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 […]

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? […]

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 […]

A Special Relationship Between the Older Adult and the Caregiver

In a previous post, my friend Shannon talked about gracefully and thankfully accepting a caregiver at a certain stage in life.  Today’s post is Part 2 of our discussion. Shannon talks about the relationship “rules” that both the caregiver and the client need to keep in mind to make the relationship a strong one.

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What is Causing this Person’s Weight Loss?

In my last post I talked about a patient who had some bleeding in her brain. That was the obvious diagnosis. However, I'm frustrated because an important diagnosis was missed. It was immediately obvious that she was severely underweight. I looked through her chart carefully. Her weight had gone from 89 pounds to 74 pounds in a little bit over a year. No one had mentioned this.

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Why did my patient have a Subdural Hematoma?

Last week I was busy taking care of some patients. I reviewed the chart on a patient who recently had some falls and bleeding in the brain. She had a “subdural hematoma”. What is a Subdural Hematoma? Subdural hematoma is a medical term for bleeding between the brain and the skull. The bleeding can be a small or large amount and is easily seen on CT scan of the brain. The bleeding is due to bursting of veins on the surface of the brain. This is usually related to an injury to the head although […]

I expect to be frail at some time in my life. What decisions will I make?

Most of us will become frail before we pass away, especially if we live to an old age. Will we still be happy when we become frail and need help from others? How can we be both happy and not a burden to loved ones? My friend Shannon has poor vision but in other ways she sees things very well.

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