May is Older Americans’ Month—the month we celebrate older adults and all they have contributed and continue to contribute throughout their lives. The theme of this year’s Older Americans’ Month is “Unleash the Power of Age.”  However, it’s hard to unleash that power— and do all that you can do with it—if you find depression is holding you back.

When we think of depression, we usually think of sorrow. But symptoms of depression in older adults may be different from those in younger people.  They can include irritability, anxiety, and social withdrawal.

More familiar symptoms of depression include:

• memory problems
• confusion
• eating too little or too much
• weight loss or gain
• complaints of pain
• sleeping too little or too much
• delusions and
• hallucinations

It’s important to recognize signs of depression in older adults and seek treatment as soon as possible. If untreated, depression can get worse, and can keep people from being engaged in life and from doing the things they enjoy. Depression is particularly common among older people. In part, this is because older adults are more likely to face significant loses than younger people. These losses include declines in health, functioning, and independence, as well as the loss of spouses, other family members, and friends.

But there’s good news: Depression in older people can be successfully treated with medications, “talking therapy,” exercise, and other approaches. In fact, about 80 percent of older people respond well to treatment, according to the National Alliance on Mental Illness.

For additional, expert, and comprehensive information about depression in later life, and how to avoid and treat it, click this link.

So don’t let depression hold you back.  If you have symptoms of depression, contact your healthcare provider. If you have a relative or friend who seems to be depressed, urge him or her to do the same.  Focus on staying involved with people you enjoy, sharing activities you find rewarding.  Both are essential to your mental health, no matter what your age.  For a wide range of things you can do with others to celebrate older people’s contributions and to inspire yourself and others to embrace “the power of aging,” visit the Older Americans’ Month website at http://olderamericansmonth.acl.gov.

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: www.nhdd.org.  Additionally, please help spread the word with Twitter, Facebook, 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.

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.

Some societies developed and published their Choosing Wisely lists last year. The AGS and others in a second group published theirs this week. And a new group of societies is now working on their lists. So, the Choosing Wisely campaign is growing, gaining momentum, and getting more and more attention from the public, from healthcare professionals, and from the media.

I encourage you to check the AGS’ list, which includes five treatments that may pose more risks than benefits in older people. Check to see if any medications or other treatments you’ve been prescribed are listed. This is particularly important for older adults. Why? Treatments that may be helpful for younger adults may not be safe or reliable in older people, because of physical changes that take place as we get older. For example, older people may respond differently to medications than younger adults.

In addition to reviewing the AGS list, you can also check the lists developed by other organizations at the Choosing Wisely website. Don’t worry if a test or treatment your healthcare provider has recommended is on one of the Choosing Wisely lists, and don’t stop a treatment if it’s on the list. Just because a test or treatment is listed doesn’t mean it’s unreliable or ineffective for you. Different people respond differently, and there is no “one-size-fits-all” when it comes to medical care.

But be sure to ask questions. Talk to your healthcare provider and sort it out. The Choosing Wisely campaign’s goal is to spark conversations about potentially unnecessary tests or treatments and to empower the public to ask questions of their healthcare providers.

To help you understand the items on the AGS’ Choosing Wisely list, the AGS Foundation for Health in Aging has developed “Ask the Expert” resources for each of our five items.

You can find additional, easily understandable background information about the AGS’ “five things.” Just visit the  “Choosing Wisely” section under Health A-Z. Complementing these resources, Consumer Reports has posted supplemental information on http://www.choosingwisely.org/. Enlightened reading!

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.

Heart disease is more common in men, particularly those with a strong family history, but it can strike anyone without warning at any time. Many people do not realize that, in addition to men, heart disease is the number one cause of death in women.

It is critical to recognize the symptoms of a possible heart attack and take immediate action. Don’t assume that it is indigestion or a muscle ache from overexertion. When in doubt, check it out.

Symptoms of a heart attack include:

• Chest pain or discomfort such as a feeling of squeezing, fullness, or pressure
• Pain in the upper arms (more common in men)
• Pain in the back, jaw or stomach (more common in women)
• Shortness of breath
• Nausea/vomiting (more common in women)
• Profuse sweating
• Light-headedness
• Unexplained anxiety (more common in women)

If you think that you are having a heart attack:

• Do not wait
• Call 911 – do not have a relative drive you to the hospital or worse, drive yourself
• Immediately chew an uncoated adult aspirin or 3 baby aspirin (an aspirin must be chewed and not swallowed whole to offer heart protection benefits).

Remember: Time is critical in protecting your heart muscle.

Healthinaging.org has a wealth of information about the causes and symptoms of different types of heart disease. You will also find information about ways to prevent a heart attack through lifestyle choices such as not smoking, eating a heart healthy diet, and exercising.

A healthy heart is the best Valentine’s Day present we can give to ourselves and to those around us. I encourage you to celebrate this Valentine’s Day by doing something good for your heart!

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 healthinaging.org – the source of a wealth of easy-to-read health information for seniors that’s reviewed by leading experts in elder health. These include:

• Tips for Beating the Holiday Blues and Depression in Later Life
• Winter Safety Tips for Older Adults and Tips for Protecting yourself from Falls and Fractures.

