19 Hospitalizations Among Adults Without Immunocompromising Conditions — United States, March–August 2021 (Published Sept 2021)
- COVID-19 Vaccines for Moderately to Severely Immunocompromised People (CDC)
- Effectiveness of Pfizer-BioNTech and Moderna Vaccines in Preventing SARS-CoV-2 Infection Among Nursing Home Residents Before and During Widespread Circulation of the SARS-CoV-2 B.1.617.2 (Delta) Variant — National Healthcare Safety Network, March 1–August 1, 2021
From medical journals:
- Heterologous SARS-CoV-2 Booster Vaccinations – Preliminary Report
- The accuracy of novel antigen rapid diagnostics for SARS-CoV-2: a living systematic review and meta-analysis
- COVID-19 Vaccine Effectiveness by Product and Timing in New York State (pre-print posted Oct 9, 2021)
- Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: a retrospective cohort study (Lancet, Oct 2021, about the Pfizer vaccine)
From news and other media:
- For COVID-19, age matters as much as vaccination status (9/27/21)
- Who Had Covid-19 Vaccine Breakthrough Cases? (10/28/21)
- C.D.C. Recommends Covid Booster Shots for Millions of Americans (10/21/21)
- If You’ve Had Covid, Do You Need the Vaccine? (10/12/21) (about hybrid immunity)
- NY Times: COVID-19 Vaccine Tracker
- NY Times: Coronavirus Variant Tracker

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122 – Update: COVID Vaccination in Aging (9.9.21 Edition) Sep 10, 2021

In This Episode:

This video update covers my latest thoughts on the Delta surge, what we’ve learned about the efficacy of COVID vaccination in older adults over the last six months, breakthrough COVID cases, and whether “boosters” will be required.

(View the show notes page to watch my subtitled talk and my slides.)

This episode covers:

The current COVID situation in US
What we’ve learned about COVID vaccination over 6 months
The latest on third doses (aka “boosters”)
How to know what’s safe & answers to FAQs
My latest recommendations for older adult & families

Note: A day after I recorded my update, the CDC released three additional studies regarding COVID vaccination. You can read about them here. Basically, one study concluded that vaccinated people are 5x less likely to get COVID, 10x less likely to be hospitalized, and 11x less likely to die of COVID. Another study found that vaccine efficacy is a bit lower in adults older than 75, compared to younger than 75, and that vaccine efficacy was better with Moderna than Pfizer. And a study in veterans found that “vaccine effectiveness in preventing COVID-19–related hospitalization was 80% among adults aged ≥65 years compared with 95% among adults aged 18–64 years.”

Related Episodes:

121 – Update: COVID Vaccination in Aging (7.29.21 Edition)

Related Resources:

BHWA:
- COVID Vaccination for Aging Adults: What to Know & Do
CDC:
- CDC COVID Data Tracker (to check your local transmission rates)
- CDC: When You’ve Been Fully Vaccinated
- Nursing Home Covid-19 Data Dashboard
- COVID-19 Vaccines for Moderately to Severely Immunocompromised People (CDC)
- Effectiveness of Pfizer-BioNTech and Moderna Vaccines in Preventing SARS-CoV-2 Infection Among Nursing Home Residents Before and During Widespread Circulation of the SARS-CoV-2 B.1.617.2 (Delta) Variant — National Healthcare Safety Network, March 1–August 1, 2021
From medical journals:
- Comparison of two highly-effective mRNA vaccines for COVID-19 during periods of Alpha and Delta variant prevalence (Mayo Clinic pre-print Aug 2021)
- Viral loads of Delta-variant SARS-CoV2 breakthrough infections following vaccination and booster with the BNT162b2 vaccine (Pre-print from Israel)
From news and other media:

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121 – Update: COVID Vaccination in Aging (7.29.21 Edition) Jul 30, 2021

In This Episode:

This video update includes my thoughts on the Delta variant and the latest CDC announcement regarding guidance for fully vaccinated adults, what to know about “breakthrough” COVID cases in nursing homes and elsewhere, recent studies on the efficacy of vaccines in older adults (and why some touted study results may not apply to older adults), who might not be well protected by the vaccine, and more.

(View the show notes page to watch my subtitled talk and my slides.)

This episode covers:

A recap of the current COVID & vaccine situation
What to know about Delta & the latest CDC mask update
“Breakthrough” COVID cases
Updates on COVID safety & efficacy in older adults and the immunocompromised
Whether boosters will be needed and whether to get one if available
My latest recommendations for older adults & families

Note: Since I recorded my update, the Washington Post has reported on the CDC’s internal presentation covering why they are so concerned about the Delta variant. The data presented is interesting and can be found here.

Related Resources:

BHWA:
- COVID Vaccination for Aging Adults: What to Know & Do
CDC:
- CDC COVID Data Tracker (to check your local transmission rates)
- Internal CDC presentation on Delta variant and breakthrough infections (July 29, 2021)
- CDC: When You’ve Been Fully Vaccinated
- Nursing Home Covid-19 Data Dashboard
- CDC Advisory Committee on Immunization Practices (meeting slides on vaccine safety and efficacy topics are usually very informative; browse for the latest ones here)
  - COVID-19 Vaccine Effectiveness studies (May 12, 2021; includes some nursing home studies)
From medical journals:
- Covid-19 Breakthrough Infections in Vaccinated Health Care Workers (July 2021)
- Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant (July 2021)
From news and other media:

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120 – Depression in Aging: Diagnosis & Treatment May 20, 2021

Watch the subtitled video and search the transcript by clicking above.
(For a short tutorial on how to search the transcript, see here.)

In This Episode:

Guest host Dr. Nicole Didyk discusses the diagnosis and treatment of depression, including why it’s often tricky to diagnose in later life, and how it can be treated. (Note: depression in the context of dementia will be covered in an upcoming episode.) Dr. Didyk is a geriatrician in Canada, and the founder of the blog and YouTube channel The Wrinkle.

She covers:

What’s different about depression in older adults?
What are the signs that an older person might be depressed?
What medical illnesses can mimic depression?
Which medications can cause or worsen depressive symptoms?
How can depression be treated in older adults?
What to do if you’re concerned about depression in an older person

Related episodes:

053 – Interview: Addressing Loneliness in Aging

Related Resources:

Suicide Prevention Helplines (available 24/7):

IOA Friendship Line (developed for older adults): 800-971-0016
United States 1-800-273-TALK
Canada 1-833-456-4566

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119 – Update: COVID Vaccination in Aging (5.14.21 Edition) May 15, 2021

In This Episode:

Dr. K provides commentary on the recent COVID developments, including the CDC’s latest mask guidance for vaccinated people, plus updated information on the effectiveness and safety of COVID vaccination for older adults. She also addresses FAQs about coronavirus vaccination.

This episode covers:

Why Dr. K has some concerns about the recent CDC mask update
What to know about “breakthrough” COVID cases, which have affected nursing homes and are being undercounted
The question of whether vaccinated people can transmit COVID
Recent studies related to COVID safety & efficacy in older adults
Why immunocompromised people might not be protected by the vaccine, especially if they have a “blood cancer” or are on medications that affect their B cells or T cells
How to think about COVID risk: yours and you exposing others to COVID risk
Answers to FAQs, including:
- Should I get vaccinated against COVID?
- Should my 90 year old mother get the COVID vaccine?
- How well does the vaccine work in older adults?
- Which vaccine is best for older adults? Which vaccine is safest?
- Should I worry that the vaccine might harm me (or my frail older parent)?
- Should I worry that I haven’t responded enough to the vaccine?
Dr. K’s current recommendations regarding COVID vaccination and staying safe given current conditions

Related Resources:

BHWA:
- COVID Vaccination for Aging Adults: What to Know & Do
CDC:
- Fully Vaccinated Adults 65 and Older Are 94% Less Likely to Be Hospitalized with COVID-19
- COVID-19 Vaccinations in the United States
- Interim Public Health Recommendations for Fully Vaccinated People
- Frequently Asked Questions about COVID-19 Vaccination
- Nursing Home Covid-19 Data Dashboard
- CDC Advisory Committee on Immunization Practices (meeting slides on vaccine safety and efficacy topics are usually very informative; browse for the latest ones here)
  - COVID-19 Vaccine Effectiveness studies (May 12, 2021; includes some nursing home studies)
From medical journals:
- Impact and effectiveness of mRNA BNT162b2 vaccine against SARS-CoV-2 infections and COVID-19 cases, hospitalisations, and deaths following a nationwide vaccination campaign in Israel: an observational study using national surveillance data (Pfizer vaccine in Israel, May 2021)
- Researchers Tie Severe Immunosuppression to Chronic COVID-19 and Virus Variants (May 2021)
New York Times:
- COVID-19 Vaccine Tracker
- Coronavirus Variant Tracker
- What Does the New Mask Guidance Really Mean? (NY Times 5/13/21)
Other articles:
- How Vaccine Hesitancy Is Driving Breakthrough Infections in Nursing Homes
- The CDC’s Big Mask Surprise Came Out of Nowhere

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118 – Updates: COVID Vaccination in Aging (3.26.21 Edition) Mar 26, 2021

In This Episode:

Dr. K provides updated information on the effectiveness and safety of COVID vaccination for older adults, including information on the Pfizer, Moderna, and Johnson&Johnson vaccines. She also addresses FAQs about coronavirus vaccination.

This episode covers:

How we can tell the COVID vaccines are working
Data on how COVID cases and deaths have fallen in nursing homes and among people aged 85+
Current COVID mortality rates in older adults
What the latest observational studies show, regarding vaccine effectiveness in people over age 80
What the Johnson & Johnson vaccine trial data shows, when it comes to older adults with chronic conditions
What’s been found so far, regarding vaccine safety
Answers to FAQs, including:
- Should I get vaccinated against COVID?
- Should my 90-year-old parent get the COVID vaccine?
- How well does the vaccine work in older adults?
- Can you get COVID if you’ve been vaccinated?
- Should you be vaccinated if you already had COVID?
- Which COVID vaccine is best for seniors? Which vaccine is safest?
- Should I worry that the vaccine might harm me (or my frail older parent)?
- When can I get vaccinated? Which vaccine should I try to get?
- If I’ve been vaccinated, is it safe to …?
Dr. K’s current recommendations regarding COVID vaccination and staying safe given current conditions

Related Resources:

BHWA: COVID Vaccination for Aging Adults: What to Know & Do
FDA (Food & Drug Administration):
- COVID-19 Vaccines
- Johnson & Johnson FDA Briefing Data
CDC:
New England Journal of Medicine:
- Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine (Pfizer vaccine)
- BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting (Pfizer vaccine in Israel)
- Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine (Moderna vaccine)
New York Times:
- COVID-19 Vaccine Tracker
- Coronavirus Variant Tracker
Uptodate.com COVID-19 Resources & Tools (Coronavirus Resources)
- Coronavirus disease 2019 (COVID-19): Vaccines to prevent SARS-CoV-2 infection

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117 – Leg Swelling in Aging: What to Know & Do Feb 25, 2021

Watch the subtitled video and search the transcript by clicking above.
(For a short tutorial on how to search the transcript, see here.)

In This Episode:

Guest host Dr. Nicole Didyk explains what older adults and families should know about leg edema (swollen legs), a common condition that affects aging adults. Dr. Didyk is a geriatrician in Canada, and the founder of the blog and YouTube channel The Wrinkle.

She discusses:

Why is it common for the lower legs to swell?
What are the most common medical causes of leg edema and what are some serious causes that should not be missed?
Which common medications can make leg swelling worse?
When should you seek immediate medical attention for swollen legs?
How can chronically swollen legs be treated?
What to know about using diuretics (water pills) for swollen legs

Related episodes:

092- Interview: Addressing Nighttime Urination & Insomnia in Aging

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

113 – Interview: Urinary Incontinence in Aging

Related Resources:

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116 – Interview: Dr. K’s New Book: When Your Aging Parent Needs Help Jan 21, 2021

Watch the subtitled video and search the transcript by clicking above.
(For a short tutorial on how to search the transcript, see here.)

In This Episode:

Dr. K talks to fellow geriatrician Dr. Nicole Didyk about her new book: When Your Aging Parent Needs Help: A geriatrician’s guide to memory loss, safety worries, resistance, and more. Dr. Didyk is the founder of the blog and YouTube channel The Wrinkle.

They discuss:

What led Dr. K to create this step-by-step guide for children of aging parents
Why the book is set up in four sections: taking stock, taking aim, taking action, plus taking the long view
How to communicate with your aging parent attentively and respectfully
How dementia and other memory or thinking issues often play a key role in an older adult’s resistance to change
Why she included practical “real-life” examples and printable downloadable “cheatsheets” that readers can reference
The A-B-C-D-E framework for taking action to help an aging parent
Why adult children often need to check themselves and accept their parents’ choices

Related Resources:

More information on the book: When Your Aging Parent Needs Help
9 Types of Issues to Address When Helping Older Parents

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115 – COVID Vaccination in Aging (12.17.20 Edition) Dec 18, 2020

In This Episode:

Dr. K discussed the new Pfizer coronavirus (COVID-19) vaccine, with a special focus on understanding how well it works and how safe it is, in aging adults.

