Better Health While Aging

Practical information for aging health & family caregivers

COVID & Aging Adults: 2023-2024 Updates

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Since the COVID-19 pandemic emerged in early 2020, COVID has become one of the top causes of illness and death in the US, and has especially impacted aging adults, for both health and social reasons.

Older age is one of the top risk factors for severe COVID; it’s even a stronger risk factor than vaccination status. So this is an important issue for us to follow in geriatrics.

On this page, I’ll be posting updates related to COVID and older adults, for 2023. I’ll be focusing on important developments and what I think is most important for older adults and their families to know, to be safer and manage these COVID times we are living through.

I also have a section below on general COVID safety principles for older adults.

 

Covid & Aging Adults: COVID News 2023-2024

COVID winter update December 20, 2023

As anticipated, we are seeing a substantial rise in COVID activity this month. This can be seen in wastewater and we’re also seeing a rise in hospitalizations.

What is a little more worrisome is that a new variant, JN.1, now seems to be taking off in the US. This variant has been active in Europe, where it is causing a marked exponential spike in COVID wastewater levels.

We are also seeing a fair amount of RSV circulating, plus some influenza.

For more on the state of these respiratory viruses, I highly recommend reading this update by epidemiologist Katelyn Jetelina, MPH PhD: State of Affairs: Dec 19, 2023.

All three of these viruses (COVID, RSV, influenza) can hospitalize vulnerable older adults 🙁

So as you consider holiday travel and gatherings, here are my recommendations:

  • Avoid gathering with others inside if you have cold symptoms (or anything worse). If you need to gather, consider wearing a mask and be sure to ventilate the space with a HEPA air filter (or open windows).
  • Consider rapid tests for COVID before having a gathering with vulnerable older adults.
  • Wear a N95 or KN95 when traveling on planes or other forms of crowded public transit. 
    • Consider a mask when in malls or other crowded indoor spaces.
  • People over age 65 should get the 2024 COVID vaccine (if they haven’t yet had it), for renewed protection against hospitalization.
    • The exception is if you’ve actually had COVID within the past few months; that’s like getting a booster but much more effective.
  • Paxlovid still works. Older adults should request it if they test positive for COVID.

 

COVID fall vaccine update September 21, 2023

The CDC announced recently that new COVID vaccines are available for the 2023-2024 season.

They are recommended for everyone over the age of 6 months, and are especially recommended for adults over the age of 65.

This fall, the COVID vaccine is a monovalent vaccine based on the XBB.1.5 subvariant of Omicron (which was the most prevalent variant at the beginning of the summer). Although there are different Omicron subvariants currently circulating, the XBB.1.5 is expected to provide good protection against hospitalization and deaths.

If you are a details and data person, you can find the slides presented at the 9/12/23 CDC meeting here.

Learn more about the new fall COVID vaccines here: CDC: Stay Up to Date with COVID-19 Vaccines.

I highly recommend that adults aged 65+ get this updated COVID vaccine, especially if they have not had COVID in the past 4 months.

I also recommend that aging adults get their annual flu shot (get one of the stronger ones recommended for older adults) and consider the new RSV vaccine for older adults.

Otherwise, my recommendations for how to stay safe in regards to COVID have not changed since my most recent video update from August, which you can view below.

Here is my most recent video update, from August 14, 2023: [Read more…]

Choosing & Using a Home Blood Pressure Monitor, & What to Ask the Doctor

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Omron blood pressure monitor

In another article, I’ve explained the key reasons that I recommend older adults and their caregivers have a blood pressure (BP) monitor at home.

To very briefly recap:

  • Many of the problems of older adults (including falls) can be related to blood pressure.
  • Home blood pressure measurements can help:
    • evaluate for drops in blood pressure with standing (a common cause of dizziness in elders)
    • check for serious illness, since these often (but not always) cause the blood pressure and pulse to be very different from usual
    • follow-up on blood pressure after a change in medication, which can help doctors and families figure out the best medication dosing for an older person much faster. This is safer for seniors.

In this post, I’ll share some tips on choosing and using a home BP monitor.

