Better Health While Aging

Latest Episodes:

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

Show notes

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

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

Show notes

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

Show notes

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

Show notes

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

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

Show notes

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

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

Show notes

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

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

Show notes

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

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

Show notes

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

Show notes

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

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

Show notes

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

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