This episode covers:

What to know about vaccine media reports and older adults
Why it’s important to try to find out the actual ages (and age distribution) of older participants in vaccine trials
How Dr. K looks at a published study to determine whether the vaccine works for her patients
Why the current Pfizer data can’t tell us whether the vaccine works in people over age 75
Why an expert dissented from the CDC’s decision to prioritize vaccination for nursing home residents
Dr. K’s current recommendations regarding COVID vaccination and keeping frail older adults safe during the pandemic

Related Resources:

BHWA: COVID Vaccination for Aging Adults: What to Know & Do
FDA (Food & Drug Administration):
- COVID-19 Vaccines
- FDA: Emergency Use Authorization for Vaccines Explained
CDC:
CDC advisory panel’s lone dissenter on why long-term care residents shouldn’t receive Covid-19 vaccine first
New England Journal of Medicine:
- Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine (12/10/20 publication of the Pfizer vaccine phase 2/3 trial data)
New York Times:
- COVID-19 Vaccine Tracker
- F.D.A. Clears Pfizer Vaccine, and Millions of Doses Will Be Shipped Right Away
Uptodate.com COVID-19 Resources & Tools (Coronavirus Resources)
- Coronavirus disease 2019 (COVID-19): Vaccines to prevent SARS-CoV-2 infection

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114 – Coronavirus Updates & Suggestions (11.18.20 Edition) Nov 20, 2020

Watch the subtitled video and search the transcript by clicking above. (For a short tutorial on how to search the transcript, see here.)

In This Episode:

Dr. K shares an update on the coronavirus (COVID19) situation and more recommendations to help older adults and people concerned about aging parents.

This episode covers:

The coronavirus situation today
Why COVID rates are so high right now
Latest developments in treatment & vaccination
What this means for older adults
If you’re wondering “Is it safe to…?”
Dr. K’s recommendations for the holidays and winter

Related news:

Resources:

Uptodate.com COVID-19 Resources & Tools (Coronavirus Resources)
What is a pulse oximeter
Center to Advance Palliative Care COVID Response Resources – see info in the symptom management section.
TheConversationProject.org:
- Conversation Guide: Being Prepared in the Time of COVID-19
PrepareForYourCare.org
- Get their easy advance directives for almost all states here.
- Get their COVID resources, including their PREPARE for COVID-19 Tip Sheet here.
POLST.org
- Learn how POLST helps frail and seriously ill adults get better care, and find out what is available for your state.
Institute on Aging Friendship Line
- This free service provides trained volunteers to talk to older adults who are lonely or depressed; they are also qualified as a crisis line for anyone contemplating harming themselves

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113 – Interview: Urinary Incontinence In Aging Oct 14, 2020

In This Episode:

Dr. K discusses urinary incontinence in aging with geriatrician Dr. Nicole Didyk, founder of the blog and YouTube channel The Wrinkle. They discuss:

Why this is such an important health issue to detect and address
Why aging tends to bring on urinary continence issues
The four main types of urinary incontinence to know about
The DIAPPERS mnemonic geriatricians often use to check for common causes of incontinence
Which medications can cause or worsen incontinence
How health providers should evaluate and diagnose incontinence
How to prevent and treat urinary issues
Timed toileting and other approaches to managing incontinence in Alzheimer’s and other dementias

Related Resources:

Urinary Incontinence in Aging: What to know when you can’t wait to go
From Dr. Didyk’s site TheWrinkle:
Canadian Continence Foundation: https://www.canadiancontinence.ca/EN/about-us.php
Continence Product advisor: https://www.continenceproductadvisor.org/
International Urogynecological Association leaflets – available in multiple languages: https://www.yourpelvicfloor.org/leaflets/
National Association for Continence: https://www.nafc.org/
Bladder diaries:
- https://myhealth.alberta.ca/Alberta/AlbertaDocuments/bladder-bowel-diary-printable.pdf (asks patient to measure urine output)
- https://www.yourpelvicfloor.org/media/Bladder_Diary-5.pdf

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112 – Flu Shots for Older Adults in COVID Times: What to Know (2020 Update) Sep 17, 2020

In This Episode:

Dr. K explains what all older adults and family caregivers should know about the new flu shots available for older adults this year and recommendations for influenza vaccination during this first COVID fall. This episode covers:

The basics of influenza and why vaccination is important
What we know about influenza and COVID-19
Why older adults are at higher risk of harm from the flu and how the vaccine works
The two key ways you can protect yourself from the flu
Why this year is a good time to make sure older adults are uptodate on their one-time pneumococcal vaccination
What to know about flu shots designed for older adults
Which influenza vaccine she thinks is best for most older adults
When to get vaccinated by
What to do if your older relative is unable or unwilling to get vaccinated

View subtitles and search the transcript for this episode, by clicking below:

Related Resources:

Flu Shots for Older Adults During COVID Times: What to Know & Do for 2020
CDC: U.S. Influenza Vaccines for the 2020-21 Season
CDC: Key Facts About Seasonal Flu Vaccine
CDC: Vaccine Effectiveness – How Well Does the Flu Vaccine Work?
CDC: Fluzone High-Dose Seasonal Influenza Vaccine
CDC: FLUAD Flu Vaccine With Adjuvant
CDC: Pneumococcal Vaccination
How to boost your immune system (Harvard Health Review)
To find a place to get your annual influenza vaccination: VaccineFinder.org

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111 – Coronavirus Updates & Suggestions (7.16.20 Edition) Jul 17, 2020

In This Episode:

Dr. K shares the coronavirus (COVID19) information and recommendations she presented on 7/16/20 to members of the Helping Older Parents Membership.

She covers:

The coronavirus situation today
Are we better at preventing COVID?
Are we better at treating COVID?
Current COVID treatments available in the hospital
Dr. K’s take on hospitalization for frail older adults with COVID
Useful resources and her recommendations for this summer

Related Resources:

Uptodate.com COVID-19 Resources & Tools (Coronavirus Resources)
What is a pulse oximeter
Center to Advance Palliative Care COVID Response Resources – see info in the symptom management section.
TheConversationProject.org:
- Conversation Guide: Being Prepared in the Time of COVID-19
PrepareForYourCare.org
- Get their easy advance directives for almost all states here.
- Get their COVID resources, including their PREPARE for COVID-19 Tip Sheet here.
POLST.org
- Learn how POLST helps frail and seriously ill adults get better care, and find out what is available for your state.
Institute on Aging Friendship Line
- This free service provides trained volunteers to talk to older adults who are lonely or depressed; they are also qualified as a crisis line for anyone contemplating harming themselves.

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110 – Coronavirus Updates & Suggestions (6.11.20 Edition) Jun 12, 2020

In This Episode:

Dr. K shares an update on the coronavirus (COVID19) situation and more recommendations to help older adults and people concerned about aging parents.

To watch the video version, click here.

This episode covers:

The coronavirus situation today
Key points on what Dr. K has learned about COVID so far (and what we’re still trying to figure out)
Updates on testing & reducing COVID transmission
If you’re wondering “Is it safe to…?”
COVID & Older Adults: the tradeoffs we’re facing
Nursing homes and COVID
Dr. K’s recommendations for this summer

Related Resources:

News & Updates:

Resources:

NEJM: False Negative Tests for SARS-CoV-2 Infection — Challenges and Implications
FDA: COVID-19 Frequently Asked Questions
CDC: Interim Guidelines for COVID-19 Antibody Testing (includes information on test sensitivity and positive predictive values)
FDA: Authorized Serology Tests Performance
AARP: How to Track COVID-19 Nursing Home Cases and Deaths in Your State
The Conversation Project COVID Advance Planning Guide
What is a pulse oximeter
Center to Advance Palliative Care COVID Response Resources – see info in the symptom management section.
PrepareForYourCare.org
- Get their easy advance directives for almost all states here.
- Get their COVID resources, including their PREPARE for COVID-19 Tip Sheet here.
POLST.org
- Learn how POLST helps frail and seriously ill adults get better care, and find out what is available for your state.
Institute on Aging Friendship Line
- This free service provides trained volunteers to talk to older adults who are lonely or depressed; they are also qualified as a crisis line for anyone contemplating harming themselves

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109 – Interview: Nursing Homes & Other Long-Term Care During COVID Times Jun 04, 2020

In This Episode:

Dr. K talks with Dr. Karl Steinberg, an expert in nursing home care and the President-Elect of the Society for Post-Acute and Long-Term Care Medicine. He has been a nursing home and hospice medical director in the San Diego area since 1995, and is currently the chief medical officer for Mariner Health Central, a 20-facility California nursing home management company. They discuss:

The varied course of COVID illness among nursing home residents
What older adults and families should know, to address COVID and advance care planning
Steps that nursing homes are now taking, to reduce COVID risk and manage cases
What we know about how COVID has affected other forms of long-term care, such as assisted-living
How we might be able to keep nursing home residents engaged socially and physically, during COVID times
Whether some facilities may eventually divide residents into those who prioritize isolation and those who are willing to tolerate slightly increased risks in order to benefit from more socialization and activities
What safer “re-opening” might look like, in nursing homes
Why it’s essential to get information from your county and state public health department

Related Resources:

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108 – Live QA: Aging Health in COVID Times Apr 17, 2020

In This Episode:

Dr. K and her guest experts Dr. Nicole Didyk and Richard Caro, PhD, answer BHWA reader questions about aging health in COVID times.

To watch the video version, click here.

Questions and issues they addressed during this call included:

The trade-off between safety and other benefits that older adults value
How to think through making an activity or situation “safer” rather than ask “is it safe?”
How to maintain physical and mental wellbeing while confined to the home, or to a locked-down facility
When it’s likely to be “safe” to resume routine health appointments, including eye and dental visits
How the pandemic situation might affect recovery from hospital delirium
What we know so far about the course of COVID in older adults who develop symptoms
What palliative care at home for COVID might look like
The challenges that nursing homes are currently facing

Related episodes:

106 – Coronavirus Updates & Suggestions (3.27.20 Edition)

105 – Coronavirus Updates & Suggestions (3.20.20 Edition)

068 – Interview: Putting Older Adults at the Center of Technology Conversations

Related Resources:

More from our guest experts:

From Dr. Didyk:
From Richard Caro:
- Technologies for Sheltering-in-Place, from TechEnhancedLife.com
- About the Longevity Explorers

Other related links and resources:

Uptodate.com: Evidence-based Information on COVID-19 (free!)
GeriPal: COVID in Long-Term Care
What is a pulse oximeter
CDC: Use of Cloth Face Coverings to Help Slow the Spread of COVID-19
Center to Advance Palliative Care COVID Response Resources – see info in the symptom management section.
PrepareForYourCare.org
- Get their easy advance directives for almost all states here.
- Get their COVID resources, including their PREPARE for COVID-19 Tip Sheet here.
TheConversationProject.org
- Conversation Guide to be prepared in the time of COVID-19 & other resources
POLST.org
- Learn how POLST helps frail and seriously ill adults get better care, and find out what is available for your state.

Services and Products:

Institute on Aging Friendship Line
- This free service provides trained volunteers to talk to older adults who are lonely or depressed; they are also qualified as a crisis line for anyone contemplating harming themselves
TrueLink Financial Debit Card
- This card was designed to help vulnerable older adults and others reduce the risk of financial exploitation.
Care.coach (formerly Gerijoy) virtual companion service for older adults
- This service provides companionship, medication reminders, and more. We have had a Helping Older Parents member give us very positive feedback about it recently.
- If you would like to be part of our Better Health While Aging group trying this service at a discount, please let us know via email. You will get 20% off the set-up fee (usually $279) and ongoing monthly charge (usually $279/month). (BHWA is forgoing any commission in order to enable a larger discount for our community.)

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107 – Interview: A Guide to Better Medical Care for Families of Aging Adults Apr 03, 2020

Click above for subtitles and click the magnifying glass for a searchable transcript.

In This Episode:

Dr. K talks with geriatrician Muriel Gillick MD, Professor at Harvard Medical School, about her latest book, The Caregiver’s Encylopedia: A Compassionate Guide to Caring for Older Adults. They discuss:

Why it’s so important for family members to be informed and proactive
Why Dr. Gillick recommends starting by understanding your relative’s overall health state
How to recognize frailty, and why it’s essential to be aware of it
Whether frailty can be reversed by exercise, and the pro and cons of pushing an older parent to exercise
The importance of “goals of care”, and what to do when trade-offs become necessary
How to ask an older person about what matters most to them
How to let the doctors know what an older person wants from their healthcare
How to get older adults — and healthcare professionals — to value the involvement of the family member
The importance of someone in the family being able to advocate for better care

Related episodes:

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

071 – Interview: How Estimating Life Expectancy Helps Older Adults Get Better Care

Related Resources:

To buy Dr. Gillick’s book at a discount, visit this link at Johns Hopkins University Press and use code “HTWN” to save 30%: The Caregiver’s Encylopedia: A Compassionate Guide to Caring for Older Adults.
Dr. Gillick’s blog: Life in the End Zone
- April 2020 post on very high COVID mortality rates in critically ill older adults
Dr. Gillick’s recent article in NY Times: Keeping Older People Safe During the Coronavirus Crisis
Discussing what matters: PatientPrioritiesCare.org

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106 – Coronavirus Updates & Suggestions (3.27.20 Edition) Mar 27, 2020

In This Episode:

Dr. K shares an update on the coronavirus (COVID19) situation and more recommendations to help older adults and people concerned about aging parents.

To watch the video version, click here.

104 – Coronavirus Special: Planning to Help Aging Parents (Plus Q&A)

089 – Giving Yourself (And Your Family) a Gift on National Healthcare Decisions Day

Related Resources:

News & Updates:

GeriPal: COVID in NYC & on Front Lines

Resources:

Uptodate.com: Coronavirus disease 2019 (COVID-19)
What is a pulse oximeter
Center to Advance Palliative Care COVID Response Resources – see info in the symptom management section.
PrepareForYourCare.org
- Get their easy advance directives for almost all states here.
POLST.org
- Learn how POLST helps frail and seriously ill adults get better care, and find out what is available for your state.
A Model Hospital Policy for Allocating Scarce Critical Care Resources

Services and Products:

Institute on Aging Friendship Line
- This free service provides trained volunteers to talk to older adults who are lonely or depressed; they are also qualified as a crisis line for anyone contemplating harming themselves
Care.coach (formerly Gerijoy) virtual companion service for older adults
- This service provides companionship, medication reminders, and more. We have had a Helping Older Parents member give us very positive feedback about it recently.
- If you would like to be part of our Better Health While Aging group trying this service at a discount, please let us know via email. You will get 20% off the set-up fee (usually $279) and ongoing monthly charge (usually $279/month). (BHWA is forgoing any commission in order to enable a larger discount for our community.)

