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 […]
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 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 […]
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.
Finding a frail older person on the floor is stressful and chaotic. In this post, I provide some guidelines about what to do after a fall. Manage falls carefully. There can be major injury even if pain is not severe. Falls can also be due to a new medical problem. The most important points are: Step by Step Care After a Fall Call 911immediately for emergencies. Even for non-emergencies, do a 5-minute assessment before moving the person. Move the person into a sitting position if she/he appears stable. Provide follow-up care. Prevent future falls. Be […]
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 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.