I have a dear friend who is incredibly accomplished and independent. I’ve always loved visiting with and hearing about her adventures — including sailing around the world on a sailboat when she was well into her 70s! But on a recent visit, I became concerned. Now 93, my friend was sleeping much of the day. She’d had some falls and was unable to reach her walker on the other side of the room. Most concerning, she’d lost weight. When I checked her kitchen, she had very little food. The leftovers in her fridge were clearly […]
Category Archives: Dr. Warren
Why Won’t Mom Eat? The Doctor says nothing’s wrong
Mom isn’t eating well and she’s losing weight. She is down to 85 pounds. I’m completely frustrated. “Mom, please eat, you’re losing weight.” She just sits there and refuses. I feel like I’m forcing her. I took her to the doctor. He did a bunch of tests. He says there’s nothing wrong. Should I be worried? I’m sorry but the answer is yes. We all notice when a person has lost too much weight. It’s alarming. Poor appetite and weight loss in the elderly result in a downward spiral of weakness, impaired healing, and dependency. […]
A Patient with Delirium. Don’t Say: “You’re Confused!”
Dr. Inouye has been discussing delirium. By coincidence I recently cared for a patient with acute and distressing delirium. Sue is an 80-year-old woman who has mild Alzheimer’s Disease. Recently she fell and fractured a small bone in her hand. She was seen in the emergency room and a cast was put on. She was given a narcotic, hydrocodone, to relieve the pain. That night, at 1:30 in the morning, she walked over to her neighbor’s house in her nightgown. Her husband was sleeping next to her but didn’t wake up. The neighbors brought her […]
Loss of Appetite: A Fifth Vital Sign
My mother was discharged from the hospital yesterday. She was treated for a serious urine infection. Now she won’t eat. She says she’s not hungry. I’ve checked her vital signs. They all seem ok. Should I be worried? Yes, this is something to be concerned about. In previous posts we discussed the four classic vital signs. They are heart rate, blood pressure, temperature, and respiratory rate. However, normal vital signs do not tell the whole story. Appetite is an important “fifth vital sign” in frail older adults. If this patient doesn’t eat, she will become […]
The Life of a Caregiver: Ojay Part 2
In a previous video, Ojay talked about how life changed for his parents. Over a number of years they moved from being hard working adult to becoming frail seniors. Over that time, Ojay became a full time caregiver. In this video, he talks about how his life has changed and about what has given him strength.
Respiratory Rate: What is Normal in Older Adults?
The four vital signs are taken at routine clinic visits. In previous posts, I’ve discussed blood pressure, heart rate and temperature. Respiratory rate is the 4th classic vital sign. Respiratory rate is the number of breaths that a person takes in a minute. The normal rate of breathing varies with age. Babies and children breath faster than adults. As we age, our lung capacity starts to decrease, and the respiratory rate goes up slightly. The normal range for an older adult is a respiratory rate of 14-20 at rest.
The Life of a Caregiver: Ojay
I wanted feedback on GeriatricswithAloha.com. A caregiver named Ojay provided that. In the process, I immediately felt that caregivers like Ojay, and patients like his parents, are the reason I’m working on GeriatricswithAloha. This is the first of a two part video about Ojay. This video talks about how he came to be a caregiver and his daily routine. It was a privilege to get a glimpse of his life.
Hypertension | What is a good blood pressure for an elderly patient? (Part 2)
My Dad has lived with us for two years ever since Mom died. He’s 87 now and has become more and more disabled due to recurrent strokes. Is there a better way to control his hypertension? He’s on 3 medicines and his blood pressure is still over 160. His doctor is suggesting another medicine. I’m very worried because he needs help walking. His pressure drops below 95 when he stands up. He gets dizzy and he falls a lot. I think it’s because of his meds. What is the best blood pressure for this person? […]