Meals on Wheels might do more than deliver hot food to isolated seniors: New research suggests it can serve as an early warning system for declining health.
The study included Meals on Wheels drivers in Guernsey County in Ohio and San Diego County, who were trained to use a mobile app to alert care coordinators if the drivers had a concern or noticed a change in a senior's condition.
The care coordinators then followed up with seniors to provide support and connect them with health and community services.
Over the 12-month study period, the drivers submitted 429 alerts for 189 clients. The most frequent alerts were for changes in health (56%), self-care or personal safety (12%) and mobility (11%).
Follow-ups on the alerts led to 132 referrals, with most for self-care (33%), health (17%) and care management services (17%), according to the researchers at West Health Institute, Brown University in Rhode Island, and Meals on Wheels America.
The study was published recently in the Journal of the American Geriatrics Society.
West Health and Meals on Wheels America plan to expand the research program to as many as 30 Meals on Wheels sites across the United States, that include about 40,000 seniors.
"By collaborating with Meals on Wheels America, we've developed a safe, cost-effective and scalable program to preemptively identify and address concerns that too often result in deterioration of a senior's medical condition or pose a major safety risk," said Dr. Zia Agha, chief medical officer at West Health Institute.
"We're excited learnings from this research program are now being implemented across the country within Meals on Wheels America's expanded program that will positively impact as many seniors as possible," Agha added in an institute news release.
In a special editor's note, Dr. Michael Malone, section editor in models of geriatric care, quality of improvement and program dissemination with the Journal of the American Geriatrics Society, wrote, "As health care systems struggle to address the social determinants of health, this innovative Meals on Wheels model may provide part of the solution."
The Story of Peter Pan Comes to Kentucky Nursing Homes
Nurse Nicole Gordon works with a performer in "Wendy's Neverland", at Sunrise Manor Nursing Home.
The dance is for Wendy’s Neverland, a play with characters and ideas from the story of Peter Pan nearly two years in the making.
Cast and crew call this number “the wheelchair ballet.” For Jeff, a Chicago-based artist, choreographing this was a no-brainer.
“Most of the residents are using a wheelchair at some point of the day — you know, even if they can walk — so let’s make that a dance,” he said.
TimeSlips' founder Anne Basting at the performance of "Wendy's Neverland" at Lee County Care and Rehabilitation Center in Beattyville.
Credit Elizabeth Kramer
There’s clamor daily when the staff members clear the dining room, and the music attracts onlookers. Sometimes the dance gains newcomers, according to Sonya Turner, Sunrise Manor’s quality of life director.
“One of our elders, she would come and watch, but yesterday she said I don't want to watch anymore. I want to be in the wheelchair ballet. I want to dance.”
Since early 2018, staff members and artists have led residents to create art and poetry that line the nursing home walls. They’ve led music sessions. There were no lines to memorize. The team worked with elders and staff to create their costumes.
Participants now include family members, and teen and adult musicians from Larue and Hardin counties and beyond.
This production mirrors others staged at homes in Beattyville and Morgantown. All were financed through a $700,000 grant from the Kentucky Cabinet for Health and Family Services collected from penalties levied on nursing homes and similar facilities.
Signature Heathcare’s Quality of Life Director Angie McAllister brought this initiative to the company.
“A lot of people bring the arts to kids and they forget elders, and the need for their personal expression and how that need grows. And to help facilitate a gain for them is a powerful move,” McAllister said.
Exercise has countless benefits for those of all ages, including a healthier heart, stronger bones and improved flexibility. For seniors, there are additional benefits, like the fact that regular exercise reduces the risk of chronic diseases, lowers the chance of injury and can even improve one’s mood.
The seniors most likely to need paid home care to maintain independent living are the least likely to be able to afford it long-term, a new study reports.
Only two out of five older adults with significant disabilities have the assets on hand to pay for at least a couple of years of extensive in-home care, researchers found.
Without some help, those elderly are much more likely to wind up in a nursing home, said lead researcher Richard Johnson. He is a senior fellow with the Urban Institute's Income and Benefits Policy Center, in Washington, D.C.
"We have this perception that the risk of becoming frail is evenly distributed across the population, but it's really not," Johnson said. "It is more concentrated among people with less education, lower lifetime earnings and less wealth."
Paid home care can significantly improve the lives of older adults with disabilities and their families, but recipients often incur substantial out-of-pocket spending. We simulated the financial burden of paid home care for a nationally representative sample of non-Medicaid community-dwelling adults ages sixty-five and older.
