Better Health While Aging

Latest Episodes:

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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
Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

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