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 […]

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.


Warmest Aloha,

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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.

After a Fall-Handle with Care

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 […]