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 […]

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 […]

I don’t think I can do this-Teepa responds

Teepa Snow is founder of Positive Approach to Care®. In our last post Teepa shared a bit about herself.
Starting as a little girl, she has become a dementia care expert and champion. We can't all be like Teepa.  In this video, Dr. Warren asks for her advice when caregiving is daunting.
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Warmest Aloha,


[email protected]

PS: I say it over and over again: There's no one more important than the caregiver in the daily life of a frail person.

Who is Teepa? The Story behind Positive Approach to Care®

Teepa Snow is the founder of Positive Approach to Care®, a dementia care company. This is the second video based on my interview with her. She is an expert and a champion. But on top of all that, she's friendly and fun with a story that goes way back.

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Warmest Aloha,


[email protected]

PS: I say it over and over again: There's no one more important than the caregiver in the daily life of a frail person.

Don’t worry, Mrs Wong, I’m getting a hold of your son now

I’m on a mission to have my mother use a medical alert device. It won’t be easy, but she needs one. Firstly, she has had several falls. The single highest predictor of a fall in an older adult is a history of a fall in the previous year. Secondly, she didn’t pass the Timed Up and Go (TUG) Assessment. Lastly, she is home alone for many hours a day. If she falls at home, she could be on the floor for hours. Some people are good candidates for a “wearable” medical alert device, some people […]

Teepa Snow

Teepa Snow is a dementia care expert and founder of Positive Approach® to Care (PAC). She is well known for her GEMS® Brain Change Model.

Dr. Warren had the opportunity to chat with Teepa. In this first video post, she talks about getting to know the person who now has a diagnosis of dementia. Although the diagnosis can't be changed, it's important to take a positive approach.

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Warmest Aloha,


[email protected]

PS: I say it over and over again: There's no one more important than the caregiver in the daily life of a frail person.

Preventing my Mom from Falling again

In the last post, I described my Mom’s recent fall. She ended up in the Emergency Room but is fine now. I was alarmed but not surprised that she fell. It was not her first tumble. Her fall did raise a red flag for me. What can be done to prevent her from tripping again? And what can be done to avoid serious injury. In this post I’ll discuss two strategies. First, improving her ability to walk safely. Experts call these “intrinsic factors”. Second, creating a “fall-proof” environment. Experts call these “extrinsic factors”. There is […]