Have you come across any resources or services that are especially helpful to older adults and families during this time? Please share below in the comments, thank you!

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105 – Coronavirus Updates & Suggestions (3.20.20 Edition) Mar 20, 2020

In This Episode:

Dr. K shares an update on the coronavirus (COVID19) situation and more recommendations to help older adults and people concerned about aging parents.

To watch the video version, click here.

089 – Giving Yourself (And Your Family) a Gift on National Healthcare Decisions Day

Related Resources:

News and Updates:

Events:

Free live online webinar on Thursday 3/26/20: Accessing Inner Resilience: Tools and Actions to Work with Challenging Times (from Zencaregiving.org)

Other resources:

PrepareForYourCare.org
- Get their easy advance directives for almost all states here.
POLST.org
- Learn how POLST helps frail and seriously ill adults get better care, and find out what is available for your state.

Services and Products:

Institute on Aging Friendship Line
- This free service provides trained volunteers to talk to older adults who are lonely or depressed; they are also qualified as a crisis line for anyone contemplating harming themselves
Care.coach (formerly Gerijoy) virtual companion service for older adults
- This service provides companionship, medication reminders, and more. We have had a Helping Older Parents member give us very positive feedback about it recently.
- If you would like to be part of our Better Health While Aging group trying this service at a discount, please let us know via email. You will get 20% off the set-up fee (usually $279) and ongoing monthly charge (usually $279/month). (BHWA is forgoing any commission in order to enable a larger discount for our community.)

Have you come across any resources or services that are especially helpful to older adults and families during this time? Please share below in the comments, thank you!

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104 – Coronavirus Special: Planning to Help Aging Parents (Plus Q&A) Mar 13, 2020

In This Episode:

Dr. K shares the coronavirus (COVID19) information and recommendations she presented on 3/12/20 to members of the Helping Older Parents Membership, plus answers to their questions about preparing themselves and protecting their aging parents. She covers:

What’s most important to know about the coronavirus situation right now
The current effort to “flatten the curve” and what that might mean in terms of how long precautions are necessary
Issues that are likely to come for frail older adults
How to think through care and housing options, and contingency planning
The importance of reviewing what matters most to your older parent
Why now is an important time to review advance care planning and preferences regarding critical care
What to know about POLST and similar advance care planning documents
Answers to member questions

Related Resources:

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103 – Interview: Better Sex in Later Life Feb 13, 2020

In This Episode:

Dr. K talks about sex in later life with geriatrician Dr. Nicole Didyk, founder of the blog and YouTube channel The Wrinkle. They discuss:

How Dr. Didyk learned more about this important topic by connecting with Nathalie Wilton, a social worker and sex therapist who focuses on older adults
Why it’s so common for health providers — and older adults — to have low “sexual literacy”, when it comes to aging and sexuality
How aging often affects sex and sexuality
Common concerns that patients have brought up in her clinical practice
What can be done if there is a mismatch in interest between two partners
The role of solo sex, toys, and activities other than intercourse
How being a hands-on caregiver to your partner can affect sex
Special issues that come up when one partner develops a dementia, such as Alzheimer’s
Tips on how to maintain and improve sexuality in later life

Related Resources:

Dr. Didyk’s audio interviews (which include transcripts) with Nathalie Wilton on The Wrinkle:
Dr. Didyk’s related BHWA Article: How Sex Changes With Aging (& What You Can Do About It)
Additional resources recommended by Dr. Didyk:
- Joan Price – author and advocate for ageless sexuality
- Come As You Are – Sex and Aging blog
- Safer sex 4 seniors – FAQ sheets and information about safe sex, and sex in general for older adults
- Sex, Intimacy and Cancer – Canadian Cancer Society, or American Cancer Society

Episode Transcript: Better Sex in Later Life Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

102 – Interview: The Importance of Grandparents & Intergenerational Connections Jan 09, 2020

In This Episode:

Dr. K talks with Kerry Byrne, PhD, a researcher and expert in aging and family caregiving, and the founder of TheLongDistanceGrandparent.com. They discuss the importance of intergenerational connections and of grandparents in particular. They cover:

Why intergenerational connections are so important to society, and how they reduce ageism
What we know about the grandparent-grandchild relationship
How Kerry’s experience living abroad led to her particular interest in “long distance” grandparents
Why grandparents are especially important, when it comes to countering ageism
How grandparents can more easily stay connected to grandchildren, especially if they live far away
Tips on fostering more intergenerational connections, whether that’s with family or others

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

Related Resources:

TheLongDistanceGrandparent.com
- Get Kerry Byrne’s free resource created especially for long-distance grandparents: ‘Ultimate Video Call Cheat Sheet’

Blogs for grandparents recommended by Kerry Byrne:
- GrandyCamp
- More Than Grand
AARP’s Grandparent Survey
To get involved in intergenerational activities:
Book: How To Live Forever: The Enduring Power of Connecting The Generations

Episode Transcript: The Importance of Grandparents & Intergenerational Connections

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101 – Interview: Avoiding Holiday Pitfalls with Aging Parents Dec 20, 2019

In This Episode:

Dr. K talks with Linda Fodrini-Johnson, MA MFT CMC, a past president of the National Association of Geriatric Care Managers (now the Aging Life Care Association) and a featured expert providing guidance in Dr. K’s Helping Older Parents Membership Program.

To help families have the best holidays possible, they discuss practical approaches to help families avoid common conflicts that come up during the holidays. They also discuss adapting the holidays for aging parents with dementia. Their talk includes:

What are geriatric care managers (also now known as aging life care professionals)
Why adult children should avoid telling their aging parents what they “should” do, and what to do instead
How to handle common causes of sibling conflict related to aging parents
How to learn more about what aging parents want for their future
What you can do if YOU are the older parent and your adult children are concerned
How to adapt the holidays so they work better for aging parents with dementia
What to do if an aging parent is showing signs of memory problems but hasn’t been diagnosed

Related episodes:

003 – Interview: Helping Reluctant Parents Address Memory Concerns

036 – Interview: Minimizing Family Conflicts & Supporting Aging Parents

Related Resources:

For more help with aging parents from Dr. Kernisan and Linda Fodrini-Johnson:

You can also get a PDF transcript of this episode, as our holiday gift to you: Click here for the Holidays with Aging Parents transcript!

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100 – Interview: Bill Thomas on Ageism, Housing & Changing Aging in 2019 Dec 12, 2019

In This Episode:

Dr. K talks with geriatrician Bill Thomas, MD, founder of ChangingAging.org. They discuss what he’s worked on during the past year, including his work fostering better aging through Minka houses, MAGIC (Multi-Ability, Multi-Generational Inclusive) Communities, and much more. They cover:

Why ageism is so important
Why it’s better to avoid age (and ability) segregation, when it comes to housing and community services
The mismatch between the housing we have and the housing we need
The problem of older adults loving houses that don’t love them back
His own experience this year of turning 60 and of moving to a smaller house
How cars affect aging and communities, and whether self-driving cars will change things
Why the Village of Hope community is designed to cultivate social capital
His recent work in value-based home health care
Whether aging issues will become part of the election conversation
Why it’s vital to confront our internal ageist narratives and appreciate our aging faces

Related episodes:

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

055 – Interview: Bill Thomas on Ageism & Innovations to Improve Aging

098 – Interview: Medicare Open Enrollment: What to Know & When to Switch

Related Resources:

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099 – Flu Shots for Older Adults: What to Know (2019 Update) Nov 14, 2019

In This Episode:

Dr. K explains what all older adults and family caregivers should know about annual vaccination against influenza. She also reports on the statistics from last year’s flu season. This episode 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

Related Resources:

Flu Shots for Older Adults: What to Know & Do for 2019-2020
CDC: U.S. Influenza Vaccines for the 2019-20 Season
Adults: Protect Yourself with Pneumococcal Vaccines
How to boost your immune system (Harvard Health Review)
2018-2019 U.S. Flu Season: Preliminary Burden Estimates
To find a place to get your annual influenza vaccination: VaccineFinder.org

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098 – Interview: Medicare Open Enrollment: What to Know & When to Switch Oct 10, 2019

In This Episode:

Dr. K talks with Michelle Allen, LCSW, about what all older adults and families should know about Medicare Open Enrollment and understanding your Medicare coverage. Michelle is an experienced social worker and geriatric care manager based in Atlanta, and is a featured expert providing guidance in Dr. K’s Helping Older Parents Membership. They discuss:

The surprisingly common misunderstandings that people often have about their Medicare coverage
The difference between traditional Medicare and Medicare Advantage plan
What is Medigap, what is secondary insurance, and what is supplemental insurance
How to find out just what type of Medicare coverage you or your older relative has
How to know whether it’s worth considering a plan switch during Medicare Open Enrollment
Why it’s a good idea to request a medication review before reviewing your Part D prescription coverage
What to consider if you frequently spend time traveling or living in other states
How to get free help understanding your Medicare coverage options

Related episodes:

093 – Interview: Hiring In-Home Care for Aging in Place: What to Know

096 – Interview: Paying for Long-Term Care: 2019 Updates

Related Resources:

Transcript: Click here.
Note from Dr. K: We don’t have the funds to transcribe most podcast episodes, but we made an exception and decided to transcribe Michelle Allen’s episode because it is such an important topic.

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097 – Interview: Common Elder Law Issues When Helping Aging Parents Sep 12, 2019

In This Episode:

Dr. K talks with elder law and estate planning attorney, Mark Gilfix, JD, about common legal issues that come up when helping aging parents. He is a partner at Gilfix & La Poll Associates, a Bay Area law firm that helped pioneer elder law. They discuss:

What is elder law and how it differs from estate planning and trust law
Why a durable power of attorney (DPOA) is a vital elder law planning tool
How DPOAs come into play if there are memory issues or other capacity concerns
The role of attorneys in checking capacity when their clients complete legal documents
What happens if you contact an older parent’s attorney with concerns about memory or capacity
The risks of undue influence, financial exploitation, and family members having an agenda
What people can do if they are concerned about the validity of an older person’s legal transaction
Options when a potentially impaired older parent refuses to release DPOA documents to family
Why it’s best for families to communicate early and often
How elder law attorneys can help with long-term care planning
Tips on starting planning conversations with your family

Related episodes:

091 – Interview: Reducing the Risk of Power of Attorney Abuse

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

070 – Interview: Addressing & Preventing Financial Exploitation in Aging

038 – FAQs On “Incompetence” & Losing Decision Capacity

Related Resources:

Gilfix & La Poll, Associates LLP
California Probate Code on Creation of Powers of Attorney
National Center on Law & Elder Rights (NCLER) Issue Brief: Drafting Advance Planning Documents to Reduce the Risk of Abuse or Exploitation
Better Health While Aging: Incompetence & Losing Capacity: Answers to 7 FAQs
American Psychological Association: Assessment of Capacity in Older Adults
American Bar Association: American Bar Association Ten Legal Tips for Caregivers
National Academy of Elder Law Attorneys
For law firms that include geriatric care coordinators: Life Care Planning Law Firm Association

For more information on the Helping Older Parents Membership Community, where people helping aging parents can regularly get guidance from Dr. K and from geriatric care managers, click here.

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096 – Interview: Paying for Long-Term Care: 2019 Updates Aug 08, 2019

In This Episode:

Dr. K talks with Howard Gleckman, senior fellow at the Urban Institute and an expert on how policy and tax issues affect older adults and their long-term care. He is also the author of Caring for Our Parents: Inspiring Stories of Families Seeking New Solutions to America’s Most Urgent Health Crisis. They discuss:

What is “long-term care” and who usually ends up paying for it
Why so many older adults end up needing some form of long-term care
That it’s Medicaid, not Medicare, that sometimes covers long-term care needs for older adults
What “triggers” need to occur for long- term care insurance policies to kick-in
Currently available options to pay for long-term care and “ongoing living assistance”
Why insurers have had difficulty offering affordable long-term care insurance
What happened to the federal long-term care program the CLASS act
How Washington State’s new public long-term care insurance plan is set up, and why it won’t help today’s older adults
The new Medicare rules that might enable Medicare Advantage plans to offer the “non-medical” services that can help older adults age in place
What are the benefits of Medicare Advantage care plans
What politicians are saying about this, and why we don’t hear more about long-term care issues

Related episodes:

059 – Interview: Long-Term Care Insurance & Financing Late-Life Care Needs

074 – Interview: How the Village Model Supports Aging in Place & Community

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

Related Resources:

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095 – Interview: Hearing Aids & Other Hearing Loss Treatment Options Jul 11, 2019

In This Episode:

Dr. K talks about hearing aids and other ways to address hearing loss with Meg Wallhagen, PhD, Professor of Gerontological Nursing at UCSF’s School of Nursing. She is a nationally recognized expert on hearing loss and has been on the board of the Hearing Loss Association of America since 2010. This episode is Part 2 of a two-part series on hearing loss. They discuss:

Why people may be entitled to workplace accommodations to address hearing loss
What should take place during an initial audiology evaluation
How audiologists adjust and fit hearing aids, and what to expect from a good audiology provider
What to expect from using hearing aids
Common hearing aid options to consider, & how to choose a hearing aid
Why it’s good to get a hearing aid with a telecoil
Why the brain needs time to adjust to hearing aids & why it’s essential to use them regularly
Who shouldn’t get hearing aids
Why a “Pocket Talker” can be a good option for people with dementia
Other alternatives to hearing aids, such as special phones
Why it’s important to address hearing loss sooner rather than later
Other simple ways to improve communication with older adults with hearing loss
Recent developments in over-the-counter hearing aids and personal sound amplification products (PSAPs)

Related Resources:

Professor Wallhagen’s Brochure (for people affected by hearing loss):
- Hearing Helps Us Stay Connected to Others
UCSF Audiology: The Speech Banana
Medicare.gov: Hearing & balance exams & hearing aids
Mayo Clinic: Hearing aids, How to choose the right one
The Hurdles to Getting Hearing Aids
Hearing Loss Association of America:
- Hearing Loss Basics
- A Guide to Understanding Hearing Loops (includes info on telecoils)
- Find a Local Chapter
AARP
- Congress Approves Over-the-Counter Hearing Aids
- Hearing Care Program: Captioned Telephone
Pocketalkers*
Hearing & Speech Center (San Francisco)
National Academies: Hearing Health Care for Adults: Priorities for Improving Access and Affordability
Better Health While Aging:
- 4 Key Things to Know About Age-Related Hearing Loss
Professor Wallhagen’s Research:
Transcript: Click here.
Note from Dr. K: We don’t have the funds to transcribe most podcast episodes, but we decided to transcribe Professor Wallhagen’s episodes, to make them more accessible to anyone experiencing hearing loss.