We found that 74 percent could fund at least two years of a moderate amount of paid home care if they liquidated all of their assets, and 58 percent could fund at least two years of an extensive amount of paid home care. Among older adults with significant disabilities, however, only 57 percent could fund at least two years of moderate paid home care by liquidating all of their assets, and 40 percent could fund at least two years of extensive paid home care. Paid home care could become less affordable if growing labor shortages raise future costs.
The new study appears in the June issue of the journal Health Affairs.
falls in seniors are the third-leading cause of chronic disability, Liu-Ambrose and her team are now looking at whether the exercise program can result in reduced medical costs in this high-risk population. This study shows the importance of a home exercise program and how all adults can benefit from increased muscle strength and balance.
Age is such joy! It brings hard-earned wisdom, a wealth of experience, inspiration for new passions and the confidence to try something new; it brings appreciation for long friendships, a capacity for compassion and a curiosity about the world that youth doesn’t offer.
Exercise is crucial for people with arthritis. It increases strength and flexibility, reduces joint pain, and helps combat fatigue. Of course, when stiff and painful joints are already bogging you down, the thought of walking around the block or swimming a few laps might seem overwhelming.
Quite understandably, few look forward to the twilight of their life and all that it brings in its wake — deteriorating health, loss of vigour, restricted mobility, increasing dependence on others, not to mention a sense of foreboding and anxiety. Yet, ageing is an inevitable part of life that one has to learn to cope with willy-nilly.
At 74, I’ve found that old age need not necessarily be a period of physical and mental decline — though some ‘erosion’ is unavoidable — if one prepares oneself for it adequately in advance. First and foremost it’s imperative to prepare to accept old age all brace for all the restrictions or limitations it imposes on one’s mobility or ability to do things that one did when younger.
Equally important is the need to adopt a positive attitude towards life. Darkly regarding old age as the evening of one’s life must be avoided at all costs if one is to weather and overcome the difficulties and irritants that life is bound to throw up. An optimistic frame of mind or a light-hearted approach does help. Indeed, nothing prevents one from looking at the sunny side of life even in one’s sunset years. American statesman Bernard Baruch, who lived to a ripe old age, once remarked, “To me, old age is always fifteen years older than I am!” And, when asked his age, British satirist Jonathan Swift once quipped evasively, “I’m as old as my tongue and a little older than my teeth!” Is there a cleverer way to parry questions about one’s age?
Also vital is the need for the elderly to stay physically and mentally active in order to keep geriatric health problems at bay, especially Parkinson’s disease. Regular physical exercise coupled with the pursuit of a hobby or pastime that keeps one mentally and usefully engaged, is the perfect antidote for the prolonged spells of ennui that plague the elderly. Keeping abreast of current affairs — political, economic and social — also does help to keep boredom away. And the spicier the social gossip or grapevine, the better.
My former British boss, based in Edinburgh and now a spry 84, still pursues his passion for fishing with a like-minded octogenarian friend whenever the weather permits. They jointly maintain a boat fitted with an outboard engine and like nothing better than to go off trout-fishing on their own. Further, he remains extremely keen to know what’s happening in Munnar’s tea plantations, over which he once ably presided as General Manager. More importantly, advancing years haven’t blunted his sense of humour which remains as robust as ever.
In fact, the role of humour and fun in dispelling gloom in old age cannot be overstressed. These indispensables are the spice of life guaranteed to bring cheer and bonhomie, besides keeping one’s mind off life’s grim realities. The elderly should let humour pep up their lives regularly by hobnobbing with those known to be witty and funny. And letting one’s hair down occasionally — the little that remains of it, at any rate — can certainly do no harm so long as one doesn’t overdo things or get carried away by American statesman Benjamin Franklin’s flippant remark that “There are more old drunkards around than old doctors!”
Old age, of course, gives one an opportunity to take stock of one’s life dispassionately and, at leisure, sift through and analyse one’s successes and failures, achievements and shortcomings notched up over the years.
Companionship, of course, is vital for the elderly. No human being is an island and isolating oneself from society, as the aged often tend to do, is not at all advisable. On the other hand, socialising — to howsoever limited an extent — can inject refreshing variety into the drab routine of a senior citizen’s life and give it a much-needed boost. There’s no substitute for staying connected with one’s contemporaries.
