Keeping & Organizing Medical Information (tips for caregivers)

I stumbled across series of three posts by a geriatrician, Dr. Leslie Kernisan, from the summer of 2013.  The three posts in the series are:

1- Journal/notebook for notes and symptoms

2- Portable and up-to-date medication list

3- Organizer to keep copies of medical results and medical records, and Personal/family task organizer.

In the third post of the series, the author discusses:

* Why caregivers should keep copies of medical results and key health information
* The most useful types of medical info to keep copies of
* How caregivers can maintain a personal health record for an older adult

The final section on maintaining a personal health record was the most valuable.  Here’s the author’s “main recommendations regarding keeping and organizing medical information”:

“I do always recommend that patients and caregivers maintain some kind of personal health record (PHR), in which they at a minimum keep copies of test results.  It is perfectly ok to just maintain a folder or binder with this information on paper. However, keeping digital copies of the information provides a good backup. If you find an online PHR that makes it easy to enter information, this is a good option too.  If as a caregiver, you ever need to take an older person to see a doctor on short notice, having test results and an up-to-date medication list will go a long way towards ensuring that doctors can provide the right medical care.”

As far as an digital record is concerned, the author seems to have a preference for Microsoft HealthVault,

And a reader commented with a good suggestion about the binder:  “Tape a large ‘IF FOUND, PLEASE CONTACT…’ note on the inside of the binder in case it gets lost.”


Risks of polypharmacy during and after a hospital stay (Washington Post, 8-15-16)

This Washington Post article is about the risks of polypharmacy — taking multiple medications — among the elderly, especially during and after a hospital stay.  The two angles of this particular article are that lots of medication is administered at the hospital that may not be needed, and patients bring home medication from the hospital (“souvenirs”) that may not need to be continued.

Some key excerpts from the article in today’s paper:

* “Older adults account for about 35 percent of all hospital stays but more than half of the visits that are marred by drug-related complications, according to a 2014 action plan by the Department of Health and Human Services. Such complications add about three days to the average stay, the agency said.”

* “Even if a drug doesn’t cause an adverse reaction, that doesn’t mean the patient needs it. A study of Veterans Affairs hospitals showed that 44 percent of frail elderly patients were given at least one unnecessary drug at discharge.”

* “Some drugs prescribed in the hospital are intended to treat the acute illnesses for which the patients were admitted; others are to prevent problems such as nausea and blood clots. Still others are meant to control side effects of the original medications.”

* “A 2013 study found that nearly a fifth of patients discharged from the hospital had prescription-related medical complications during their first 45 days at home. About 35 percent of those complications were preventable, and 5 percent were life-threatening.”

* A geriatric pharmacist working at a UCLA hospital “tries to answer several questions to determine what’s best for a patient. Is the drug needed? Is the dose right? Is it going to cause a problem?”

* “One of [the pharmacist’s] go-to references is known as the Beers list, a compilation of medications that are potentially harmful for older patients. The list, named for the doctor who created it and produced by the American Geriatrics Society, includes dozens of medications, including some antidepressants and antipsychotics.

Link to the Beers list

Access is free but you do have to register for online access.

Here’s a link to the Washington Post article:

Health & Science
‘America’s other drug problem’: Giving the elderly too many prescriptions
Washington Post
By Anna Gorman
August 15, 2016 at 3:51 PM


Six tips for care professionals on handling difficult families

A Place for Mom ( has a Senior Living Blog.  In a post last month, someone noted that senior care professionals often handle difficult patients but sometimes the families can be even more difficult.  Six tips were shared:

1. “Work on Your Perspective” – view the upset family member as an ally.

2.  “Practice Your Soft Skills” – ask gentle questions to clarify the family member’s concerns.

3.  “Be Professional” – state your points firmly and calmly, or ask a colleague to step in.

4.  “Set Boundaries” – if someone is yelling at you, tell them you need to leave if they continue yelling.

5. “Don’t Get Hooked” – keep communication brief and let the family member know how much time you are able to talk.

6. “Keep Families Involved” – good communication with family members is invaluable.

The post is copied below.



Handling Difficult Families
Senior Living Blog on
By Katherine O’Brien
July 28, 2016

We’ve all had difficult patients, but sometimes it’s not the patients, but the families who will give you grief.

6 Tips for Handling Difficult Families

Before you lose your cool with the argumentative daughter, opinionated son or the partner who regularly makes a scene, have a glance at our six tips for dealing with challenging family members.

1. Work on Your Perspective

First off, when dealing with unpleasant family members, don’t waste energy trying to change their behavior; instead, strive to change something that is in your control, namely, your own attitude. Look past a caregiver’s demands and confrontational manner so that you can muster up some empathy. (Imagine how you would feel if your mother and father were incapacitated or in pain.) And try to view adult children as allies, rather than adversaries; after all, you do both want the best for their parent.

