National Healthcare Decisions Day

April 16 is National Healthcare Decisions Day, and I hope that you will take this time to discuss and document your healthcare wishes.  We all need to be prepared in the event of a health crisis, and having the talk is easier than most people think, but many of us need a little inspiration or a reminder to do it.  I hope that this message and National Healthcare Decisions Day are all you need.

Please take some time today and have the talk with your loved ones.  There are all sorts of free resources, including free advance directive forms for each of the 50 states and a great short video to get you thinking and talking, on the NHDD website:  Additionally, please help spread the word with TwitterFacebook, and LinkedIn.

Advance care planning is something we ALL should do and encourage others to do, regardless of age or current health.  Discussing your wishes can be one of the most important gifts you ever give your loved ones.


American Geriatrics Society Helps You “Choose Wisely”

This week, the American Board of International Medicine (ABIM) Foundation published the latest of its ground-breaking Choosing Wisely® “five-things” lists, and I’m pleased to report that one of these new lists comes from the American Geriatrics Society. In case you’re not familiar with these important Choosing Wisely lists, here’s a little background:

Two years ago, the ABIM Foundation and Consumer Reports launched the Choosing Wisely campaign to encourage people to learn more about the tests and treatments their healthcare providers recommend, and to question and discuss these with their healthcare professionals under certain circumstances. There are two parts to the Choosing Wisely campaign. Numerous medical societies have gone through an in-depth review process to identify five tests or treatments for which there may not be enough medical research that shows safety or effectiveness. In some cases, the research may even show unwanted effects. At the same time, the Foundation and Consumer Reports have been encouraging people to check the lists to see if tests or treatments their healthcare providers have recommended are on them. If so, the campaign urges people to bring this up with their healthcare professionals and discuss it. Continue reading

Heart Healthy Reflections for Valentine’s Day

Valentine’s Day is a time of flowers, chocolate hearts, and celebrations of love and life.  For thousands of years, the heart has symbolized love and passion and has inspired great poetry, literature, art, and music. But maybe this year we should start a new tradition on Valentine’s Day: To check in with ourselves and those around us to look for signs of heart disease.

There are several types of heart disease, with coronary artery disease being the most common. It is estimated that more than 80 million Americans have at least one major risk factor for heart disease and stroke, such as high blood pressure, obesity, diabetes, and high cholesterol levels.

All told, some one million people a year will die of heart disease. Though one of the risk factors is advancing age, more than 150,000 heart disease and stroke deaths every year are among people younger than 65. With the rise in obesity and type 2 diabetes rates in children, we will likely see increased rates of heart disease and stroke occurring at earlier ages. Continue reading

My Favorite Time of Year…

This time of year has always been one of my favorites. It’s a time when things slow down a bit, allowing more time with family and friends – time to catch up, celebrate cherished rituals, and enjoy favorite foods and one another’s company. But while this can be a wonderful time of year, it can also be challenging, particularly for older adults.

For some older people, the end of another year can be a powerful reminder of how many years have already passed. Traditions like lighting the menorah candles or decorating the Christmas tree may bring to mind family and friends who are no longer with us. For some older adults, health problems can make it difficult, or perhaps impossible, to travel to traditional get-togethers with relatives and old friends. All of these things can contribute to the “holiday blues” or, more seriously, depression.

In colder parts of the country older adults may face other challenges. Older people run higher risks of injuries while shoveling snow, for example, and are more likely to develop frostbite and hypothermia –  a life-threating condition in which your body temperature drops to dangerous levels. Snow and icy weather can also put older adults at risk of falls and fractures.

The good news, however, is that there are many things older people, and their caregivers, can do to help address these problems. And you’ll find them on – the source of a wealth of easy-to-read health information for seniors that’s reviewed by leading experts in elder health. These include:

You’ll also find 10 Healthy New Year’s Resolutions for Older Adults on I recommend it for adults of all ages. In fact, I’ve resolved to make a few of the ten my own this New Year.

Here’s wishing you and yours a happy season!

The Conversation Project

It’s not easy to contemplate the end of your life and consider what kind of care you do, and don’t, want when that time comes. And it’s equally difficult to talk with a loved one about the kind of end-of-care care he or she would prefer. My guess is that discussions like these are particularly difficult for us in the US, where we tend to shy away from discussions about death in general. “We Americans don’t like limits, we don’t like boundaries, (and) death is the ultimate boundary,” the journalist Bill Moyers recently pointed out. “So why talk about something we don’t want to happen?”

The answer to that question is this: As uncomfortable as discussions about what we and our loved ones want at the end of life may be, these are among the most important conversations we will ever have. Deciding in advance what care we do and don’t want, while we are able to weigh the benefits and drawbacks of our options and share and discuss our choices with those we love and our healthcare providers, can make the difference between a good death and one that is less so.

Encouraging these essential conversations—with both your loved ones and your healthcare providers—is the focus of The Conversation Project, an important new initiative of the Institute for Healthcare Improvement. I hope you’ll visit the initiative’s website, and encourage others to do the same.

The Conversation Project was the inspiration of Pulitzer Prize winning journalist Ellen Goodman, who conceived of it after her mother’s death. “My mother and I talked about everything,” she  explained in a recent interview. “But when she was no longer able to make her own decisions, I realized we hadn’t talked about her wishes for the end of life. I understood only after her death how much easier it would have been if I had heard her voice in my ear as these decisions had to be made.”

Among other things, The Conversation Project website includes an extremely thoughtful and thought provoking feature, “Your Conversation Starter Kit.” It begins with some truly attention-getting statistics about what people tell pollsters they want at the end of life and, in contrast, what many of us actually get. It also includes thought-provoking questions that can help you clarify what you want, what roles you’d like your loved ones to play at the end of your life, and what your healthcare providers need to know. It also helps you figure out with whom, when, and where you want to have The Conversation, and tips for introducing the subject in a non-threatening way. Just as important, the site urges readers to take time to make these decisions, formulating them over the course of many, not one, conversation. I encourage you take a look at the starter kit and let it help you find where you want to go.