My Dad is 85 years old. He has had hypertension for decades, but it is getting harder to control. He’s on 2 medicines and his blood pressure is still over 160. His doctor is suggesting another medicine. Is that a good idea? We all know that hypertension is bad. How important is it to decrease the systolic pressure below 160 mm in a patient who is over 80 years old? This is the first of two articles about blood pressure. The first article discusses the benefits of treatment. The second article discusses a challenging and […]
Category Archives: Dr. Warren
Heart Rate in Frail Older Patients | Too slow, too fast, irregular, and just right
My Mom is 86 years old and “frail”. She has been in and out of the hospital for heart problems. I’ve been checking her oxygen levels, her blood pressure, and her heart rate. Her heart rate is usually around 55. Sometimes it dips as low as 48 then goes back up. That seems slow to me. Her PCP says that her slow heart rate is due to her medicines. Is her heart rate too slow? Is it making her weaker? Is she getting enough oxygen to her brain? In the above scenario, the patient’s heart […]
Fever in a Frail Older Patient | Always a Warning Sign
Tom is the main caregiver for his mom, Beth. He is worried that she’s sick. He calls the doctor: “Hi Doctor, I’m worried about my mom. She just doesn’t seem herself. She doesn’t want to get out of bed. She looks weak. She recognizes me but she isn’t talking. She’s not eating either.” Does she have a fever? “I’m not sure, she feels kinda warm.” How do you know when a frail older person has become sick? In this and future posts I will talk about the importance of They are called “vital” signs for […]
3 Important No-no’s | Talking to a Person with Dementia /Alzheimer’s Disease
Dad has Alzheimer’s disease. You are a loyal daughter (Jill) who visits often and brings his favorite foods. On one visit, Dad has a big smile when he sees you. “Hi Mary” “Dad, I’m NOT Mary. (Mary is your older sister.) What’s my name?” “Oh, gosh. Where’s Mary?” “Dad, I’m Jill!! Why do you always ask about Mary? Are you trying to get on my nerves?”
What’s the Most Likely Outcome in Your Case?
Mom Has Been Misplacing Things Your 84-year-old mother has Alzheimer’s disease. She has always tended to be anxious. Now that she has Alzheimer’s disease, the anxiety is much worse. She has been misplacing things such as her glasses and medicines. This happens frequently and she quickly becomes upset. She will claim that somebody took them. The hired caregiver becomes so fed up with the constant accusations that she leaves. “I didn’t want her here anyway,” says Mom. “She kept stealing my things!” The caregiver is gone but things continue to disappear: “Where did you put […]
Agitation – A Clear Description Leads to the Best Action Plan
A nurse working at night in the hospital calls the doctor asking for help: “I have a patient, Mrs Jones. She’s very agitated. Can you order some Imagine being the doctor in the above situation. The request can have multiple outcomes. The night doctor does not know the patient well. In addition, the doctor is busy and does not want more phone calls about the patient. In the worst-case scenario, a high dose of the medicine is ordered. The patient subsequently becomes over sedated and the next day she chokes on her food leading to […]
She Doesn’t Want to Do Anything? Is that Depression? Maybe Not
“Mom used to enjoy shopping, seeing friends, and going out to eat. After she was diagnosed with mild Alzheimer’s Disease, she’s changed. Now she just wants to stay at home and sit there.” It’s logical to think that a person with Alzheimer’s Disease might be depressed. After all, isn’t it a depressing disease? Depression IS commonly seen in Alzheimer’s Disease and other types of dementia. Loss of interest is a key feature. However, there is another possibility that is frequently overlooked. That person may have apathy, a loss of interest in doing things. Let’s take […]
The Brain is Like a Computer | Is It just Getting Older, or Is It Getting Dementia?
What is dementia? Here are some simple concepts to start with: The brain does three very important things. Each of these is impacted when a person develops dementia. The brain can be thought of as an amazing, living super computer. Dementia is a general term for diseases that injure the brain over time. An old brain is not the same as an injured brain. Three Important Things a Brain Does The first moments of life are unforgettable. A baby is born and starts crying. From that moment forward, the brain will experience a lifetime of […]
Is Mom in the Hospital? Remember the 8 Ds
