“There’s Nothing Like a good Bowel Movement” made the point that chronic constipation is all too common and distressing among seniors. In the past, doctors defined constipation as having fewer than 3 bowel movements a week. Anything else was considered “normal”…hmmm…really?? Obviously, the patient was much more uncomfortable than the physician. We now evaluate constipation more broadly, starting with the patient’s perspective. Here are two important questions: Question 1: What bothers the patient the most? Different answers mean different problems. A. It’s very painful to have a bowel movement. Sometimes only small pieces of stool […]
There are 3 questions that I always ask my patients. They are about “E, S, B&M”: How well are you eating? How well are you sleeping? How are your bowel movements? These are questions that patients are glad I ask. They show that I care about life’s most basic needs. It’s a doctor’s more specific way of asking “how are you doing?” ESBM are important in childhood, adult life and as people get older. The answers to these questions are “life” vital signs. Just like heart rate or respiratory rate, they give me clues about […]
In the last several videos, Dr. Ariel Green, an Associate Professor at Johns Hopkins University School of Medicine, discussed risks related to medication use among older adults. She has also described problems associated with specific classes of medications. Here are some bottom-line points: Polypharmacy – Too many medicines The greater the number of medications a person takes, the higher the likelihood of problems. This includes side effects, interactions between medicines, and mistakes in taking medicines correctly. Five or more medicines is a rule of thumb that doctors use. More medicines are likely to result in […]
Holidays are a time of gift giving. Remember to give yourself an especially important gift: the “just right” amount of connection with others. Caregiving is hard work. Take care of yourself. If you don’t treat yourself well during the Holidays, when will you? Give yourself the gift of connection. I believe that there are five keys to a happy life: 1) having a sense of purpose 2) feeling spirituality 3) doing things that you enjoy 4) taking care of your body AND 5) connecting with other people. Think of these as your daily emotional vitamins. […]
In previous posts, Dr. Green had discussed some of the hazards associated with medication use among older adults. She has also discussed classes of medications that are of concern. In this final post, Dr. Green discusses approaches she has used to deprescribing. Warmest Aloha, [email protected] 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.
In our last post Dr. Ariel Green described a patient who improved dramatically when many of her medicines were stopped. In this video, Dr. Green describes the classes of medications that can cause problems in seniors. Dr. Green is an Associate Professor of Medicine at the Johns Hopkins School of Medicine, Division of Geriatric Medicine. Warmest Aloha, [email protected] 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.
Whether it’s hypertension, diabetes, arthritis there’s always a prescription. For every problem there’s one or more drugs. But is this always good? Dr. Ariel Green, Associate Professor of Medicine at Johns Hopkins School of Medicine points out that medicines are sometimes the problem. Geriatricians know. Every pill is a potential problem. Warmest Aloha, [email protected] 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.
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 […]
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. […]
For more than 30 years, Dr. Sharon K. Inouye has dedicated herself to the identification and prevention of delirium in the hospital. She is the founder of the widely replicated Hospital Elder Life Program (HELP). In her last video, Dr. Inouye described prevention of delirium and long-term outcomes. She now discusses the difficulties elderly patients face in the hospital. She also talks about her ongoing efforts.