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Leslie Kernisan, MD MPH

Practical advice to help caregivers help aging adults

Medical caregiving for elderly

The Blog Has A New Home: Introducing GeriatricsForCaregivers.net

June 11, 2014 By Leslie Kernisan, MD MPH

The Geriatrics for Caregivers Blog Has Moved!

I am very pleased to announce that as of May 2014, the blog and other health information for caregivers is now on a new website, dedicated to geriatric health information for family caregivers.

To visit, please click below!

Geriatrics For Caregivers

 

I will continue to maintain drkernisan.net for my part-time geriatric consultation practice.

Thank you for visiting, and I hope to see you over at Geriatrics for Caregivers.

Filed Under: Medical caregiving for elderly

Hospital Delirium: What to know & do

April 25, 2014 By Leslie Kernisan, MD MPH

Delirium

“How should delirium be managed in the hospital?”

This question came up during this week’s Geriatrics for Caregivers Q & A call, as we were discussing the Choosing Wisely recommendation to avoid tying down older adults who become confused during a hospitalization. (See item 5 in last week’s post.)

Delirium is a common and important problem for all older adults in the hospital; it doesn’t just happen to people with a dementia diagnosis!

But many family caregivers have hardly heard of hospital delirium. This is too bad, since there’s a lot that caregivers can do to prevent this serious complication, or at least prevent an older loved one from being physically restrained if delirium does occur.

In this post, I’ll review what caregivers absolutely should know about hospital delirium.  And, we’ll cover some of the things you can do if it happens to your loved one. [Read more…] about Hospital Delirium: What to know & do

Filed Under: Medical caregiving for elderly

5 More Treatments You Should Question in Older Adults

April 16, 2014 By Leslie Kernisan, MD MPH

Choosing WiselyLast week, I wrote about the first Choosing Wisely list of 5 treatments that older adults and their doctors should question.

In this post, I’ll cover the 2014 Choosing Wisely list for healthcare in aging adults, which was released by the American Geriatrics Society (AGS) this past February. This 2014 edition of things to question include:

  • The most popular class of medications prescribed for Alzheimer’s and other dementias,
  • Breast, colon, and prostate cancer screening,
  • A common approach to weight loss and poor appetite,
  • The prescribing of additional medications,
  • A common — but risky — approach to handling confusion during hospitalization.

As I explained in my last post, Choosing Wisely is a health education campaign meant to help patients and their doctors more easily spot common tests and treatments that are often overused. 

For the Choosing Wisely items selected by AGS (my specialty society), I’d say the real problem is that these are healthcare interventions that are usually used before safer alternatives have been tried.

Many older adults and their caregivers are never told that a safer alternative exists. People often also have an overly optimistic understanding of the likely benefits, but haven’t been properly informed of the risks.

Aren’t doctors supposed to offer the safest alternatives first? Of course they are. However, many doctors haven’t been trained in modifying healthcare to better fit the needs of aging adults. And it’s often hard for a busy clinician to keep up with the latest recommendations from experts in geriatrics.

By learning about the Choosing Wisely recommendations, you can prepare yourself to be a “smarter” patient or caregiver, and you can be more proactive about making sure the healthcare you get is a good fit for your family’s needs. That’s why Choosing Wisely is supported by Consumer Reports, which makes the recommendations available on their website.

In this post, I’ll review the 2014 list of five Choosing Wisely items that older adults — and their families — should question. I’ll also share some tips for caregivers, related to each item. [Read more…] about 5 More Treatments You Should Question in Older Adults

Filed Under: Medical caregiving for elderly

Choosing Wisely: 5 Treatments You Should Question

April 10, 2014 By Leslie Kernisan, MD MPH

Balancing benefits & burdensDid you know that it’s important to think about “Choosing Wisely,” when it comes to healthcare?

It’s true! Choosing Wisely is a health education campaign meant to help patients and their doctors more easily spot common tests and treatments that are often overused. To do this, many medical societies are creating lists of “Five Things Physicians and Patients Should Question.” Consumer Reports is also a partner in this project.

If you’re a caregiver for an aging person, you probably should know about the Choosing Wisely items identified by the American Geriatrics Society (AGS). These are treatments or tests that are:

  • Commonly given to older adults,
  • Often unlikely to help aging adults live better, or longer,
  • Riskier than many patients and caregivers realize.

In other words, these are treatments that older adults often don’t receive, when geriatricians are involved.

Of course, most older adults aren’t under the care of a geriatrician. If this is your family’s situation, learning about the Choosing Wisely items can be a good way to make sure your older relative avoids healthcare that is unnecessary, or even harmful.

In this post, I’ll review the “Five Things to Question” that were identified by the AGS in their intial Choosing Wisely list. (The AGS recently published a second list; I’ll review those items in a follow-up post.) I’ll also share some tips for caregivers, related to each item. [Read more…] about Choosing Wisely: 5 Treatments You Should Question

Filed Under: Medical caregiving for elderly

How to find geriatric care — or a medication review — near you

March 28, 2014 By Leslie Kernisan, MD MPH

Medications & AgingA caregiver brought up a common question during this week’s Q&A call:

“How can I find a geriatrician to review medications, and help care for my mother with dementia?”

Although my recent posts have been about preventing falls, I’ve often emphasized the importance of spotting and reducing risky medications. That’s because medications are one of the easier risk factors to modify, when it comes to preventing falls.

Understandably, this caregiver — who lives far from her parents — wants to find someone to help her mother directly.

Now, medication review is usually included in geriatric primary care care. Geriatric care, after all, means healthcare modified to be a better fit with what happens as people get older. And being careful with medications is pretty integral to this approach.

But, although geriatric primary care is certainly worth looking for, it can be hard to find. (Read on for suggestions below.)

So it’s good to have a plan B, which can be getting a medication review — and fall risk assessment — outside of geriatric primary care. This can also be a good option if your parents are reluctant to change primary care doctors.

In this post, I’ll describe 3 places to look for geriatric primary care, and then 3 options for medication review. [Read more…] about How to find geriatric care — or a medication review — near you

Filed Under: Medical caregiving for elderly

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Disclaimer

The material on this site, including any exchanges in the comments section of the blog, is for informational and educational purposes only. Any comments Dr. Kernisan may make regarding an individual's story or comments should not be construed as establishing a physician-patient relationship between Dr. Kernisan and a caregiver, or care recipient. None of Dr. Kernisan's website or group information should be considered a substitute for individualized medical assessment, diagnosis, or treatment.
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The Geriatrics for Caregivers Blog by Leslie Kernisan, MD MPH is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
Based on a work at drkernisan.net/blog.
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