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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It had been a hectic day in the urgent-care clinic of my large family practice, and I was starting to worry about the time: My last two patients had put me thirty minutes behind. I felt relieved when I saw the note for the next patient: "Seventy-four-year-old female with UTI." A urinary tract infection! This should be quick and uncomplicated. I walked into the room to find a well-dressed older woman seated on ...

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An excerpt from At Peace: Choosing a Good Death After a Long LifeCopyright © 2018 by Samuel Harrington, MD. Reprinted with permission of Grand Central Publishing. All rights reserved. The momentum to treat in America is unmatched around the ...

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Part of a series. We are all aging every day, but mostly we ignore, do not recognize or deny it. Then all of a sudden, we look in the mirror and realize that older age has found us. Even then each person deals with aging differently. There is Dr. Seuss’ "Cat in the Hat" who sees nothing but adversity in aging. There are others who accept aging but ...

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Camille’s dark glasses disguised a black eye she suffered falling from bed, cowering to take cover. Someone fired shots near her bungalow’s back window again, a routine rhythm of her slice of Chicago that she has heard for years now. The 82 year old walks with a cane but carries a brick in her purse. She’s not afraid to use it on a badly behaving neighbor. Most would think she has more ...

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Cancer screening can save lives. Mammographies reduce the chance women will die of breast cancer; and colonoscopies reduce the chance people will die of colon cancer. But should my 93-year-old father receive a screening colonoscopy? The test is uncomfortable, carries risks, and costs money. Even more importantly, my dad probably won’t live long enough to benefit from the test. That’s why most medical experts think people like my dad—people unlikely to ...

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As we continue to lead longer and healthier lives, too many Americans aren’t taking advantage of an easily accessible set of tools that could protect their well-being into old age: adult vaccines. As a nation, we’ve embraced a regular schedule of vaccines for our children. But science shows that they are proven life-savers for us grown-ups, too. The numbers are staggering: tens of thousands of Americans die each year from flu ...

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