2. Practice Your Soft Skills

When a caregiver is upset rather than attacking it pays to take the time to actively listen to their concerns. Sometimes they just need to vent, and your hearing them out might relieve some of their anxiety. Even if that’s not the case, if you can, stop what you are doing so that you can be fully present, listening to what they are saying, instead of thinking about how to respond. You should also reflect back what you heard them say in your own words, then ask gentle, probing questions to clarify their concerns and get to the root of their problem. Sometimes, you’ll discover that the issue they appear to be upset by (Dad being dressed in sweats instead of “regular” pants) is not their real concern. They might be feeling helpless over their father’s situation or feel that that the residence is not relaying information in a timely manner.

3. Be Professional

If a family member is attacking rather than upset, know that their tantrum might have little to do with anything you have done and a lot to do with their fear or anger. So, instead of defending yourself or engaging in an argument, try to emotionally detach, stating your points firmly and calmly, while maintaining open body language (don’t cross your arms when facing them, for instance). If you are too emotionally triggered to do this, take some deep breaths, which can aid in calming you down. It’s better to leave the room, at least momentarily, than to fight back. In some cases, it might help defuse the situation if a colleague steps in and takes over.

4. Set Boundaries

Remember that listening to verbal abuse is not in anyone’s job description. If a relative yells at you, for example, ask them to stop, letting them know that you will leave the room if their behavior does not change. (Don’t forget to report and document this behavior.)

5. Don’t Get Hooked

Also, along the lines of setting boundaries, avoid getting into long, unproductive conversations with someone who is argumentative. Instead, keep the communication brief and to the point, letting the caregiver know the amount of time you have available to talk. If they are pelleting you with questions at a time when you have a lot on the go, ask them to write their questions down so that you can answer them in one shot when you’re available.

6. Keep Families Involved

It’s not always easy to coordinate care plan conferences with family members who live out of town or who work in the daytime, but don’t let this be an excuse for carrying on without their participation. Instead, find a time that works for them and ask them to join the meeting via phone or secure video chat. On top of this, make sure that they are always kept in the loop about any changes in their parent’s condition or in the treatment plan. Remember, good communication can go a long way.


After caregiving (when a loved one dies)

Someone in our local support group who just lost a parent sent me this article from  Though the article is from, I think the article applies to any caregiving relationship.

The author of the article quotes the author of a book on caregiving:  “Caregiving is a never-ending test of your strength, until one day it stops and the feeling of ‘what do I do now?’ mixed with sadness begins.”

Here are some “tips for transitioning back to your own life after a loved one you’ve been caring for, dies”:

1.  Seek Out Support – A bereavement support group…can be very helpful.

2.  Know that Guilt is Normal – Caregivers commonly feel guilt: guilt that you may have been angry at your loved one for getting sick in the first place; guilt that you didn’t do enough; and guilt that you couldn’t save them. … It is also normal to feel relief when your loved one dies, both because they are no longer suffering and because you no longer have to carry the responsibility of their care.

3.  Take Care of Yourself – When you’re caregiving, it’s all too easy to let your own needs fall to the wayside. … Make that dentist appointment that has been on your to-do list for months, get your haircut, and, while you’re at it, do something a little extravagant for yourself like getting a massage or buying a new handbag.

4.  Welcome the Extra Time – Family, friends, and faith organizations are where most people start to reconnect with the world.

5.  Reach Out to Friends

6. Enjoy Quality Time with Your Spouse

Here’s a link to the article:

After Caregiving: How to Fill the Void
Tips for transitioning back to your own life after a loved one you’ve been caring for, dies.
By Anne Fritz


Conditions with symptoms similar to dementia

This post may be of interest to those dealing with dementia-like symptoms and wondering if there are other causes besides neurological disorders.

An article, in Next Avenue, is about non-neurodegenerative conditions that cause dementia-like symptoms.  See:

Is It Dementia? Maybe or Maybe Not
Other conditions come with similar symptoms, experts say
Next Avenue
By Emily Gurnon, Health & Caregiving Editor
August 3, 2016

Lots of conditions present with dementia-like symptoms — depression, medication side effects, nutritional deficiencies, or metabolic problems, for example.  The key to knowing if it’s dementia or something else is testing.  Sometimes that’s neuropsychological testing, blood tests, depression testing, or neuro-imaging.  Or changing medications.

My father had progressive supranuclear palsy (confirmed through brain donation).  When we saw the first neurologist, I was very surprised when the neurologist ordered a syphilis test.  He said he wanted to be as sure as he could be that it was PSP and not something else.  Sure enough, syphilis is listed below as a condition causing dementia-like symptoms.