*Note: our Pocketalker link is an Amazon affiliate link. We are now participating in the Amazon Associates affiliate program, so if you buy through the link on our site, Better Health While Aging will earn a small commission, at no additional cost to you. Thank you for your support!

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094 – Interview: Hearing Loss in Aging: Why It Matters & Getting Evaluated Jun 27, 2019

In This Episode:

Dr. K talks about how we can help older adults address hearing loss with Meg Wallhagen, PhD, Professor of Gerontological Nursing at UCSF’s School of Nursing. She is a nationally recognized expert on hearing loss and has been on the board of the Hearing Loss Association of America since 2010. This episode is Part 1 of a two-part series on hearing loss. They discuss:

Why hearing loss in aging usually causes distortion of sounds, and how that affects understanding speech (and grandchildren)
Why it usually doesn’t help to speak more loudly to someone with hearing loss
How hearing loss affects the health, wellbeing, and social relationships of older adults
Why older people often don’t want to address hearing loss
The problem of healthcare professionals overlooking hearing loss
How hearing loss affects brain function
Why it can become harder to successfully address hearing loss once it’s severe
How hearing loss should be evaluated and what happens during a hearing test
Why poor Medicare coverage of hearing loss often creates barriers to care
How Professor Wallhagen’s brochure can help older adults agree to address hearing loss

Related Resources:

Professor Wallhagen’s Brochure (for people affected by hearing loss):
- Hearing Helps Us Stay Connected to Others
UCSF Audiology:The Speech Banana
Medicare.gov: Hearing & balance exams & hearing aids
National Academies: Hearing Health Care for Adults: Priorities for Improving Access and Affordability
Hearing Loss Association of America’s: Hearing Loss Basics
Better Health While Aging:
- 4 Key Things to Know About Age-Related Hearing Loss
Professor Wallhagen’s Research:

Transcript: Click here.
Note from Dr. K: We don’t have the funds to transcribe most podcast episodes, but we decided to transcribe Professor Wallhagen’s episodes, to make them more accessible to anyone experiencing hearing loss.

Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email. Click here now.

093 – Interview: Hiring In-Home Care for Aging in Place: What to Know Jun 13, 2019

In This Episode:

Dr. K talks with Michelle Allen, LCSW, about what families should know, when they want to obtain or hire in-home care to help an older person with aging in place. Michelle is an experienced social worker and geriatric care manager based in Atlanta, and is a featured expert providing guidance in Dr. K’s Helping Older Parents Membership Community. They discuss:

How geriatric social workers (and geriatric care managers) help older adults and families address aging issues
Why families and older adults usually seek out privately paid in-home care
Why most of the home care services older adults need to age in place are not covered by Medicare
What is “home health care,” and how to get Medicare to pay for certain medically skilled home services
What to know about hiring paid in-home caregivers
The pros and cons of hiring through an agency versus hiring an individual caregiver
Why families have to pay taxes, if they hire someone without going through an agency
Common mistakes that families make, when hiring in-home help to assist an older person
Why aging in place may not work out, and how to plan for other options
The benefits of working with “life care planning” elder law firms, which provide geriatric care coordinators such as Michelle

Related episodes:

059 – Interview: Long-Term Care Insurance & Financing Late-Life Care Needs

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

Related Resources:

Family Caregiver Alliance: Hiring In-Home Help
About Aging Life Care Professionals
Medicare and Home Health Services
- Medicare.gov PDF: Medicare & Home Health Care
Platforms to find paid in-home care for older adults
- Carelinx.com
Information on paying taxes to paid caregivers:
- Learn more about your tax responsibility as a household employer
- Do you need to pay taxes for your part-time caregiver?
To find your local Area Agency on Aging: Eldercare.gov Locator
For law firms that include geriatric care coordinators: Life Care Planning Law Firm Association

For more information on the Helping Older Parents Membership Community, where people helping aging parents can regularly get guidance from Dr. K and from Michelle Allen:

Learn More About the Helping Older Parents Membership Community!

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092- Interview: Addressing Nighttime Urination & Insomnia in Aging May 30, 2019

In This Episode:

Dr. K talks with geriatrician Shachi Tyagi, MD, Assistant Professor of Medicine at the University of Pittsburg. Her research focuses on two common issues in older adults, insomnia and having to urinate at night (nocturia). They discuss:

Why nocturia becomes common as we age
Common health problems that may be related to nocturia
The relationship between nocturia and sleep problems
How nocturia should be assessed and how it can be managed
“Brief behavioral treatment” and other recommended insomnia treatments that can also improve nocturia
Why sleep medications should be avoided in aging
How to reduce the risk of nighttime falls related to nocturia
Options for addressing nocturia and sleep issues in dementia
Tips on tracking bladder and sleep symptoms, and how to get help from your health providers

Related episodes:

032 – 5 Top Causes of Sleep Problems in Aging

088 – Interview: Avoiding Inappropriate Prescribing in Aging & What to Know About the Beers Criteria

Related Resources:

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091 – Interview: Reducing the Risk of Power of Attorney Abuse May 16, 2019

In This Episode:

Dr. K speaks with senior attorney David Godfrey, JD, of the American Bar Association Commission on Law and Aging, about drafting better power of attorney documents so as to reduce the risk of abuse. David works closely with the National Center on Law and Elder Rights and authored an issue brief in 2018 that covers advance planning and how to avoid exploitation. They discuss:

What is a general durable power of attorney (POA) and why every person should complete one
Common reasons why older adults may need someone else to transact business for them, such as temporary or permanent incapacity
Why court intervention may be necessary if an older person does not have a POA
How POAs can be used for financial exploitation, and how drafting protections in the POA document can reduce the risk of abuse
6 key precautions to take, when drafting a general durable power of attorney
How requiring third party accounting can reduce family conflict
Why it’s a good idea to require a second signature for major transactions
The benefits of granting the power to revoke the POA to a third party
How older adults can find affordable legal assistance, for help drafting a POA
Options for older adults who have no close family available to serve as an agent
Resources to help guide agents to manage power of attorney duties

Related episodes:

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

070 – Interview: Addressing & Preventing Financial Exploitation in Aging

Related Resources:

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090 – More on Avoiding Risky Medications & on Using the 2019 AGS Beers Criteria May 02, 2019

In This Episode:

Dr. K provides more information on what’s included in the 2019 update of the American Geriatrics Society AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults, with a focus on which drugs she thinks are most important to avoid. She also addresses which medications are associated with falls, cognitive impairment, and other key conditions. She covers:

How the 2019 Beers Criteria is organized
Options for accessing the 2019 update
Which medications should be avoided in people with memory problems, per the Beers Criteria
Which drugs to avoid or use with caution if you have a history of falls or fractures
Other common risky medications to be aware of
What to know about opioid painkillers and the 2019 Beers Criteria
5 things you can do to be proactive about medications safety in aging
Where to find consumer brochures that can help you discuss deprescribing for the most common risky medications

Related episodes:

088- Interview: Avoiding Inappropriate Prescribing in Aging & What to Know About the Beers Criteria

073- Anticholinergic Medications & Protecting Brain Health

031- Choosing the Safest Over-the-Counter Painkiller in Aging

046- Interview: Deprescribing & Reducing Risky Medications in Aging

034- Preventing Falls: 10 Types of Medication to Reconsider

Related Resources:

Better Health While Aging
Healthinaging.org
Canadian Deprescribing Network
The EMPOWER Brochures (from the Canadian Deprescribing Network):
- Anti-inflammatory medications like ibuprofen (Non-steroidal anti-inflammatory drugs or NSAIDs)
- Antipsychotic medication as sleeping pills or for Dementia
- Medications for allergies and itchiness (First-generation antihistamines)
- Medication for type-2 diabetes (Sulfonylurea diabetes medication)
- Sleeping pills & anti-anxiety medication (Sedative-hypnotic medication, such as Ativan, Ambien, and others)
- Stomach pills for acid reflux (Proton-pump inhibitors)
Daily Aspirin Therapy: Understand the Benefits & Risks

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089 – Giving Yourself (And Your Family) a Gift on National Healthcare Decisions Day Apr 18, 2019

In This Episode:

Dr. K shares a personal story and explains why it’s so important to take the time to talk with others and make plans to provide others with guidance, since most of us will at some point be unable to make our own healthcare decisions. She covers:

The importance of National Healthcare Decisions Day
What “advance care planning” means, and why it’s more than completing legal forms
Four key steps in advance care planning
Why it’s essential to have conversations with others, including with healthcare providers and with family
Two free online tools you can use to guide you through reflection, conversations, and completing paperwork
Five common pitfalls to avoid if possible
Five questions you can ask yourself, every April when it’s National Healthcare Decisions Day

Related Resources:

National Healthcare Decisions Day Website
PrepareForYourCare.org
- Easy-to-Read Advance Directives (available for almost every state!)
The Conversation Project
- List of Starter Kits (available in multiple languages and also for Alzheimer’s and related dementias)
Advance Directive for Dementia (from Barak Gaster, MD)
5 Questions to Ask Yourself on National Healthcare Decisions Day
Other BHWA articles on advance care planning and end-of-life

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088 – Interview: Avoiding Inappropriate Prescribing in Aging & What to Know About the Beers Criteria Apr 04, 2019

In This Episode:

Dr. K talks with geriatrician Dr. Michael Steinman, Professor of Medicine at UCSF and an expert on medication safety in older adults. He recently served on the expert panel that authored the American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults, which lists medications that older adults should avoid or use with caution. They discuss:

What is “inappropriate prescribing” and why it affects an estimated 50% of older adults
How ageism can affect medication prescribing
How inertia, hospitalizations, and other factors lead to medications “accumulating”
Why it’s not safe to assume that all your medications are being prescribed for a good reason
How to be proactive about asking your health providers to review whether all medications are still necessary and appropriate
What is the Beer’s Criteria list and how does the Expert Panel decide what should be on it
Why older adults become more vulnerable to medications as they age
Some key Beers Criteria medications older adults should know about
What you can do if you’re taking a medication on the Beer’s Criteria list
How pharmacists can help, and other tips on ensuring safer medication use in aging

Related episodes:

046 – Interview: Deprescribing & Reducing Risky Medications in Aging

073 – Anticholinergic Medications & Protecting Brain Health

034 – Preventing Falls: 10 Types of Medication to Reconsider

Related Resources:

(Note: To date, HealthinAging.org and the American Geriatrics Society have not made the full 2019 Beers Criteria available for free to the public. For a full list, an option is to purchase the pocketcard, which we link to below.)