And don’t worry: I won’t tell you that you have to plan on checking every day for the rest of your lives. Although there are times when it’s great to check daily — like the week after a change in medication — the most important thing is to have a good BP monitor at home and know how to use it at least occasionally.

Tips for choosing a home blood pressure monitor

[Read more…]

Providing Elder Care: Covering the Cost of Home Care, Assisted Living & Other Options

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aging woman with caregiverOne of the most common questions I get asked is “How can I get care for my aging parent and how much will it cost?”

The answer generally depends on these factors:

  • What kind of elder care does the older person need or want?
  • What are the available options for providing the needed elder care?
  • How much do the different options cost?
  • What are the options for paying for the desired type of elder care?

These are important questions to consider. If your aging parent seems to need help, it’s imperative to find out what are your options for providing the needed support. And finances do often determine how a family proceeds with arranging elder care.

And even if your aging parent doesn’t need help now, they very well might in the future. So it’s also reasonable to plan ahead, and consider how elder care might be provided, if/when it becomes needed in the future.

Now, the truth is that most older adults don’t need much assistance from others. But research shows about 70% of older adults do end up needing some form of “senior care,” for a time ranging from a few months to several years.

So in this article, I’ll share the key things to know, about options for elder care and how to pay for it. Specifically, I’ll cover: [Read more…]

7 Common Brain-Slowing Anticholinergic Drugs Older Adults Should Use With Caution

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Want to keep your brain — or the brain of someone you love — as healthy as possible?

Then it’s essential to know which commonly used medications affect brain function.

In this article, I’ll go into details regarding a type of medication that I wish all older adults knew about: anticholinergic drugs.

 

[Read more…]

3 Ways to Prevent Injury From a Fall
(Plus 3 Ways That Don’t Work as Well as You’d Think)

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elderly person falling hip fracture

Worried about falls in an older person?

You’re right to be concerned, especially if the older person has already experienced a fall. Research suggests that falling once doubles your chance of falling again.

And falls, as everyone knows, can cause life-changing injuries. The Centers for Disease Control (CDC) reports that:

  • One out of five falls causes a serious injury such as broken bones or a head injury
  • Each year at least 300,000 older people are hospitalized for hip fractures
  • More than 95% of hip fractures are caused by falling, usually by falling sideways
  • Falls are the most common cause of traumatic brain injuries

For these reasons and more, preventing falls is a major focus of preventive care for older adults, and is a big part of what we do in geriatrics. (Learn more about how we do this in this article: Why Older People Fall & How to Reduce Fall Risk.)

But if we want to protect older people from the potentially devastating consequences of falls, it’s not enough to help them reduce falls.

We also need to think about how we can reduce the likelihood of injury from a fall.

In this article, I’ll share with you three approaches that can help reduce fall-related injuries.

Then I’ll address two other approaches that are sometimes tried, but are less likely to help.

3 ways to prevent fractures and other injuries related to falls 

[Read more…]

8 Great Gift Ideas for Older Adults & Family Caregivers

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It’s getting to be that time of the year: the season when many of us start looking for a thoughtful gift to give to an older loved one.

I’ll be honest: I’m not much of a shopper and it’s not my style to give physical gifts just for the sake of doing so. 

But I do think it can be wonderful to give something that brightens a person’s day. 

And it’s even better when a gift is practical, useful, or otherwise helps an older person make the best out of life.

One of my favorite resources, when it comes to identifying useful items to help with age-related challenges or caregiving, are the lists put together by DailyCaring.com.

They have a great list of 50 top gift ideas for seniors, and another terrific list of gifts related to Alzheimer’s and dementia.

In this article, I’ll share my list of eight gifts that can help older adults cope with common late-life challenges. 

Four are for older adults in general, and then four are especially useful for those living with Alzheimer’s or a related dementia.

Four great gift ideas for older adults:

[Read more…]

Is Your Aging Parent OK?
What to check & how to talk about it

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Have you been getting worried about your aging parent, or wondering if they are ok continuing to live as they are?

Maybe they’ve been mostly okay but now you’re spotting some problems with memory, such as forgetfulness or asking the same questions repeatedly. Or maybe you’ve noticed trouble with driving, keeping up the house, managing stairs, or paying bills.