You’ll also find 10 Healthy New Year’s Resolutions for Older Adults on healthinaging.org. 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 AGS Foundation for Health in Aging is committed to helping prevent falls.  We have created a series of five new, easy-to-follow videos illustrating how older adults can avoid falls. I encourage you to take a look and to share these videos with others.

The Foundation’s new falls prevention videos cover:

What you can do to avoid falls at home—simple things you can do to prevent falls, such as making sure all your rugs are firmly fastened to the floor or have nonskid backing; and installing night-lights in your bedroom, hallways, and bathroom.

Falls assessment—a quick, simple, and reliable test your healthcare provider can use to determine whether you’re at increased risk of falling.

How your healthcare professional can help lower your risk—things your healthcare provider can do to help you lower your odds of falling, such as : identifying whether any of your medications or supplements might increase  your risk of a fall and finding safer alternatives; and checking your balance, vision, leg strength, blood pressure, and the way you walk, and recommending exercises and lifestyle changes to make you surer on your feet.

How to choose and use a cane—expert advice for choosing the right cane, in the right size, and using it appropriately.

How to choose an use a walker—an explanation of the different types of walkers, and advice for finding and using the right one.

The expert content for all five videos comes from Healthinaging.org, which includes a wealth of additional information, tips, and tools to help older adults prevent falls. Just type “falls” in the search box above, and start lowering your risk today.

So this month—National Family Caregiver Month—and beyond, we at the American Geriatrics Society Foundation for Health in Aging (HIA) hope you’ll show your support for the women and men you know who are caring for their aging relatives. While growing numbers of husbands, sons, brothers, nephews, and grandsons are now playing this role, they may be less likely than women to reach out for help with caregiving when they need it, according to a recent Wall Street Journal article. This means we need to do more to reach out to them.

Organizations and services for family caregivers are already doing this. The Journal story, for example, spotlights a Colorado home care service that created a virtual community just for men—www.malecaregivercommunity.com—thinking it would be more appealing to male caregivers . It has been. “Since it started in June, more than 84 discussions have developed,” the paper reports.

In addition to support, family caregivers also need top-notch information. And that’s where Healthinaging.org comes in. Among other things, it offers comprehensive information about caring for even the most medically complex older adults—those with multiple, chronic health problems. Just as important, it offers information about caring for yourself if you’re a caregiver. We hope you’ll mention the site to the family caregivers you know— men and women alike.

Healthinaging.org is pleased to feature this guest blog from Anand K. Parekh, MD, MPH, HHS Deputy Assistant Secretary for Health (Science and Medicine).

Did you know that 75 million Americans, including three of four persons over 65, have multiple chronic conditions? This means the typical senior may not only have diabetes, he or she may also have arthritis, high blood pressure and perhaps even asthma.

That’s a lot to manage.

And people with multiple chronic conditions are at higher risk for hospitalizations, hospital readmissions, and adverse drug events.

The U.S. Department of Health & Human Services (HHS) has put together a plan to help in managing multiple health problems. The plan has four goals: to foster health care and public health system changes, to maximize the use of self-care management, to provide tools and information to health workers, and to facilitate research to fill knowledge gaps.

At HHS, we’ve supported significant research on health outcomes among individuals with multiple chronic conditions and have created a nationwide research network. We’ve worked with partners such as the National Quality Forum to create tools that will facilitate the development of quality measures for this population. These measures help patients and families determine whether their healthcare providers and facilities are using well-tested approaches to caring for people with multiple conditions. And finally, we’re working with the research and regulatory community to ensure that individuals with multiple chronic conditions are included in research studies.

In addition, the Affordable Care Act provides new and innovative ways to tackle this public health challenge. Millions of Americans with multiple chronic conditions are now eligible for preventive care, such as flu shots, blood pressure and cholesterol tests, mammograms, and colonoscopies – free of charge. Many are also participating in new care coordination models, such as “medical homes” and “accountable care organizations,” which promote the use of electronic health records and other mechanisms for managing patient care, so that those with multiple doctors can be confident that all their doctors have the information they need.

So, if you have multiple chronic conditions, here are four tips that may be helpful:

1. Identify a medical quarterback. It’s critical to have a provider, usually a primary care physician, who is responsible for managing all your conditions and medications.
2. Make healthy choices. It’s estimated that 80% of heart disease and stroke, 80% of type 2 diabetes, and 40% of cancers could be eliminated if Americans would do three things: stop smoking, eat a healthy diet, and get regular exercise.
3. Take advantage of community resources. There are many local resources that can support opportunities for health promotion and disease prevention. Find a trusted organization, such as a local YMCA or Area Agency on Aging, to see if they have programs that may be able to help you.
4. Monitor your medications. People with multiple chronic conditions usually take multiple medications. Develop a reminder system to make sure that you’re taking your medications at the right time.

By taking these four steps, people with multiple chronic conditions can optimize their health status and quality of life.

The American Geriatrics Society’s guiding principles on managing the care of older adults with multiple health problems builds on our work at HHS. We are pleased to share and promote our common goal of optimizing the health and quality of life for older adults with multiple chronic conditions.

Tell us about your experiences caring for friends and family or patients with multiple health problems, or how you’ve managed your own complex health issues.

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.