From HealthinAging.org:
About the 2019 Beers Criteria Update:
Other Related Articles by Michael Steinman:
- What is this drug for? Prescriptions without indications
- Beyond the Prescription: Medication Monitoring & Adverse Drug Events in Older Adults
How to Taper Benzodiazepines (Helpful consumer handout with sample tapering schedule)
Related Better Health While Aging Articles:

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087- Interview: Coping with Difficult Older Parents Mar 21, 2019

In This Episode:

Dr. K talks with family caregiving expert Barbara Kane, LCSW, co-author of “Coping With Your Difficult Older Parent: A Guide for Stressed-Out Children.” She is a co-founder of Aging Network Services, which provides geriatric care management and psychotherapy services. They discuss:

What it means to be a “difficult” older person, and why most such older parents have been “difficult” their entire lives
Categories of difficult behavior, including dependent, “turnoff”, self-centered, controlling, self-destructive, and fearful behaviors
How Aging Network Services helps adult children examine and improve their own interactions with their aging parents
Why age-related challenges are especially hard on “difficult” people
Why adult children must often learn to tolerate an older parent’s unhappiness
How it can help to stop arguing, stop “trying to fix,” and stop “trying to please”
Tips on boundaries and setting limits with an older parent
How bringing in a geriatric care manager can help an aging parent accept needed help
Strategies for better communication with siblings when discussing plans for aging parents

Related episodes:

069- Evaluating Memory & Thinking Problems: 10 Causes & 10 Things to Check

028- When Older Parents Resist Help: 4 Tips for Better Talks

Related Resources:

Coping With Your Difficult Parent: A Guide for Stressed-Out Children
Aging Network Services
Aging Life Care Association: What You Need To Know
Related articles on Better Health While Aging:
- 6 Ways that Memory & Thinking Change with Normal Aging (& What to Do About This)
- Cognitive Impairment in Aging: 10 Common Causes & 10 Things the Doctor Should Check

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086 – Interview: Creating Age-Friendly Health Systems at UCSF Mar 07, 2019

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

Related episodes:

039 – Interview: Creating Age-Friendly Health Systems

062 – Interview: Preventing Hospital Delirium & Maintaining Brain Health

Related Resources:

About Age-Friendly Health Systems:
- Creating Age-Friendly Health Systems – A vision for better care of older adults
- Institute for Healthcare Improvement Initiatives: Age-Friendly Health Systems
UCSF Geriatric Inpatient Services:
- Welcome to UCSF’s Acute Care for Elders Unit
- UCSF Hip Fracture Protocol
- UCSF Delirium Reduction Campaign (includes information on how families can help!)
About UCSF’s “AWOL” Delirium Screening Tool
Related articles on Better Health While Aging:
- Hospital Delirium: What to know & do
- 10 Things to Know About Delirium

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085 – Understanding Lab Tests: 4 Common Blood Tests for Older Adults Feb 21, 2019

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

Related episodes:

007 – How a Personal Health Record Helps You Be Proactive

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

031- Choosing the Safest Over-the-Counter Painkillers in Aging

Related Resources:

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084 – Interview: Understanding White Matter Changes in the Aging Brain Feb 07, 2019

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

Related episodes:

078 – Interview: The Biology of Aging & Longevity

072 – Cognitive Aging: How Memory & Thinking Change as One Gets Older

048 – How Cerebral Small Vessel Disease Affects Most Aging Brains

Related Resources:

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083 – Interview: Disrupting Dementia and Creating Dementia-Friendly Communities Jan 24, 2019

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

Related episodes:

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

074 – Interview: How the Village Model Supports Aging in Place & Community

055 – Interview: Bill Thomas on Ageism & Innovations to Improve Aging

Related Resources:

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082- Interview: Bill Thomas on Housing & Communities as Engines of Independence in Aging Jan 10, 2019

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

Related episodes:

055 – Interview: Bill Thomas on Ageism & Innovations to Improve Aging

074 – Interview: How the Village Model Supports Aging in Place & Community

035 – Interview: Aging in the Right Place

Related Resources:

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081 – Interview: How to Plan Ahead for Your Later Years Dec 27, 2018

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

Related episodes:

060-Interview: Negotiating Family Caregiving Expectations After Hospitalization

015- Interview: Practical Advice for Family Caregivers & Next Step In Care

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

036 – Interview: Minimizing Family Conflicts & Supporting Aging Parents

Related Resources:

Books by Carol Levine:
- Navigating Your Later Years for Dummies
- Planning For Long-Term Care For Dummies
Other recommended AARP resources
- AARP Checklist for Family Caregivers
CDC Home Safety Checklist
United Hospital Fund- Next Step in Care
Medicare Rights Center
Find Your Public Library

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080 – Interview: Smartwatches as Medical Alert Devices (What to Know & How to Choose) Dec 13, 2018

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

Related episodes:

068 – Interview: Putting Older Adults at the Center of Technology Conversations

010 – Interview: Choosing a Wearable Medical Alert System for Older Adults

Related Resources:

From Tech-Enhanced Life:
- Smartwatches as Medical Alerts (this is Richard’s in-depth report; highly recommended by Dr. K!)
- Medical Alert Systems Guide & Selection Tool
- About the Longevity Explorers

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079 – QA: Advice for Older Parents Frustrated by Their Family’s Concerns Nov 29, 2018

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

Related episodes:

028 – When Older Parents Resist Help: 4 Tips for Better Talks

077 – Interview: Making Advance Care Planning Easier Through PREPARE

036 – Interview: Minimizing Family Conflicts & Supporting Aging Parents

013 – Interview: Solving Hard Problems in Helping Aging Parents

Related Resources:

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078 – Interview: The Biology of Aging & Longevity Nov 15, 2018

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

Related Resources:

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077 – Interview: Making Advance Care Planning Easier Through PREPARE Nov 01, 2018

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

Related episodes:

071 – Interview: How Estimating Life Expectancy Helps Older Adults Get Better Care

063 – Giving Yourself (And Your Family) a Gift on National Healthcare Decisions Day

Related Resources:

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076 – Flu Shots for Older Adults: What to Know (2018 Update) Oct 18, 2018

In This Episode:

Dr. K explains what all older adults and family caregivers should know about annual vaccination against influenza. She also reports on the statistics from last year’s flu season. This episode 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
What to know about the intranasal flu vaccine available for people age 2-49

Related Resources:

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075 – Preventing Falls: 4 Approaches to Ask Your Doctor About Oct 04, 2018

In This Episode:

Dr. K reviews her four most used fall prevention approaches, which are routine in geriatrics care but are often overlooked by busy primary care providers. She covers:

The three questions about falls that PCPs should be asking older adults
How the CDC’s STEADI fall prevention algorithm can help you understand what your health provider should be doing
Why medication review is an essential part of fall prevention
The importance of checking blood pressure sitting and standing
How a physical therapy evaluation can help
The recent research suggesting Tai Chi helps prevent falls
How to get a good home safety assessment done
Why Vitamin D is no longer recommended for fall prevention (but is still worth taking)

Related episodes:

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

034 – Preventing Falls: 10 Types of Medication to Reconsider

004 – What to Do If You’re Worried About Falls

005 – Interview: Otago & Proven Exercises for Fall Prevention

011 – Vitamin D: The “Healthy Aging” Dose & FAQs

Related Resources:

CDC Steadi:
How to Prevent Falls: 4 Proven Approaches To Ask Your Doctor About
10 Types of Medications to Review if You’re Concerned About Falling
Videos Illustrating Otago Exercises for Fall Prevention (includes CDC-recommended assessment exercises)
Effectiveness of a Therapeutic Tai Ji Quan Intervention vs a Multimodal Exercise Intervention to Prevent Falls Among Older Adults at High Risk of Falling: A Randomized Clinical Trial
Occupational Therapy Geriatric Group at the University at Buffalo free home safety workbook:
- Home Safety Self-Assessment Tool (HSSAT)
Vitamin D: the Healthy Aging Dose (Plus Answers to 7 FAQs)
US Preventive Services Task Force: Falls Prevention in Community-Dwelling Older Adults

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074 – Interview: How the Village Model Supports Aging in Place & Community Sep 20, 2018

In This Episode:

Dr. K talks with UC Berkeley Professor Andrew Scharlach about his work studying the Village Model and other approaches to supporting aging in place. He is an expert on creating aging-friendly communities and formerly directed Berkeley’s Center for the Advanced Study of Aging Services. They discuss:

What is a Village and what’s usually included in the Village model
How Villages differ from Naturally Occurring Retirement Communities (NORCs)
The grassroots history of the first Village and the growth of the Village model
Why aging in community may be a better goal than aging in place
Why Professor Scharlach and his colleagues decided to study Villages, and what they’ve learned so far
How Villages appear to benefit their members
How the goals and ambitions of Villages have evolved over time
How Villages manage funding and other challenges
Whether Villages are a good fit for people who are frail or declining
Whether Villages really do prevent unwanted relocations

Related Resources:

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073 – Anticholinergic Medications & Protecting Brain Health Sep 06, 2018

In This Episode:

Dr. K explains what older adults and families should know about anticholinergic medications and their negative impact on brain health. Many commonly used over-the-counter and prescription medications are anticholinergic, and on the Beer’s List of Medications Older Adults Should Avoid or Use With Caution. She covers:

What it means for a medication to be anticholinergic
The evidence linking anticholinergics with confusion, delirium, and dementia
Seven commonly used types of medication that are quite anticholinergic
Why it’s important to minimize anticholinergics if you’re worried about memory or have been diagnosed dementia
How you can determine whether you or your parent’s medications are anticholinergic
What to do, if you or an older person you care for is taking an anticholinergic medication

Related Resources:

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072 – Cognitive Aging: How Memory & Thinking Change as One Gets Older Aug 23, 2018

In This Episode:

Dr. K explains how memory and thinking change as one gets older, due to normal cognitive aging. She covers:

How cognitive aging is different from a neurodegenerative process such as Alzheimer’s disease
6 ways that memory, other mental processes, and emotional processing change with aging
Why certain mental tasks become harder in late life
The difference between fluid and crystallized intelligence
Worrisome signs that should not be attributed to normal cognitive aging
Practical ways to maintain better brain function, and to compensate for normal age-related changes

Related episodes:

069 – Evaluating Memory & Thinking Problems: 10 Causes & 10 Things to Check

057 – How to Manage Cardiovascular Risk Factors for Better Brain Health

048 – How Cerebral Small Vessel Disease Affects Most Aging Brains

Related Resources:

6 Ways that Memory & Thinking Change with Normal Aging (& What to Do About This)
10 Early Signs and Symptoms of Alzheimer’s (includes examples of normal aging)
How to Promote Brain Health: The Healthy Aging Checklist, Part 1
Cognitive Aging: Progress in Understanding and Opportunities for Action (National Academy of Medicine Report)
- Cognitive Aging Action Guide for Individuals and Families
Pocket Talker

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071 – Interview: How Estimating Life Expectancy Helps Older Adults Get Better Care Aug 09, 2018

In This Episode:

Dr. K talks with Sei Lee, MD, an expert on prognosis and using estimated life expectancy to improve medical care for older adults. Dr. Lee is an Associate Professor in the UCSF Division of Geriatrics. They discuss:

What the term “prognosis” means, especially when it comes to older adults
Why a person’s likely life expectancy should be used to tailor medical care
How the answers to simple questions can be used to predict mortality
Why even a good life expectancy calculator can’t make exact predictions for a specific person
Common forms of medical care that may not be worth doing, if life expectancy is limited
Why it’s important to reconsider intensive diabetes treatment
How the Eprognosis.org website can help people learn whether cancer screening is still likely to benefit them
The challenges of discussing prognosis and life expectancy with older adults
Examples of how we can better focus medical care on “what matters the most”

Related episodes:

024 – Interview: Better Cancer Screening While Aging

039 – Interview: Creating Age-Friendly Health Systems

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

Related Resources:

Eprognosis.org
Dr. Sei Lee’s related research:
- Development and Validation of a Prognostic Index for 4-Year Mortality in Older Adults
- Prognostic Indices for Older Adults: A Systematic Review
Recommended news columns:
- The New Old Age (New York Times)
- Navigating Aging (Kaiser Health News)

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070 – Interview: Addressing & Preventing Financial Exploitation in Aging Jul 26, 2018

In This Episode:

Dr. K talks with attorney Candace Heisler, JD, an expert on addressing financial exploitation and other forms of elder abuse. Ms. Heisler served as assistant district attorney for the City and County of San Francisco for over 25 years, and remains active in training various professionals to address elder abuse. They discuss:

What it means to financially exploit an older person
The role of trust and relationships in facilitating financial exploitation
Why it can be hard to determine whether financial abuse has occurred
What to do if you suspect that an older relative has been financially exploited
The role of Adult Protective Services in investigating worrisome situations
The difference between pursuing a criminal case versus a civil case
What is “undue influence” and how it’s related to financial abuse
Steps older adults can take to reduce their risk of being financially exploited
How to reduce the risk of that a power of attorney might be misused

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

Related Resources:

Financial Exploitation in Aging: What to Know & What to Do
Candace Heisler’s recommended resources:
Legal Services for the Elderly Program
National Academy of Medicine: Cognitive Aging: Progress in Understanding and Opportunities for Action
The New Yorker: My Mother and Her Scammer

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069 – Evaluating Memory & Thinking Problems: 10 Causes & 10 Things to Check Jul 12, 2018

In This Episode:

Dr. K explains what should happen during an initial medical evaluation when an older person develops memory or thinking problems. She covers:

What is cognitive impairment and why it’s important to get a medical evaluation
What kind of cognitive changes are considered normal with aging
10 common health issues that can affect memory and thinking
10 things a health provider should generally do, during an initial evaluation for cognitive impairment
The key things the initial evaluation should address
Whether to expect a definitive diagnosis
What to expect from your health providers

Related episodes:

002 – What to Do If You’re Worried About Someone’s Memory

003 – Interview: Helping Reluctant Parents Address Memory Concerns

Related Resources:

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068 – Interview: Putting Older Adults at the Center of Technology Conversations Jun 28, 2018

In This Episode:

Dr. K talks with Richard Caro, PhD, a co-founder of Tech-Enhanced Life, who facilitates ongoing “Longevity Explorer” meetings in which older adults come together to discuss interests, challenges, and new technologies. They discuss:

Why Richard and his colleagues decided to start these peer-to-peer technology conversations among older adults
The types of technologies and challenges that older adults have brought up
What some Longevity Explorers thought of Alexa and other technologies
Why innovators and businesses should tap into the insights of older adults
The importance of purpose and engagement in late life
How to find or start a Longevity Explorers group in your area
Tech-Enhanced Life’s recent work on helping companies co-design with older adults, and now also family caregivers

Related Resources:

About the Longevity Explorers
For people interested in joining or starting a Longevity Explorers group, click here. (Family caregivers are also welcome to sign up.)
Explorer Insights:
- Amazon Echo and Alexa for the Elderly
- Best Jar Opener for Older Adults

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067 – Interview: Managing Difficult Alzheimer’s Behaviors Without Medications Jun 14, 2018

In This Episode:

Dr. K talks with Paula Spencer Scott, a family life expert and the author of Surviving Alzheimer’s: Practical Tips and Soul-Saving Wisdom for Caregivers. They discuss:

Paula’s personal experiences caring for her father and her in-laws affected by dementia
Why she didn’t write a memoir, and instead opted to focus on featuring Alzheimer’s experts and practical caregiving how-tos
The “Why-This, Try-This” approach to troubleshooting challenging dementia behaviors
Why it’s so important to learn to better respond to dementia behaviors, and only use medication as a last resort
A 7-step process that you can use to safely manage difficult Alzheimer’s behaviors
Why it’s important to “be kinder than you feel” (and be kinder to yourself)

Related Resources:

By Paula Spencer Scott:
- 7 Steps to Managing Difficult Dementia Behaviors (Safely & Without Medications)
  - PDF Cheatsheet: 7 steps to managing difficult dementia behaviors
- Surviving Alzheimer’s: Practical Tips and Soul-Saving Wisdom for Caregivers
Delirium: A common problem that speeds Alzheimer’s decline, and how to avoid it
How to Manage Sleep Problems in Dementia
Resources for Dementia Caregivers
- Your local Area Agency on Aging (find it here)
- Local Alzheimer’s Association chapters (find them here)
- Alzheimer’s Reading Room
- AlzAuthors

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066 – Interview: Addressing Potential Self-Neglect in Older Adults May 31, 2018

In This Episode:

Dr. K talks with Aanand Naik, MD, a geriatrician with a special interest in self-neglect and vulnerability among older adults. Dr. Naik is Associate Professor at Baylor College of Medicine and recently authored the chapter “Evaluating Capacity for Safe and Independent Living Among Vulnerable Older Adults” in the textbook “Ethical Considerations and Challenges in Geriatrics.” They discuss:

What does “self-neglect” mean, and what are the related risks?
How common is self-neglect in older adults?
What are some common signs that might indicate self-neglect?
What does it mean to be able to manage one’s self-care and self-protection?
What can you do if you’re concerned about potential self-neglect in an older person?
How can doctors and other health professionals help address possible self-neglect?
What is the role of Adult Protective Services in addressing this issue?
When might the courts become involved?

