On a curiously warm morning last February, the minister arrived at my childhood home to guide my father to the other side. When he approached the bedside where all of us were gathered around with the Eagles Pandora radio humming in the background, my dad emerged from a semi-conscious state and sat up as best as he could. “Listen. I am not dying,” he declared. As an early-career researcher focused ...

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Many of us have moms and dads or older friends and relatives in nursing home facilities and care very much about their well-being and the supports they receive. But who’s caring for the care aides who do the bulk of the frontline work in nursing homes? Their welfare is almost entirely overlooked in the health system. And it turns out, the health of the care aide affects the Read more...

How do we balance freedom and safety for those with dementia, particularly in the risky domains of sex, driving and money? In 2014, Henry Rayhons, a 78-year-old Iowan, was arrested because he allegedly had sex with his wife. Wait. What? The Rayhonses, both previously widowed, met while singing in a church choir. Over time, Mrs. Rayhons developed dementia and went into a nursing home. At one point, a roommate reported hearing ...

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The digital divide used to be about who had internet access and who didn't, with broad implications for every aspect of life — especially health care. But digital health innovation is growing rapidly, with projections showing a $536.6 billion market by the end of 2025 compared to the $179.6 billion market at the end of 2016. So, what does that mean for the digital divide? We ...

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I am not a doctor of finance.  I’m a medical doctor.  So when I enter an elderly patient’s home, I’m not expecting to do a wallet biopsy.  Whether they can pay me or not is of little consequence.  I do think, however, about whether they will be able to afford the care I prescribe.  Will they have enough to pay for that extra caregiver?  Is there cash to keep a roof over ...

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If one more person tells me to be sure to take care of myself, I'm going to bury my face in a pillow and scream. "Go for a walk, take a vacation," they advise. I know they're trying to help, but really? Giving me one more thing to do? Oh well, they're just doing the best they can. I moved my folks across the country, from Florida to Washington State, and into ...

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Signing the divorce papers was probably Charlie’s lowest point.  His wife sitting by his side, occasionally she would swat at the air at some invisible fly buzzing around the room.  There was no fly.  Just the acrid smell of the nursing home, a horrifying mix of sweat, shit, and desperation.  He tried to focus his aged eyes on the legal papers as the tears swirled past his nose and losing traction, fell ...

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Martha (not her real name) was not an overly complex case in my field of geriatric psychology. But the case was complex enough to require multiple approaches and reliable follow up. And in rural Mississippi, follow up can be elusive. Soon it occurred to me that Martha’s case is emblematic of how caring for this vulnerable population often runs up against a huge problem -- the Medicare merry-go-round. A 78-eight-year-old with ...

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The recent passing of former first lady Barbara Bush, an American icon, also brought a commonly debated discussion to light, palliative, and end of life care. Many articles were published regarding her last days, mentioning she was “foregoing further medical care” or “no longer pursuing medical treatment.” These types of statements are not only inaccurate, they also minimize the incredible medical care provided by palliative care and hospice teams. To realize ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. I recently saw a 74-year-old patient to establish ongoing care. In reviewing her medical history, she presented me with the list of the 15 medications she was taking. I was a bit shocked given her medical history which really consisted of only the ...

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