Better Health While Aging

Latest Episodes:

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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