Related episodes:

038 – FAQs On “Incompetence” & Losing Decision Capacity

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

Related Resources:

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065 – Reconsidering “Successful Aging” May 17, 2018

In This Episode:

For Older Americans Month, Dr. K reflects on what it means to “successfully age,” and how we might help older adults accordingly. She covers:

How our conception of “successful” or “better” aging influences the way we judge others and ourselves
How the media and others often depict successful aging, and why this is problematic
A different model of success in aging which puts more emphasis on adapting to — rather than managing to avoid — common age-related challenges
Why aging might be less about individual choices than many people think
How we might better appreciate older adults for their resilience and adaptations to late-life challenges

Related Resources:

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064 – What to Know About Constipation & Laxatives May 03, 2018

In This Episode:

Dr. K explains how older adults and families can prevent and manage constipation, including how to safely and effectively use over-the-counter laxatives. She covers:

What exactly does it mean to be constipated, and why is it more common with aging
The most common causes of constipation, and which “red flag” signs shouldn’t be ignored
Medications that often make constipation worse
How constipation should be evaluated and treated
The laxative myth you shouldn’t believe
3 types of over-the-counter laxative that work, and the one that doesn’t
Why she often recommends prunes
What to do if you’re concerned about constipation for yourself or someone else

Related Resources:

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063 – Giving Yourself (And Your Family) a Gift on National Healthcare Decisions Day Apr 19, 2018

In This Episode:

Dr. K shares a personal story and explains why it’s so important to take the time to talk with others and make plans to provide others with guidance, since most of us will at some point be unable to make our own healthcare decisions. She covers:

The importance of National Healthcare Decisions Day
What “advance care planning” means, and why it’s more than completing legal forms
Four key steps in advance care planning
Why it’s essential to have conversations with others, including with healthcare providers and with family
Two free online tools you can use to guide you through reflection, conversations, and completing paperwork
Five common pitfalls to avoid if possible
Five questions you can ask yourself, every April when it’s National Healthcare Decisions Day

Related Resources:

National Healthcare Decisions Day Website
PrepareForYourCare.org
- Easy-to-Read Advance Directives
The Conversation Project
- List of Starter Kits (available in multiple languages and also for Alzheimer’s and related dementias)
Advance Directive for Dementia (from Barak Gaster, MD)
5 Questions to Ask Yourself on National Healthcare Decisions Day
Other BHWA articles on advance care planning and end-of-life

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062 – Interview: Preventing Hospital Delirium & Maintaining Brain Health Apr 05, 2018

In This Episode:

Dr. K talks with geriatrician Sharon Inouye, MD MPH, a nationally-known expert on delirium who is Professor of Medicine at Harvard Medical School and Director of the Aging Brain Center at the Institute for Aging Research, Hebrew SeniorLife. They discuss:

What is delirium and what are common symptoms of delirium
What are common causes of delirium, and what can make it worse
How Dr. Inouye became interested in studying delirium
The difference between delirium and dementia, and how the two conditions are related
The problem with using restraints and bed alarms, when someone is delirious
How to treat delirium, and how to keep a person safe while delirious
How the Hospital Elder Life Program helps reduce delirium (by 40-60% in some studies!)
Why many hospitals still don’t have a HELP program
The most effective ways to maintain brain health while aging

Related episodes:

039 – Interview: Creating Age-Friendly Health Systems

014 – Delirium & Hospital Confusion

Related Resources:

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061 – Interview: Using Technology to Balance Safety & Autonomy in Dementia Mar 22, 2018

In This Episode:

Dr. K talks with Mary Hulme, geriatric social worker specialized in dementia and the co-author of “Caring from Afar: A Guide to Home Sensor Systems for Aging Parents.” They discuss:

How geriatric social workers help older adults and families
Why safety is no longer the automatic top priority in social work
How to use an older person’s goals when weighing safety versus autonomy
What is positive risk-taking in dementia
Why Mary likes home sensor systems
Features and options to consider when selecting a PERS system
GPS-enabled devices and options for tracking people with Alzheimer’s or a related dementia
Tips on discussing safety and location tracking with an older relative

Related episodes:

010 – Interview: Choosing a Wearable Medical Alert System for Older Adults

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

Related Resources:

Mary Hulme’s website: Moonstone Geriatrics
How can ‘positive risk-taking’ help build dementia-friendly communities?
Alzheimer’s Association: Ethical and Care Issues
- Statement on Electronic Tracking
Family Caregiver Alliance

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060 – Interview: Negotiating Family Caregiving Expectations After Hospitalization Mar 08, 2018

In This Episode:

Dr. K talks with caregiving expert Carol Levine, Director of the Families and Health Care Project at the United Hospital Fund of New York and author of “Planning for Long-Term Care for Dummies.” In this episode, they discuss negotiating caregiving expectations with hospital staff and family members, including:

Why it’s common for older adults and their family members to have different ideas of what kind of help is needed after a hospitalization
How to better negotiate what you can and can’t do with hospital staff — or with an older loved one who’s being discharged home
How Carol managed expectations once her husband required significant caregiving
What to know about the new laws (CARE acts) that require hospitals to coordinate with family caregivers
How drawing a “CareMap” can help
Why it’s often worth getting a professional to help you discuss caregiving with family members
How to make hospital discharge decisions if an older person has become confused in the hospital
How family caregivers can reduce guilt and set healthy boundaries

Related Resources:

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059 – Interview: Long-Term Care Insurance & Financing Late-Life Care Needs Feb 22, 2018

In This Episode:

Dr. K talks with Howard Gleckman, a family caregiving and long-term care insurance expert who is a senior fellow at the Urban Institute. He is also the author of Caring for Our Parents: Inspiring Stories of Families Seeking New Solutions to America’s Most Urgent Health Crisis. They discuss:

Howard’s own story of caring for his aging in-laws and parents
Who usually pays for the assistance and services that most older people eventually need
Why many people think they have LTC insurance when in fact they don’t
The statistics on how likely you are to need long-term care, and how much it usually costs
Key things to think about when considering LTC insurance
Why boomers are less likely to have family available to help with their late-life care needs
How a public catastrophic LTC insurance program might work
Why there hasn’t been a lot of political pressure to address long-term care issues
Whether it’s better to buy LTC insurance versus save on your own

Related Resources:

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058 – Avoiding Missed Flu in Older Adults Feb 08, 2018

In This Episode:

Dr. K explains why influenza is easily missed in older adults and what families can do, to help their older loved ones get diagnosed and treated before it’s too late. She covers:

Recently published research finding that hospitalized older adults often aren’t tested for the flu virus
Why it’s important to not miss the flu in older adults
The usual symptoms of “influenza-like illness”
Common symptoms of influenza in older adults
Why older adults may not show typical influenza symptoms
What the CDC currently recommends, regarding influenza diagnosis and treatment
What to do, if an older person falls ill during influenza season

Related Resources:

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057 – How to Manage Cardiovascular Risk Factors for Better Brain Health Jan 25, 2018

In This Episode:

Dr. K explains cardiovascular risk factors, which often contribute to cerebral small vessel disease, a common brain health problem in older adults. She covers:

Why blood vessel health is key to brain and heart health
3 key ways blood vessels become damaged over time
What is atherosclerosis
The top risk factor for having a heart attack, stroke, or other cardiovascular event
12 key cardiovascular risk factors to know
5 key approaches every older adult should use, to improve cardiovascular health
What to do, if a brain scan shows signs of cerebral small vessel disease

Related episodes:

048 – How Cerebral Small Vessel Disease Affects Most Aging Brains

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

Related Resources:

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056 – Top 10 Checklist for Better Health This Year Jan 11, 2018

In This Episode:

Dr. K shares her top ten aging health suggestions, for older adults and family caregivers to consider for the New Year. She covers:

Top suggestions for maintaining mobility
Medications known to dampen brain function
The benefits of reviewing medications for safety and usefulness
The most useful information to include in your personal health record
Addressing advance planning for healthcare and for finances
Why it’s so important for older adults to socialize, contribute, and identify activities they love
Life wishlists

Related episodes:

052 – Maintaining Mobility & Preventing Falls in Aging: Myths & Truths
046 – Interview: Deprescribing & Reducing Risky Medications in Aging
016 – 3 Reasons You Should Have a Home Blood Pressure Monitor
007 – How a Personal Health Record Helps You Be Proactive

Related Resources:

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055 – Interview: Bill Thomas on Ageism & Innovations to Improve Aging Dec 28, 2017

In This Episode:

Dr. K talks with geriatrician Bill Thomas, MD, founder of ChangingAging.org, the Eden Alternative, and the Green House Project. They discuss his recent efforts to counter ageism and his latest housing-related projects, including:

What is ageism and why is it so pervasive
The stories we tell ourselves about aging (including our own aging) and youth
Thinking about lifespan in terms of childhood, adulthood, and elderhood
Why it’s a problem for older adults to cling to “adulthood” as part of their identities
The words we use and why we might embrace the term “elder”
How having “too much house” is risky in aging, and how a Minka house might help
How Bill Thomas is planning for his own aging
His plan to pilot a “Multi-Ability, multiGenerational, Inclusive, Community” (“MAGIC”) in 2018

Related episodes:

035 – Interview: Aging in the Right Place

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

100 – Interview: Bill Thomas on Ageism, Housing & Changing Aging in 2019

Related Resources:

ChangingAging.org:
- Independence Rising (Nov 2017 article by Bill Thomas)
- Minka (includes pictures)
MyMinka.com
Senior Living Innovator Bill Thomas Introduces MAGIC Housing Model
We’re lucky if we get to be old, physician and professor believes
Reframing Aging
When It Comes to Older Adults, Language Matters: Journal of the American Geriatrics Society
Experiences from Pagan Women: A Closer Look at Croning Rituals

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054 – How to Make Difficult Decisions Easier: Using Goals of Care & Weighing Benefits vs Burdens Dec 14, 2017

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

Related episodes:

Related Resources:

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053 – Interview: Addressing Loneliness in Aging Nov 30, 2017

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

Related Resources:

Scholarly papers:
- Loneliness in Older Persons: A predictor of functional decline and death
- Living Alone, Socially Isolated or Lonely—What are We Measuring?
Related new stories:
- Easing Old People’s Loneliness Can Help Keep Them Healthy (NPR)
- Researchers Confront an Epidemic of Loneliness (NY Times)
Services & Innovations:
- Institute on Aging Friendship Line
- Covia.org Well Connected (formerly Senior Center Without Walls)
- Find your local Department of Aging and Adult Services: Eldercare.gov
- AARP Connect2Affect
- Prepare for Your Care
- Age UK

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052 – Maintaining Mobility & Preventing Falls in Aging: Myths & Truths Nov 16, 2017

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

Related Resources:

Videos Illustrating Otago Exercises for Fall Prevention
Seismic (formerly Superflex)
Choosing the Right Cane or Walker
National Council on Aging (NCOA): Evidence-Based Fall Prevention Programs
Go 4 Life Exercise Videos (from the National Institute on Aging at NIH)

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051 – Interview: Innovations to Help Older Adults & Family Caregivers Nov 02, 2017

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

Related episodes:

017 – Interview: Paying for Long-Term Care & Other Family Caregiving Challenges
035 – Interview: Aging in the Right Place
039 – Interview: Creating Age-Friendly Health Systems
049 – Better Primary Care for Older Adults: the Oak Street Health Story

Related Resources:

Daughterhood Circles
Aging 2.0
Caremore
Program of All-Inclusive Care for the Elderly (PACE)
Smart Living 360
Dr. Bill Thomas
- ChangingAging.org
- The Minka House Project
Caregiver Action Network

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050 – Flu Shots for Older Adults: What to Know Oct 19, 2017

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

Related Resources:

Flu Shots for Older Adults: What to Know & Do
TABLE 1. Influenza vaccines — United States, 2017–18 influenza season
Adults: Protect Yourself with Pneumococcal Vaccines
How to boost your immune system (Harvard Health Review)
To find a place to get your annual influenza vaccination: VaccineFinder.org

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049 – Better Primary Care for Older Adults: the Oak Street Health Story Oct 05, 2017

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

Related Resources:

