Leslie Kernisan, MD MPH

Practical advice to help caregivers help aging adults

Medical caregiving for elderly

8 Things to Have the Doctor Check After an Aging Person Falls

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Aging womanIf you want to prevent dangerous falls in an aging adult, here’s one of the very best things you can do: be proactive about getting the right kind of medical assessment after a fall.

Why? There are three major reasons for this:

  • A fall can be a sign of a new and serious medical problem that needs treatment. For instance, an older person can be weakened and fall because of illnesses such as dehydration, or a serious urinary tract infection.
  • Older adults who have fallen are at higher risk for a future fall. Although it’s a good idea for any older person to be proactive about identifying and reducing fall risk factors, it’s vital to do this well after a fall.
  • Busy doctors may not be thorough unless caregivers are proactive about asking questions. Most doctors have the best intentions, but studies have shown that older patients often don’t get recommended care. By being politely proactive, you can make sure that certain things aren’t overlooked (such as medications that worsen balance).

All too often, a medical visit after a fall is mainly about addressing any injuries that the older person may have suffered.

Obviously, this is very important! However, if you want to help prevent future falls, it’s also important to make sure the doctors have checked on all the things that could have contributed to the fall.

Even if you’re pretty sure your loved one just tripped and stumbled, a good evaluation can uncover issues that made those trips and stumbles more likely.

In this post, I’ll list eight key items that you can make sure the doctors check on, after a fall. This will help you make sure your loved one has had a thorough work-up, and can reduce the chance of future serious falls. [Read more…] about 8 Things to Have the Doctor Check After an Aging Person Falls

Why Older People Fall

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Falling person

 

Why do older people fall?

This is actually not a question I am often asked. Instead, people usually want to know things like “How do I keep my mother from falling?” or “What should I do? My grandfather’s been falling.”

In this post, I’ll explain

  • How understanding just why older people fall can help you keep a loved one safer;
  • Why personalized fall prevention works better than relying on general fall prevention tips;
  • The mental framework I use to think about why an older person might fall, and how you can use this to avoid falls.

The benefits of understanding why older people fall

Most people know that falls are dangerous for older adults, because they can easily cause a life-changing injury, such as a broken hip. Fear of falling can also seriously affect an aging adult’s quality of life, and can keep a person from being active.

So, many caregivers are interested in fall prevention. And the good news is that although it’s not possible to prevent all falls, it almost always IS possible to take actions that will reduce your loved one’s chance of a bad fall.

But how, exactly, should you go about reducing fall risk?

Now, you can — and should — try to implement the general tips that are often listed on a fall prevention resource: exercise, medication review with the doctor, vision checks, and home safety reviews.

But if you really want to help a loved one avoid falls, I recommend you learn to better understand why he or she might fall.

Why? Because by understanding why an older person falls, you’ll then be able to:

  • Identify which fall prevention strategies are most likely to help the person you worry about.
  • Recognize risky situations, and take steps to avoid them.
  • Know which medical conditions — and/or medications — to ask the doctors to look into.
  • Understand what may have  brought on a specific fall, which can help you avoid future falls.

In other words, learning why older people fall means that you’ll be able to understand why YOUR older loved one is likely to fall. [Read more…] about Why Older People Fall

Blood pressure medications linked to serious falls: What you can do

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BP cuff & medicationsHave you had any concerns about an older person falling, or being at risk for a broken hip?

Falls are an important problem in aging adults, so I’d already been planning to discuss falls in the upcoming Geriatrics for Caregivers Q&A call on March 25th.

But coincidentally, a new clinical research study relevant to millions of older adults was just featured in the news.

The study, completed by a team of geriatrics researchers at Yale, found that in older adults aged 70 or older, taking blood pressure medication was linked to a higher risk of serious falls. (Serious falls as in, falls that caused an ER visit for a fracture, a dislocated joint, or a brain bleed. Serious stuff indeed!)

So, if the person you care for has a diagnosis of hypertension, and if you’ve had any concerns regarding falls or near-falls, these study results should be of interest to you.

In this post, I’ll review the key results of this study. Then I’ll tell you what I think are the most important practical take-aways for family caregivers.

This post will also include some practical tips to help you minimize the risk of your loved one experiencing a serious fall. [Read more…] about Blood pressure medications linked to serious falls: What you can do

Delirium: How Caregivers Can Protect Alzheimer’s Patients

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This week’s Q & A call was about how to better manage health and healthcare issues, when you’re taking care of someone with a dementia such as Alzheimer’s.

Most of the caregivers’ questions were about delirium. This is the state of worse-than-usual confusion that people can develop when they are sick or under serious stress.

I love talking to Alzheimer’s caregivers about delirium, because this is a really common problem that family caregivers absolutely can do something about!

The key is to know that people with dementia are especially prone to get delirium when they fall ill (especially in the hospital). And then you’ll want to know the basics on how to spot this problem, and how to get the doctors to address it properly.

A fact I wish more caregivers of elders knew: delirium can be the only obvious sign of a potentially serious health problem, such as a heart attack, a urinary tract infection, or a pneumonia. (Especially when it comes to older people with Alzheimer’s, they often don’t voice focused complaints the way younger people do.)

The trouble is, even though delirium is very common in older adults, studies have shown that it’s often missed by doctors and nurses. This is a important problem in healthcare, for three key reasons: [Read more…] about Delirium: How Caregivers Can Protect Alzheimer’s Patients

2 More Things to Know About Better Healthcare in Alzheimer’s

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In my last post, I listed three things that I often wish more caregivers knew, about getting better medical care for a loved one with Alzheimer’s or another dementia.

In this post, I’ll list two more important things for dementia caregivers to know. Again, this will be an excerpt from Paula Spencer Scott’s book “Surviving Alzheimer’s: Practical tips and soul-saving wisdom for caregivers.”

But first a quick word on Paula’s book, which as best I can tell is really unique. On their own, her tips on handling common everyday problems —  such as personality changes, memory glitches, difficult behaviors, and personal care issues — are good enough that I’d recommend her book to family caregivers because I love the practical “Why This, Try This” format she provides. She also offers solid advice on managing caregiver stress and relationship tensions.

Yet what’s really nifty about Paula’s book, is that she combines these practical tips with a section called “The Big Picture: Insights & Inspiration from the Wizards of Alz.” This is a compilation of twelve condensed expert interviews, and yours truly was very honored to be included.

Each expert has a different contribution to make to dementia caregiving. Whereas I focus on how caregivers can better manage the health issues, Bob DeMarco offers advice on “stepping into Alzheimer’s world,” Anne Basting provides guidance on using art therapy and storytelling, Teepa Snow suggests ways to decode the secret language of dementia, Leeza Gibbons encourages caregivers to not forget about themselves, and researcher Dr. Richard Isaacson provides cutting-edge advice on diet and dementia. (To see the full list of experts, you can preview the table of contents here, by clicking “look inside.”)

This creates a really rich and diverse package of perspectives, insights, and practical advice.  So if you are looking for help surviving as a caregiver to someone with Alzheimer’s or another dementia, I encourage you to consider Paula’s book. (Note: Paula was my editor at Caring.com, and I also consider her a personal friend. But I wouldn’t tell you I recommend her book unless I really did like it.)

And now, back to what you can do, to get better healthcare for a loved one with dementia.

Two more things I wish caregivers knew about healthcare & dementia [Read more…] about 2 More Things to Know About Better Healthcare in Alzheimer’s