Old age, of course, gives one an opportunity to take stock of one’s life dispassionately and, at leisure, sift through and analyse one’s successes and failures, achievements and shortcomings notched up over the years. It’s also the time when the elderly inevitably reach ‘anecdotage’. They turn nostalgic and love to recall “those good old days” when they were young and life was radically different from what it is today. They try to pass on the benefit of their varied experiences to the younger generation though the latter seldom has the time, patience, or inclination to hear them out. In such circumstances penning down one’s experiences is a good way of keeping oneself usefully engaged in old age. One never knows — one’s memoirs may make the bestseller list some day!
Reading some old Christmas letters from my grandad. Glad to make a cameo, where my three year old self is described as a 'handsome charmer who, amazingly for his age, has a sense of humour described as sardonic.' A rude little man, even then!
True, physical debility will be a stumbling block for many, quite literally. Ageing and stiffening body joints will ‘creak’ in protest and make mobility difficult — something one should learn to take in one’s stride stoically. Some of the more spirited among the elderly resort to the pretence of acting and behaving as if they are not as old as they really are. This game of ‘make-believe’ is indeed known to help in making light of one’s physical infirmities.
Above all, peace of mind, which everyone seeks but few are fortunate to find, is absolutely necessary. It’s the vital and efficacious balm that brings equanimity to one’s life, helping to salve the inevitable discomforts, irritants and problems of ageing. And, of course, it does help to promote overall health besides physical and mental well-being.
The Biblical lifespan of three score and ten years is now a thing of the past. Thanks to dramatic advances in medical science and technology, we can now expect to live well beyond 90 years and perhaps even longer, given reasonably satisfactory health. And this, assuredly, isn’t wishful thinking. Indeed, it is said there are more nonagenarians and centenarians around today than ever before, negating American humourist Josh Billings’ caustic observation, “Three score years and ten are enough. If a man can’t suffer all the misery he wants in that time, he must be numb!”
Admittedly, many hope for longevity without the inherent disadvantages of growing old. However, trying to put off ageing is futile and unrealistic (no matter what such proponents may tell us to the contrary) for it’s an integral and essential part of life that can never be reversed. So we must resign ourselves to growing old (since it’s the only method known so far of living a long time!). And in the process let’s try to make life as fulfilling and meaningful as possible.
Eating well is important at any age- adequate nutrition is necessary for health, quality of life and vitality. Unfortunately, for a variety of reasons, many seniors are not eating as well as they should, which can lead to poor nutrition or malnutrition, easily being mistaken as a disease or illness.
Our bodies change as we get older, including perceptual, physiological and and general age-related conditions — such as dental or gastrointestinal conditions. These changes all influence the performance of our body as a whole, which in turn, influences our eating, nutritional intake and overall health.
Perceptual changes later in life can also influence our nutrition, such as changes in hearing, smell and taste:
Hearing: Diminished or loss of hearing also affects our nutrition and food experience. The difficulty and frustration from the inability to hold a conversation with our eating partner out at a restaurant or at a social function can limit one’s food experience.
Smell:The loss of smell can also have a huge impact on the types of food one chooses to eat as there is a loss of satisfaction that can lead to poor food choices.
Taste:One of the most common complaints is in regards to the diminished taste in food. As taste buds decrease, so does our taste for salty and sweet — often times making food taste more bitter or sour.
One reason nutritional needs change is due to physiological changes that occur later in life:
Energy:Expenditure generally decreases with advancing age because of a decrease in basal metabolic rate and physical activity, thus decreasing caloric needs.
Function:Our bodies also begin to experience a decrease in kidney function, redistribution of body composition and changes in our nervous system.
Other Aging-Related Changes
Other changes in body function may impact nutritional intake, such as:
Dentition:The makeup of a set of teeth (including how many, their arrangement and their condition). The loss of teeth and/or ill-fitting dentures can lead to avoidance of hard and sticky foods.
Gastrointestinal Changes:Chronic gastritis, constipation, delayed stomach emptying and gas, may lead to avoiding healthy foods, such a fruits and vegetables — the food categories that should be more emphasized rather than eliminated.
These factors alone may contribute to why 3.7 million seniors are malnourished and shed light on the importance of educating caregivers and aging seniors as to specific dietary need options, as well as, catered senior diets and nutritional needs.
Basically, it's a stronger flu shot. Four times stronger to be precise.
This flu vaccine could significantly reduce the risk of hospitalization among especially vulnerable seniors, a large, random clinical trial has found.
Vaccines typically don’t work very well in older people—a problem because the flu can lead to serious respiratory infections in frail patients such as elderly nursing home residents.
