Leslie Kernisan, MD MPH

Practical advice to help caregivers help aging adults

Medical caregiving for elderly

What should a geriatrician try to teach caregivers?

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Next Tuesday, on December 17th, I’ll be trying something new: a free Q & A conference call, for caregivers of older adults.

Why? Because after spending the past several years writing articles and blog posts for family caregivers, I’m interested in taking things in a slightly new direction. These Q & A sessions will help me learn more about what kinds of questions caregivers have regarding the health issues of the people they care about.

In fact, I’m considering the possibility of creating some kind of small course or curriculum, to help caregivers learn more about how to manage the health issues of aging adults.

What I have in mind would be similar to a “mini-med school” course, but with the following features:

  • The topic would be related to some aspect of geriatrics, i.e. health and healthcare that’s adapted for frail and vulnerable aging adults. This means that either I could plan a course about the geriatric approach to a common condition (such as diabetes, or osteoarthritis), or we could address a geriatric “syndrome” such as memory problems, falls, pain, physical declines, etc.
  • The course would take place largely online. I’m not considering a MOOC; I don’t have the resources to create a “massive open online course.” But I am envisioning a course that would leverage Internet technologies in some way, such as by combining online course material with teleseminars, and maybe even an online forum for the learners.

Now, this upcoming Q & A call is not part of a course. But it should be a good learning experience for those caregivers who call in, and will help me learn more about what topics would be useful in a class for caregivers.

And, I’m really looking forward to doing these calls and working on some kind of course, as I’ve long believed that we geriatricians should be actively teaching caregivers more of what we know. After all, health issues are almost always part of what caregivers end up dealing with, or at least worrying about.

If you’re a caregiver with questions for me, or if you’re otherwise interested in learning how geriatricians approach health issues in aging adults, I hope you’ll join my conference call next Tuesday, December 17th, at 12:30pm Pacific Standard Time.

Can’t make it on Tuesday 12/17 at 12:30pm PST? Those who register for the call beforehand will later have an opportunity to download a recording of the call.

For more information, and to sign-up for the call-in information, click below:

Info & Registration Page for December 17th Q & A Call

Questions? Comments? You can speak your mind below, or send me an email at info [AT] drkernisan [DOT] net.

A common problem that speeds Alzheimer’s decline, and how to avoid it

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Earlier this week, while I was listening to a social work colleague (Mary Hulme of Moonstone Geriatrics) give a talk on dementia at the public library, the following question came up:

“How can one keep Alzheimer’s from getting worse?”

Now, Alzheimer’s disease — the most common underlying cause of dementia symptoms — does slowly get worse no matter what. (Given enough years, it will eventually damage the brain to the point of causing a slow death, which is why Alzheimer’s is a terminal disease.)

But on the other hand, we do know that some things tend to slow the progression of brain decline, whereas other things seem to speed up the decline. In other words, the actions we take — and don’t take — can influence a person’s dementia journey.

In my experience, people often have heard about things that might slow down decline (exercise is one of my favorites).

But it seems to me that people are often much less well-informed about the things that can speed up Alzheimer’s decline. This is too bad, because often it is possible to take actions to avoid or minimize things that might cause dementia to get worse faster.

So today I’m going to write about what I think is the most important of these potentially dementia-accelerating problems: delirium.

Delirium: What it is, why it matters

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Tools to Help with End-of-Life Planning

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Yesterday I did a webinar with Family Caregiver Alliance, on end-of-life issues for dementia caregivers.

(4/10/14: I have just uploaded this powerpoint to Slideshare, so you can see my slides here.)

As you can imagine, this is a big topic that can’t be covered comprehensively in an hour.

So, I focused the talk mainly on something that I often find myself wishing families had spent more time on: advance care planning. Specifically, I talked about how individuals and families can approach planning for future medical care, in the context of a diagnosis of Alzheimer’s or another form of dementia.

Why? Because in my own experience, the last stage of life for a person with dementia is often strongly influenced by what kind of planning did — or didn’t — happen earlier on.

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Upcoming Webinar on Dementia & End-of-Life Planning

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Are you caring for an older person with Alzheimer’s or another dementia?

Would you like to learn more about planning and managing end-of-life issues?

If so, you might be interested in an online webinar this week that I’ll be doing in collaboration with Family Caregiver Alliance.

It’s scheduled for Thursday, November 7th, at 1pm PST (4pm EST). During the webinar, I’ll review how families can better address end-of-life planning in the context of a dementia diagnosis. I’ll also offer some suggestions as to how to handle common challenges at the end-of-life itself.

I will be taking live questions during the last part of the webinar. This is the part that I’m most looking forward to!

To sign up for the webinar, click here: https://www3.gotomeeting.com/register/764240806

Please note that Family Caregiver Alliance, who invited me to present, is charging $15 for the webinar.

How We Can Get to Better End-of-Life Care

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What is good care at the end-of-life, and how can we do better as a society?

This is the question that the Institute of Medicine (IOM) is now studying, and they have created a “Committee on Approaching Death: Addressing Key End-of-Life Issues.”

As part of their research into the current state of end-of-life care, the IOM is inviting the public to send them comments via this online comments page. (Comments must be submitted by November 1st, 2013.)

In particular, the IOM wants to hear about the following topics:

  • Barriers to and opportunities for improving care for individuals and their families,
  • Patient and family experiences with care, and
  • Health care provider experiences.

Now, as you can imagine, addressing end-of-life issues is a big part of what we do in geriatrics. Furthermore, I’m thrilled to see the IOM addressing this issue, since their reports are highly respected and often end up influencing policy and funding.

So I was very glad to provide some comments to the IOM, and encourage others — family caregivers, geriatric care managers, clinicians, or really anyone who has had personal experiences with end-of-life situations in the US — to submit comments as well.

The best reports, after all, result from the academics’ expert opinions being informed by the experiences of those of us in the trenches, trying to navigate real end-of-life situations.

My comments on Better End-of-Life Care for Older Adults

Below, I share the comments that I’m submitting in response to the IOM’s questions.

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