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 […]
Category Archives: Geriatrics with Aloha
Teepa Snow
Warmest Aloha,
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.
She was falling too often. We made the difficult decision to put her in a nursing home.
The last several posts have been about fall prevention strategies. However, there are seniors who continue to fall frequently despite interventions. Some individuals are unstable as soon as they stand up and start walking. Other “frequent fallers” have dementia, poor judgement, and impaired impulse control. An accident can happen as soon as you’re not watching. Frequent falls can result in the decision to put a person into a nursing home. But nursing homes have limited success in reducing falls. Nursing home strategies include health assessments, medication review, exercise programs, and environmental improvements. However, falls continue […]
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 […]
A Major Fall Waiting to Happen
Yikes, my 93-year-old Mom fell. Fortunately, it wasn’t serious, and I only heard about it the next day. Help arrived promptly since it happened outside. She was taken to the Emergency Room for evaluation and triage. They made the initial determination that she was stable enough to wait. After 8 hours of waiting, she decided she felt just fine and left. She’s not looking forward to going to the ER again. I’m not at all surprised that my Mom fell. That’s because it’s not the first time. A previous fall is the highest single predictor […]
Will Kate Fall Again?
Kate is an 84-year-old widow with mild Alzheimer’s Disease. She lives alone and in the past year she has lost 10 pounds. She has also fallen multiple times. This is serious. The last time she fell she was on the floor for at least 8 hours. Her daughter called and then came by when Kate didn’t answer the phone. She was hospitalized for a condition called rhabdomyolysis. Afterwards, she was in a skilled nursing facility before returning home. She regained weight and received physical therapy. The daughter has “decluttered” the apartment to decrease the risk […]
I’m still a person
The physician who hired me decades ago was a leader. It took his entire career but against a great deal of resistance, he built a premier healthcare system. Even so, he always had time for me. Whenever I stopped by, he would always pull up a chair. It was as if my activities and ideas were just as important as his. There’s something else I remember. I became his healthcare provider not long after he developed Parkinson’s Disease. He ended up being a frequent user of the healthcare system he built. He had many falls. […]
Three Pillars of Dignity: Dr. Warren joins Amy Goyer on Facebook Live
Amy Goyer has taken care of her mom, dad, and sister all at the same time. She is the real deal, a sandwich generation caregiver. Amy is author of the book: “Juggling Life, Work, and Caregiving”. She also hosts the AARP Caregivers Discussion Group on Facebook. Amy and I had a strong connection ever since we met in Hawaii during pre-Covid days. Last week, we finally had a chance to videochat with her caregivers group. We decided to talk about a particularly important topic: dignity. Why dignity? Because it’s one thing to take care of […]
Asleep All Day and Awake all Night
Joan is a retired elementary school teacher. She is the kind that students remember with great fondness. Now she’s 84 years old and life has changed. She has Alzheimer’s Disease and lives with her daughter’s family. Although she can still hold a conversation, she is anxious. She falls asleep for long periods during the day but is frequently awake at night. Then she goes from room to room switching on the lights and searching for her cat. Her PCP prescribes a sedative. However, one night, Joan’s search for the cat leads her outside, and she […]
YOUR Path to Good Sleep
The last several posts have been about the importance of sleep and the barriers that older adults face. We’ve all seen ads for expensive beds that will miraculously improve sleep. But buying an expensive bed is not the right way to start. It’s also not the correct first step to ask a health care provider for a sleeping pill. A logical, calm, and customized approach is needed. This post is about finding YOUR path to the best sleep possible. Sleep clinics consistently start with a sleep journal Journals examine sleep patterns over a period of […]