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MRI brain small vessel ischemic disease — **048 – How Cerebral Small Vessel Disease Affects Most Aging Brains** Sep 21, 2017
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

Signs of cerebral small vessel disease. From Inzitari et al, BMJ. 2009 Jul 6;339:b2477. doi: 10.1136/bmj.b2477

**Related episodes:**

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

002 – What to Do If You’re Worried About Someone’s Memory

004 – What to Do If You’re Worried About Falls

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

Related Resources:

Cerebral Small Vessel Disease: What to Know and What to Do

How to Diagnose & Treat Mild Cognitive Impairment

How We Diagnose Dementia: The Practical Basics to Know

Why Older People Fall & How to Reduce Fall Risk

New Blood Pressure Study: What to Know About SPRINT-Senior & Other Research

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047 – Unintended Weight Loss in Aging Sep 07, 2017

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

Related Resources:

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046 – Interview: Deprescribing & Reducing Risky Medications in Aging Aug 24, 2017

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

Related Resources:

The Canadian Deprescribing Network
The EMPOWER Brochures
- Anti-inflammatory medications like ibuprofen(Non-steroidal anti-inflammatory drugs or NSAIDs)
- Antipsychotic medication as sleeping pills or for dementia
- Medications for allergies and itchiness (First-generation antihistamines)
- Medication for type-2 diabetes (Sulfonylurea diabetes medication)
- Sleeping pills & anti-anxiety medication(Sedative-hypnotic medication, such as Ativan, Ambien, and others)
- Stomach pills for acid reflux (Proton-pump inhibitors)
The 2015 American Geriatrics Society Updated Beers Criteria: Medications that Older Adults Should Avoid or Use with Caution
7 Common (Anticholinergic) Drugs That Are Toxic for Your Brain
Starting a conversation and questions to ask your doctor about your medications
Test Your Knowledge About Antipsychotics

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045 – HIPAA: Key Basics & 5 FAQs for Family Caregivers Aug 10, 2017

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

Related Resources:

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044 – Hospice Medications & What to do if You’re Concerned Jul 27, 2017

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

Related Resources:

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043 – How Hospice Helps at the End of Life, & Hospice for Alzheimer’s Jul 13, 2017

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

Related Resources:

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Dr. Lawrence Weed and Dr. Leslie Kernisan — **042 – Why Healthcare is Flawed & How to Improve It: The Work of Dr. Lawrence Weed** Jun 29, 2017
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

**Related episodes:**

006 – Interview: Surviving Cancer & Better Healthcare Through Being an e-Patient
018 – High Blood Pressure Treatment in Older Adults: Research Findings & Practical Tips

Related Resources:

Medicine in Denial (2011)

Medicine in Denial Review: A book on how to really leverage technology to improve healthcare (Geritech.org)

4 Steps to Get Better Advice from Doctors

Dr. Lawrence Weed, Pioneer in Recording Patient Data, Dies at 93

Dr. Lawrence L Weed, MD (Burlington Free Press Obituary)

The Heroism of Incremental Care (New Yorker article by Atul Gawande)

Larry Weed’s 1971 Internal Medicine Grand Rounds

Dr. Weed & Dr. K, in Vermont in 2013.
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041 – UTIs and Urine Bacteria in Aging: How to get the right diagnosis & avoid unneeded antibiotics Jun 15, 2017

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

Related episode:

014 – Delirium & Hospital Confusion

Related Resources:

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040 – Dehydration in Older Adults: How to Prevent It, Detect It, & Treat It Jun 01, 2017

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

Related Resources:

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039 – Interview: Creating Age-Friendly Health Systems May 18, 2017

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

Related episodes:

019 – Interview: How Foundations Are Improving Health & Aging
025 – Interview: Palliative Care to Live Well with Cancer

Related Resources:

Age-Friendly Health Systems: How Do We Get There? (HealthAffairs.org)
New Grants Totaling $5.5 Million Begin Charting a Course to Age-Friendly Health Systems (John A Hartford Foundation)
Institute for Healthcare Improvement: Creating Age-Friendly Health Systems
How Health Systems Can Provide Better Care For Seniors
If ACE Units Are So Great, Why Aren’t They Everywhere?

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038 – FAQs On “Incompetence” & Losing Decision Capacity May 04, 2017

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 Apr 20, 2017

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

Related episodes:

036 – Interview: Minimizing Family Conflicts & Supporting Aging Parents
013 – Interview: Solving Hard Problems in Helping Aging Parents

Related Resources:

AskHarry.info: Answers to Your Estate Planning Questions
- You can ask attorney Harry Margolis your questions on this site
How Many Agents Should You Name on Your Durable Power of Attorney?
ElderLawAnswers.com
How to Avoid Problems Due to Senior Incapacity: The (Better) Durable General Power of Attorney

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036 – Interview: Minimizing Family Conflicts & Supporting Aging Parents Apr 06, 2017

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

Related episodes:

015 – Interview: Practical Advice for Family Caregivers & Next Step In Care
017 – Interview: Paying for Long-Term Care & Other Family Caregiving Challenges
013 – Interview: Solving Hard Problems in Helping Aging Parents

Related Resources:

Circle of Life Partners: A community that supports the health and wellbeing of families and aging parents.
- Sign up for the free newsletter here: Join Circle of Life Partners
- For Janet’s HIPAA app, sign up for the newsletter or email info@circleoflifepartners.com
Don’t Give Up on Them: Janet’s website for her book.

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035 – Interview: Aging in the Right Place Mar 23, 2017

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

Related Resources:

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034 – Preventing Falls: 10 Types of Medication to Reconsider Mar 09, 2017

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

Want to learn more about preventing falls? Click here to learn more about the upcoming Personalizing Fall Prevention Workshops

Related episodes:

004 – What to Do If You’re Worried About Falls

005 – Interview: Otago & Proven Exercises for Fall Prevention

Related Resources:

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033 – Safer Treatments for Insomnia in Aging Feb 23, 2017

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

Related Resources:

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032 – 5 Top Causes of Sleep Problems in Aging Feb 09, 2017

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

Related Resources:

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031 – Choosing the Safest Over-the-Counter Painkiller in Aging Jan 26, 2017

In This Episode:

Dr. K explains which over-the-counter (OTC) painkiller is usually safest, and which analgesics are much riskier than people realize. She covers:

Why frequent aches and pains should always be evaluated by a doctor
Why harm from OTC painkillers is surprisingly common
Why acetaminophen (known as paracetamol outside the U.S.) is usually considered the safest OTC analgesic for older adults
Why non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen are on the Beer’s List of medications older adults should avoid or use with caution
The most common risks and side-effects of OTC painkillers, and how to avoid them
The special case of aspirin, which doctors no longer recommend as a painkiller
Tips on selecting an OTC painkiller and on working with your doctor to treat frequent pain in aging

Related Resources:

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030 – Drugs for Difficult Dementia Behaviors: What to Know Jan 12, 2017

In This Episode:

Dr. K explains what families should know about the five types of medications used to treat difficult behaviors in people with Alzheimer’s and other dementias. She covers:

Why “chemical restraints” such as antipsychotics and tranquilizers are often prescribed inappropriately
How antipsychotics, benzodiazepines, mood stabilizers, antidepressants work for dementia behaviors, and how much improvement to expect
Common side-effects to look out for
The pros and cons of each type of medication
Important non-drug approaches that can help with dementia behaviors, and why these should be used before resorting to medications
Tips and suggestions for families considering these drugs
What you can do if your relative with dementia is taking antipsychotics or tranquilizers

Related Resources:

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029 – The Healthy Aging Checklist Dec 29, 2016

In This Episode:

Dr. K explains the six key things every older person should do, for healthier aging. She covers her recommendations for:

Promoting brain health and emotional well-being
Promoting physical health
Checking for and addressing commonly neglected senior health problems that can sabotage healthy aging
Optimizing the care of chronic medical conditions
Getting recommended preventive health services
Addressing medical, legal, and financial advance planning

Related episodes:

011 – Vitamin D: The “Healthy Aging” Dose & FAQs

005 – Interview: Otago & Proven Exercises for Fall Prevention

Related Resources:

The Healthy Aging Checklist Series (each includes a downloadable PDF cheatsheet):

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028 – When Older Parents Resist Help: 4 Tips for Better Talks Dec 15, 2016

In This Episode:

Dr. K explains four things family caregivers should try, for better conversations with older parents who are resisting help. She covers:

How cognitive problems often complicate family conversations
The importance of hearing and validating an older person’s emotions
How to discuss an older person’s goals, and why safety shouldn’t automatically be the top priority
Ways to respond when an older parent voices “unrealistic” goals, such as never having help at home
Why it’s important for family caregivers to identify their own fears and desires, when it comes to aging parents

Related Resources:

027 – Interview: Planning for Aging When Single & Childless Dec 01, 2016

In This Episode:

Dr. K talks with Carol Marak, founder of the Elder Orphans Facebook Group and editor of SeniorCare.com. They discuss aging issues facing those who have no spouse or adult children. They cover:

Carol’s experience with her own aging parents, which led her to think of her own future as an aging single woman with no children
The controversy around the term “elder orphan,” and why Carol finally chose to use it
Isolation, transportation difficulties, affordable housing, and other concerns that are often discussed in the Elder Orphans Facebook group
Why affordable housing that enables aging-in-community is so important
Cohousing and other options for aging-in-community
Choosing a power of attorney for health or finances
Carol’s top tips for elder orphans

Related Resources:

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026 – 4 Medications for Alzheimer’s & Other Dementias: FAQs & Tips Nov 24, 2016

In This Episode:

Only four medications are FDA-approved for the treatment of Alzheimer’s disease and other dementias. Dr. K explains how they work and addresses frequently asked questions. She covers:

The two different categories of medication that are FDA-approved, and how they work to help people with dementia
The different stages of dementia, and how this relates to the FDA-approval of these drugs
How well these drugs work, and what families can expect
Common side-effects of these medications
Whether these medications work for mild cognitive impairment
When to consider stopping these medications
Which vitamins might also help treat Alzheimer’s disease
Practical tips for people considering these medications or already taking them

Related Resources:

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025 – Interview: Palliative Care to Live Well with Cancer Nov 10, 2016

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

Related Resources:

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m_jsc00476f1 walter life expectancies 2001 — **024 – Interview: Better Cancer Screening While Aging** Oct 27, 2016
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

Related Resources:

Life expectancies of women and men by quartiles of health, from Dr. Walter’s 2001 article on cancer screening in older adults:

A selected list of Dr. Walter’s publications:

Cancer Screening in Elderly Patients: A Framework for Individualized Decision-Making

Screening Mammography in Older Women: A Review

80 is the new 60: Implications of Irrational Exuberance Regarding Longevity on Prostate Cancer Treatment Decisions

ePrognosis.org

Life-expectancy calculators

Breast and/or colon cancer screening tool

With 12 Questions, Quiz Gauges 4-Year Death Risk in Older Adults

NYTimes.com: Interactive tools to assess the likelihood of death

Prostate cancer screening decision aids (videos & PDF guide from the American Cancer Society)

US Preventive Services Task Force: Prostate Cancer Screening

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023 – Anemia in Aging: 10 Common Causes & What to Ask Oct 13, 2016

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

Related Resources:

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022 – QA: Helping a Paranoid Older Parent and Checking Safety Sep 29, 2016

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

Related Resources:

Please post any follow-up questions below! If there are enough questions, Dr. K will address them in a follow-up episode.

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021 – Vitamin B12 Deficiency: Risks, Diagnosis, & Treatment Sep 15, 2016

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

Related Resources:

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020 – How to Diagnose & Treat Mild Cognitive Impairment Sep 01, 2016

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

Related Resources:

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019 – Interview: How Foundations Are Improving Health & Aging Aug 18, 2016

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

Related Resources:

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018 – High Blood Pressure Treatment in Older Adults: Research Findings & Practical Tips Aug 04, 2016

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

Related Resources:

3 Ways Home Blood Pressure Monitors Help Older Adults
Can This Treatment Help Me? There’s a Statistic for That (NY Times article about the number-needed-to-treat)
What the New Blood Pressure Guidelines — & Research — Mean For Older Adults
New Blood Pressure Study: What to Know About SPRINT-Senior & Other Research
6 Steps to Better High Blood Pressure Treatment for Older Adults

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017 – Interview: Paying for Long-Term Care & Other Family Caregiving Challenges Jul 21, 2016

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

Related Resources:

Daughterhood.org
What Are the Chances You’ll Need Long-Term Care And How Much Will It Cost?
Recommended by Anne
- Your local Area Agency on Aging to find support groups, ombudsmen
- Caregiving.com
- National Academy of Elder Law Attorneys

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016 – 3 Reasons You Should Have a Home Blood Pressure Monitor Jul 07, 2016

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

Related Resources:

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015 – Interview: Practical Advice for Family Caregivers & Next Step In Care Jun 23, 2016

In This Episode:

Dr. K talks with caregiving expert Carol Levine, Director of the Families and Health Care Project at the United Hospital Fund of New York and author of “Planning for Long-Term Care for Dummies.” They discuss:

Carol’s experience managing care for her husband for 17 years, after he was badly injured in a car accident
Top challenges that family caregivers face, based on Carol’s work doing surveys and focus groups with family caregivers
Tips on finding, hiring, and working with a paid caregiver in the home
The problem of doctors underestimating the work that family caregivers do
How families can manage the cost of hiring caregivers, and how to manage family conflicts that may arise
Why dealing with the healthcare system is a common source of frustration for families, and how NextStepInCare.org helps families
What society can do to better support family caregivers

Related Resources:

NextStepInCare.org
- NSIC Guide: Working with Home Health Aides
- NSIC Guide: HIPAA: Questions and Answers for Family Caregivers