Some aging parents simply begin to seem more withdrawn. Others start leveling accusations at others, claiming someone took or moved something, or acting paranoid.

When families notice these types of changes, it’s often really hard to know what to do next. How do you know if they really need help or not, and what kind of help to get? And what do you do if they refuse to discuss it, or get mad when you bring it up?

Since this is such a common dilemma for families, I’ve recorded a video, explaining exactly what you can do, if you’ve noticed some worrisome changes in your parent and are trying to figure out what to do next. Here’s how to know if your aging parent needs help, and how to talk to them about your concerns.

 

This video covers:

[Read more…]

3 Ways Home Blood Pressure Monitors Help Older Adults

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how to check BP at homeIf I had to recommend one key piece of healthcare equipment that older adults & caregivers should have at home, it would be this: a good home blood pressure (BP) monitor.

Why? Because BP measurements (and pulse measurements, which machines check at the same time) are an incredibly useful tool when it comes to assessing and optimizing an older person’s health and well-being. This is true even for those older people who aren’t being treated for hypertension (chronic high BP).

As I’d love for more older adults and families to understand how home BP monitors can help them, in this article I’ll explain how home BP monitors can be helpful specifically for older adults. (And then see my related article here: Choosing & Using a Home Blood Pressure Monitor, & What to Ask the Doctor .)

3 ways a home blood pressure monitor can help you

[Read more…]

What the New Blood Pressure Guidelines — & Research — Mean For Older Adults

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blood pressure monitor and medications

Are you on medication to lower blood pressure? Or are you caring for an older person with hypertension, also known as high blood pressure? 

If so, you are probably wondering just what is the right blood pressure (BP) for older adults.

This is a good question, given that guidelines on blood pressure have changed, especially due to the results of the landmark Systolic Blood Pressure Intervention Trial (abbreviated as “SPRINT”).

The SPRINT study first made headlines in part because the findings seemed to contradict expert hypertension guidelines released in December 2013, which for the first time had proposed a higher goal BP ( a systolic BP of less than 150mm mercury) for most adults aged 60 or older.

In particular, SPRINT randomly assigned participants — all of whom were aged 50 or older, and were at high risk for cardiovascular events — to have their systolic blood pressure (that’s the top number) treated to a goal of either 140, or 120. Because the study found that people randomized to a goal of 120 were experiencing better health outcomes, the study was ended early.

For those of us who specialize in optimizing the health of older adults, this was obviously an important research development that could change our medical recommendations for certain older adults.

But what about for you, or for your older relative? Do the SPRINT results mean you should talk to the doctor about changing your BP medications?

Maybe yes, but quite possibly no. In this article, I’ll help you better understand the SPRINT study and results, as well as the side-effects and special considerations for older adults at risk for falls. This way, you’ll better understand how SPRINT’s findings might inform the BP goals that you and your doctors choose to pursue.

Here’s what this post will cover: 

  • What is currently considered “normal” blood pressure for older adults in their 60s, 70s, 80s
  • What the latest blood pressure guidelines recommend
  • What to know about the landmark SPRINT blood pressure in older adults trial, including who was included and excluded, and what type of BP medications were used most often
  • What the actual likelihood of benefits and harms was within SPRINT, and what you might expect if you are similar to the SPRINT participants
  • Why you probably need to make a change in how your blood pressure is measured before considering a SPRINT-style systolic BP goal of 120
  • My own approach and how to avoid over-treatment of high blood pressure

[Read more…]

Medications Older Adults Should Avoid or Use with Caution:
The American Geriatrics Society Beers Criteria (2023 Update)

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Today we’re covering a touchstone resource for geriatricians: the “Beers List” of medications that older adults should avoid or use with caution.

(Technically, it’s called “The AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults.” I personally think of it as the list of “risky medications” for older adults.)

If you want to know which medications older adults should be careful about, this is the list!

This list gets updated every few years, so the Beers Criteria published in May 2023 is about as up-to-date as you can get for this type of guideline document. 

You should know that experts in geriatrics and in medication safety go through a very careful process of reviewing the research on medications, and of updating this list of medications that older adults should avoid or use with caution.

So in this article, here’s what I’ll be sharing with you:

[Read more…]

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