Melanie became a caregiver “all of a sudden”. It started two years ago when her tech savvy husband couldn’t use the TV remote control. At 77, he was diagnosed with Alzheimer’s Disease. Things have changed dramatically since then. Now, much of what he says doesn’t make any sense. In addition, he fractured his hip and is unsteady on his feet. He can’t be left alone. It has been a huge adjustment for Melanie. She was desperately looking for hired help at home and found a person who was compassionate, skilled, and dedicated. She was thrilled. […]
Author Archive: Dr. Warren
My Goal in 2024
I’m taking a big step and want to tell you about it. My 2024 goal is to finish a book about how to care for frail older people. It will be from a geriatrician’s perspective. One year from now a book will be available online and in print. Why do I have this goal? More than 10,000 babies are born daily in the United States. At the same time more than 10,000 people turn 65 per day. Many seniors eventually become frail. It’s easy to find 100 books about how to take care of children. […]
2023: The Year in Caregiving
1. Home and community-based healthcare are definitely coming to the forefront Most care of frail older adults happens in the home and community. Up to now, the healthcare system has not acknowledged this reality. Healthcare has been based in the clinic, hospital, and nursing facilities. The result has been intense care in those settings and few services in the home. Caregivers receive little support. We are now at a turning point. The importance of home and community-based services is finally being recognized. Providing more healthcare in the home setting is good news for frail older […]
Doing Good: What matters to a frail older person?
Susan has had a fulfilling life. As a woman, she made it in the world of architecture and became quite successful. She raised 3 children and had many friends. She enjoyed golf and swimming. But life took an unexpected turn at the age of 75. Even though she had few risk factors, she started having memory problems. She was eventually diagnosed with Alzheimer’s Disease. In a few short years, Susan has declined quite a bit. She is now frail. Her gait is unsteady, and she has fallen many times. One fall resulted in a hip […]
Making the Holidays Joyous
A special message to caregivers: Caregiving is hard and dedicated work. Make sure your holidays are joyous. I recommend the best gift of all. Take care of yourself. If you don’t treat yourself well during the Holidays, when will you? How Much Celebration do You Need? Give yourself an especially important gift: the “just right” amount of holiday celebration. People are different. Some people love holiday gatherings. Others are happiest connecting less often, with lots of quiet time in between. (There have been holidays where I was so busy, seeing many people every day, that […]
What does “doing good” mean for a frail older person?
Four decades ago, I finished my training in internal medicine. My first real life “job” was working at On Lok in San Francisco Chinatown. On Lok focuses on providing healthcare to frail older patients. There is an emphasis on home and community-based services. Daycare services and medical transport are included. On Lok was the original site of the Program of All-Inclusive Care for the Elderly (PACE). The above picture was taken at On Lok. I’m sitting with a 100-year-old patient. She would always walk up to me, show me her watch, and ask me what […]
Will we all become frail as we age?
Almost half of the people born in 1940 are still alive today. They are over 80 years old. For people who were born in 1950 or later, more than 70% are expected to live past the age of 80. What will life be like for these people? Is 80 the new 70? Or will living longer mean an extended period of weakness and frailty? It is true that frailty can be delayed. However, it is more controversial whether this has happened. Some people will live with extended periods of frailty. Why do some people become […]
Frailty – A Major Turning Point in Life
“I recently went to my 50th reunion. A bunch of old people showed up. They looked like the grandparents of the people I knew in high school. It was freaky. The school athletes are now anything but athletes. They looked overweight and out of shape. Some even had problems walking.” Have you ever been to a high school reunion? Everyone is roughly the same age, but some people seem to “age” sooner and more rapidly than others. As the years go by, some of these classmates will become frail while others will not. Will we […]