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014 – Delirium & Hospital Confusion Jun 09, 2016

In This Episode:

Dr. K explains the basics of delirium, a state of worse-than-usual mental function that can affect up to 30-70% of older adults after surgery and during serious illnesses. She covers:

Why delirium has been referred to as post-operative confusion or even ICU psychosis
The story of her father’s delirium
Why people often confuse delirium with dementia, and how the two conditions are related
Why families often notice signs of delirium before doctors and nurses do
3 key reasons delirium is so important for us all to learn more about
10 things to know about delirium, including how it can be diagnosed, treated, and prevented

Related Resources:

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013 – Interview: Solving Hard Problems in Helping Aging Parents May 26, 2016

In This Episode:

Dr. K talks with Carolyn Rosenblatt, RN JD, an elder law attorney who specializes in helping families concerned about older parents and who is the author of “The Family Guide to Aging Parents.” They discuss:

Why concerns about managing money and safety are so common
What you can do if an older person refuses to come in for evaluation or help
Why it’s important for older adults to talk to their families about their finances and assets, and how adult children can bring up this conversation if their parents aren’t addressing it
Why a durable power of attorney for finances is so important and how to do it inexpensively
Why you shouldn’t rely on estate planning done a long time ago
The pros and cons of springing durable powers of attorney
Tips on preventing abuse of a financial power of attorney and on choosing the right person
Tips on advance planning for healthcare

Related Resources:

The Family Guide to Aging Parents, by Carolyn Rosenblatt RN JD
AgingParents.com
Eldercare.gov Locator (use to find your local Area Agency on Aging and low-cost legal resources)
ABA/APA Assessment of Capacity in Older Adults
PrepareForYourCare.org
Alzheimer’s Association: Legal Planning
American Bar Association Toolkit for Healthcare Advance Planning
5@55: The 5 Essential Legal Documents You Need by Age 55
Addressing Medical, Legal, & Financial Advance Care Planning: The Healthy Aging Checklist Part 6
How to Avoid Problems Due to Senior Incapacity: The (Better) Durable General Power of Attorney

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012 – Q&A: Answers to Your Questions On Aging & Health May 12, 2016

In This Episode:

Dr. K answers nine audience questions related to the health of older adults:

How many extra opinions to get from different doctors when you have a serious condition?
What causes legs to feel unbalanced and prone to falling?
How to deal with declining abilities, dementia, and physical dependency when you don’t have family to provide care or money to hire someone?
Is there a way to recapture sexual activity after three impotent years?
Why doesn’t Medicare cover hearing aids?
Why is it so difficult for people to admit they are aging and why do we shove aging people aside? What can be done about this, to help us prepare for an aging society?
Is chronic muscle pain an indication of old age and is it bad to ignore it?
What does conservative treatment for severe chronic kidney disease involve and what happens if you decide to not start dialysis?
What is normal aging in the area of memory loss?

Related Resources:

Eldercare Locator (use to find local Area Agency on Aging)
Family Care Alliance Care Navigator
Addressing Medical, Legal, & Financial Advance Care Planning
Sexual Dysfunction in Males

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011 – Vitamin D: The “Healthy Aging” Dose & FAQs Apr 28, 2016

In this Episode:

Dr. K discusses her approach to vitamin D for healthy aging, including:

What dose of Vitamin D is likely right for most older adults
Why she believes that most older adults should take a vitamin D supplement
What experts such as the US Preventative Services Task Force and the American Geriatrics Society recommend
Dr. K also addresses many common questions people have about vitamin D, including:
- What type of Vitamin D should I take?
- Do I need to have my blood level checked?
- Will Vitamin D really prevent falls or fractures?
- Will Vitamin D really prevent dementia, cancer, or premature death?
- If I’m outside a lot, do I need a vitamin D supplement?
- What should one’s vitamin D level be?
- Is a higher level of vitamin D better for you?

Related Resources:

Vitamin D: the Healthy Aging Dose to Prevent Deficiency & FAQs
Vitamin D Fact Sheet (for Health Professionals), from the National Institutes of Health Office of Dietary Supplements
Getting Enough Vitamin D in Later Life, from HealthinAging.org
Choosing Wisely: 5 Treatments You Should Question

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010 – Interview: Choosing a Wearable Medical Alert System for Older Adults Apr 21, 2016

In This Episode:

Dr. K talks with Richard Caro, PhD, a co-founder of Tech-Enhanced Life, who recently spent several months testing out wearable medical alert systems. They discuss:

What Richard learned through hands-on testing of several different personal emergency response systems (PERS)
Key PERS features to consider before buying, including who will respond when the alert is triggered and whether the responder can be heard through the pendant versus the base station
The pros and cons of automatic fall-detection
How to see past the marketing and learn more about different PERS features, in order to select the right PERS for you
Whether there are any stylish and attractive wearable alert systems available for sale in the US
Why Richard and his colleagues founded Tech-Enhanced Life

Related Resource Featured in Podcast Episode:

Tech-Enhanced Life Medical Alert System Selection Guide

Additional Notes on this Topic:

Although we don’t discuss it in depth in the episode, Consumer Reports did publish an article on medical alert systems in June 2014 (updated July 2015). Dr. K feels that the report itself is short and overall not as useful as the Tech-Enhanced Life selection guide. However, she likes the fact that there are over 60 comments, sharing information regarding customer service, contracts, and other aspects of the service.

To reach Richard Caro regarding Tech-Enhanced Life and/or the PERS guide: You can email info@techenhancedlife.com or see their contact page here.

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009 – Q&A: Answers to Your Questions on Helping Older Parents Apr 14, 2016

In This Episode:

Dr. K answers nine audience questions related to helping older parents:

How to find a facility for an older father with dementia who is a “two-person assist”? How to make sense of the jargon on care levels and how are facilities classified?
How to help an older mother with bipolar, especially if she seems to be going into a manic phase?
How to maintain sanity and better respond to an older father with Alzheimer’s disease, who gets agitated and angry in the afternoons and evenings?
Whether to worry about withdrawal symptoms, after an older mother is hospitalized and treated with haloperidol for delirium
How to keep assisting without losing hope, in the context of a mother with Alzheimer’s and an older father with Parkinson’s and sleep problems
What to do when it’s hard to get an older mother to take her medications, and how to get her to understand the importance of recommended procedures such as cataract surgery
What to do if both you and your elderly mother have been diagnosed with mild cognitive impairment, and how to handle caregiving issues
Whether anxiety can cause abdominal pain and shortness of breath in someone with dementia, and how to improve bad breath that has been attributed to acid reflux
What can be done if an older father with mild cognitive impairment has been refusing to leave the house for several months

Expert contributors to some answers:

Carolyn Rosenblatt, RN, Elderlaw Attorney, AgingParents.com
Mary Hulme, LCSW, Licensed Geriatric Social Worker, MoonstoneGeriatric.com

Related Resources:

Eldercare Locator (Use to find your local Area Agency on Aging)
Assisted Living Levels of Care

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008 – Interview: Helping Families with Memory Loss: The Care to Plan Online Tool Apr 07, 2016

In This Episode:

Dr. K talks with Professor Joseph Gaugler, PhD, an expert in family caregiving and dementia, who is on the faculty of the University of Minnesota’s Center on Aging. They discuss:

Care to Plan, a new online tool developed by Dr. Gaugler and his colleagues, designed to help family caregivers of people with Alzheimer’s and other dementias
How Care to Plan uses an easy online 20-question assessment to create a personalized plan of support for family caregivers
Why different families may need to prioritize different support strategies
Seven different types of support that are known to help family caregivers: Education, Problem Solving, Support Groups, Change Your Thinking, Brain Health, Take a Break, and High-Powered Combinations
The benefits of attending a local university-led conference about memory loss and dementia, such as the University of Minnesota’s Caring for a Person with Memory Loss Conference

Related Resources:

Care to Plan Online Tool (for people helping someone with memory loss)
The University of Minnesota’s Caring for a Person with Memory Loss Conference
Caregiver Education and Support Resources recommended by Professor Gaugler:
Support Groups and Online Forums recommended by Professor Gaugler:

Questions or comments about the Care to Plan tool?

Professor Joe Gaugler would love to hear from your questions and feedback. You can post in the comments below, or you can email him directly at gaug0015@umn.edu.

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007 – How a Personal Health Record Helps You Be Proactive Mar 31, 2016

In This Episode:

Dr. K explains why she always recommends that older adults and families keep their own copies of key health information. She covers:

Why this proactive approach — which is also known as maintaining a personal health record (PHR) helps older adults get better healthcare from doctors
The five common healthcare pitfalls that you can avoid or minimize, by maintaining a PHR
What health information is most useful to request and why
Options for organizing and keeping health information
Why it’s good to bring a paper copy of relevant health information to doctors’ visits, and other tips on bringing medical information to doctors

Related Resources:

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006 – Interview: Surviving Cancer & Better Healthcare Through Being an e-Patient Mar 24, 2016

In This Episode:

Dr. K talks with “e-Patient Dave” deBronkart, a co-founder of the Society for Participatory Medicine. Dave is a well-known advocate for improving healthcare by encouraging people to become “equipped, enabled, and empowered” when it comes to their own healthcare. They discuss:

How getting information from an online patient community helped Dave survive a usually fatal cancer
What is an “e-patient,” and why being proactive leads to better healthcare
Why public access to health information is creating a sea change in the practice of medicine
How the patients’ rights movement is creating a culture change that some doctors find threatening
Why it’s better for patients and doctors to act as partners and “share the knowledge”
Practical tips on getting more informed regarding your own (or your family member’s) healthcare
What kinds of doctors to avoid, and how to get a second opinion

Related Resources:

e-Patient Dave’s books:
- Let Patients Help! A patient engagement handbook
- Laugh, Sing, and Eat Like a Pig: How an Empowered Patient Beat Stage IV Cancer (and what healthcare can learn from it)
About the patient empowerment movement
Practical resources to participate more in healthcare
- Center for Advancing Health: Be A Prepared Patient
- How to Age Better by Optimizing Chronic Conditions: The Healthy Aging Checklist Part 4

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005 – Interview: Otago & Proven Exercises for Fall Prevention Mar 17, 2016

In This Episode:

Dr. K interviews Tiffany Shubert, PhD MPT, a practicing physical therapist on faculty at the University of North Carolina, and a leading expert on exercise programs for fall prevention. They discuss:

What types of exercise work best for fall prevention, and why
Why strength and balance exercises are so important for aging adults
Why walking is not enough, when it comes to fall prevention
Easy tests you can do at home, to check an older person’s leg strength and balance
What’s involved in the Otago Exercise Program, an exciting new physical therapy program proven to reduce falls in older adults and endorsed by the Center for Disease Control (CDC)
How to find Otago near you
Why any exercise or physical therapy program for fall prevention should involve exercises done in standing, that are challenging, that get more challenging over time, and that involve at least two hours/week of exercises
Other proven programs to reduce falls in older adults
Tips on doing fall prevention exercises in people with Alzheimers or other dementias

Related Episodes:

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

004 – What to Do if You’re Worried About Falls

Related Resources:

Carolina Geriatric Education Center: Otago Resources
- Otago Implementation Guide (designed for use by physical therapists)
- Otago Exercise Guide (for older adults)

Videos Demonstrating All Exercises Used in Otago
How to do the 30 Second Chair Rise Test (to check is score is ok for age, see here)
How to do the 4 Stage Balance Test
Information on other fall prevention programs:
- Stepping On
- A Matter of Balance
- National Council on Aging (NCOA): Evidence-Based Fall Prevention Programs
- FallProof Program
- iStandFit (online program for Otago exercises)

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004 – What to Do If You’re Worried About Falls Mar 10, 2016

In This Episode:

Why older adults fall
How to identify underlying health risk factors and fall triggers, so that you can personalize your fall prevention plan
The three step process Dr. Kernisan uses to create a fall prevention plan for an older person
Medications that geriatricians often reduce or stop, to reduce fall risk
How blood pressure medication can increase fall risk, and a simple test to discuss with the doctor

Related Resources:

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003 – Interview: Helping Reluctant Parents Address Memory Concerns Mar 03, 2016

In This Episode:

Dr. K interviews Linda Fodrini-Johnson, MA MFT CMC, a past president of the National Association of Geriatric Care Managers and the founder of Eldercare Services in the San Francisco Bay Area. They discuss:

How adult children can better approach aging parents, when there’s been concern about memory problems or financial transactions
What is a geriatric care manager (also known as an aging life care professional), and how they help families address memory concerns
How to find a geriatric care manager with the right counseling skills for your needs
How to get free help and advice from geriatric care managers and trained aging professionals
Why people often tell Linda they wish they’d gotten more help or information sooner

Related Resources:

Aging Life Care Association (formerly the National Association for Professional Geriatric Care Managers); click here to search for an expert near you.
Eldercare Locator: use to find your local Area Agency on Aging, which can refer you to local resources
5 Things to Know About Aging & Financial Decline
The Village Plan

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002 – What to Do If You’re Worried About Someone’s Memory Feb 25, 2016

In This Episode:

Why it’s important to take action, if you notice memory or thinking problems
Common treatable medical problems that can cause or worsen memory and thinking
What to take note of, and what information to bring to the doctor
How to communicate with the doctor beforehand (which is especially useful if your parent or relative feeling defensive)
What should be covered during a preliminary medical evaluation for memory or thinking concerns

Related Resources:

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001 – Introducing the Better Health While Aging Podcast Feb 24, 2016

In This Episode:

Dr. Kernisan introduces the Better Health in Aging podcast
We discuss three common questions people often ask Dr. K:
- What IS geriatrics?
- At what age should geriatrics care start?
- Do I need a geriatrician?
Dr. K introduces herself and explains more about why she’s starting this podcast.

Related Resources:

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