The Better Health While Aging Podcast

Get practical health tips from a geriatrician and other experts! We discuss common health problems that affect people over age 60, the best ways to prevent and manage those problems, and we also often address common concerns and dilemmas that come up with aging parents and other older loved ones.

092- Interview: Addressing Nighttime Urination & Insomnia in Aging

by Leslie Kernisan, MD MPH 20 Comments

Better Health While Aging

092- Interview: Addressing Nighttime Urination & Insomnia in Aging

00:00 / 58:21

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

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

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging

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

00:00 / 53:26

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

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

by Leslie Kernisan, MD MPH 2 Comments

Better Health While Aging

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

00:00 / 00:40:21

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

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

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging

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

00:00 / 39:14

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

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

by Leslie Kernisan, MD MPH 5 Comments

Better Health While Aging

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

00:00 / 47:31

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

[Read more…]

087- Interview: Coping with Difficult Older Parents

by Leslie Kernisan, MD MPH 5 Comments

Better Health While Aging

087- Interview: Coping with Difficult Older Parents

00:00 / 1:04:14

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

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

by Leslie Kernisan, MD MPH 2 Comments

Better Health While Aging

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

00:00 / 1:02:55

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

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085 – Understanding Lab Tests:
4 Common Blood Tests for Older Adults

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging

085 – Understanding Lab Tests:
4 Common Blood Tests for Older Adults

00:00 / 38:24

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

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

by Leslie Kernisan, MD MPH 40 Comments

Better Health While Aging

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

00:00 / 1:02:56

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

[Read more…]

083 – Interview: Disrupting Dementia and Creating Dementia-Friendly Communities

by Leslie Kernisan, MD MPH 2 Comments

Better Health While Aging

083 – Interview: Disrupting Dementia and Creating Dementia-Friendly Communities

00:00 / 1:00:19

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

[Read more…]

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