“…the rate of hospitalization for any reason, respiratory or otherwise, was significantly lower in the high-dose group…”
While a prior study showed that older individuals could respond better to the high-dose vaccine, it focused on relatively healthy older adults, says lead author Stefan Gravenstein, professor at both the Warren Alpert Medical School and the School of Public Health at Brown University.
It still needed to be established that it would help even the frailest folks, like those who reside in nursing homes.
In this study, a quarter of the sample was over 90. DId the high-dose vaccine also work better than regular-dose vaccine in the population we consider least able to respond. This paper says yes, it can.
The study compared hospitalization rates among more than 38,000 residents of 823 nursing homes in 38 states during the 2013-14 flu season based on Medicare claims data. Just under half the homes, 409 to be exact, administered the high-dose vaccine while the other 414 provided a standard dose.
In the end, the hospitalization rate for respiratory illnesses among high-dose patients was 3.4 percent compared to 3.8 percent among standard-dose patients over the six months after vaccination. Statistical analysis revealed that the relative risk of hospitalization for respiratory illness was 12.7 percent lower for the high-dose group.
Moreover, the rate of hospitalization for any reason, respiratory or otherwise, was significantly lower in the high-dose group as well. For every 69 people given the high-dose vaccine vs. the standard-dose vaccine, one more person stayed out of the hospital during the flu season.
“Respiratory illness as the primary reason for hospitalization accounted for only about a third of the reduction in hospitalization that we measured,” says Gravenstein.
For many patients, the vaccine appeared to help prevent hospitalization for other problems also, including cardiovascular symptoms.
Gravenstein says the finding of a significant reduction in hospitalizations was particularly notable because the predominant flu strain during the 2013-14 season, A/H1N1pdm, was believed to be less virulent in older people who had spent a long lifetime building up immunity to similar strains.
“That there was differential protection in this context both underlines the potential importance of even low-virulence or less transmissible strains to older populations and the fact that vaccines may afford relevant effectiveness among frail older persons even when A/H1N1 predominates,” the authors write.
The study did not find a significant difference in the rate of death. Researchers speculate that while the standard-dose vaccine might not have been strong enough to stave off illness entirely, it may still have been sufficient to prevent deaths in combination with hospital care.
But a significant reduction in hospitalizations can still be a benefit, Gravenstein says, even though the high-dose vaccine is more expensive than the standard-dose vaccine. Especially for older, frail patients, reducing otherwise necessary trips to the hospital can maintain a higher quality of life.
Ultimately, Gravenstein says, the study should provide nursing home leadership with useful information to consider as they plan for future flu seasons.
FYI...This is NOT medical advice. Talk to your health care provider.
In 2013,pharmacy benefits managerExpress Scripts estimated that the United States wasted $418 billion on “bad medication-related decisions”—with $55.8 billion alone on high-priced medications when more affordable drugs could have been used instead.
Expensive is simply notalways better.
Here are ten prescriptions that are usually very expensive, even with insurance. All of them have cheaper alternatives that work just as well.
Dexilant.This is a very expensive brand-name proton pump inhibitor (a class of drugs that includesPrilosecandProtonix). A number of studies have compared the various proton pump inhibitors to one another and while some differences have been reported, they have been small and of little clinical importance. Do yourself a favor and givelansoprazoleorpantoprazolea try instead.
Benicar.Used for high blood pressure, this is an expensive brand-name angiotensin receptor blocker (ARB) in a class that has many generic options. Benicaris certainly no better than the cheaper drugs in the class (valsartanandlosartanare examples). Plus,Benicarcan produce a “sprue-like enteropathy” which gives you severe chronic diarrhea and weight loss, and can occur months to years after starting the drug. Hmmm.
Vytorin. This is a mixture ofsimvastatinandZetia(ezetimibe). Unless you’ve recently had a heart attack, you don’t need to waste money on this and here is why: statins, like the cheap genericsimvastatinalone, are the first choice in virtually all patients with high cholesterol in whom the goal is reduction of cardiovascular risk. People have been paying forVytorinfor years and yet it remains “uncertain” whether the combo ofsimvastatinandZetiathat makes upVytorin provides additional clinical benefit. A recent study showed benefit in people hospitalized after heart attack but for most people, stick with just thesimvastatinpart and don’t bother with the combo.
Bystolic. There is no evidence this beta blocker is better than two similar generic options,metoprololandcarvedilol.Bystolicis what is known as a “beta 1 selective” beta blocker used for the treatment of high blood pressure and it does provide a survival benefit in patients with heart failure. Sounds great, right—but wait. In heart failure patients, there are three beta blockers that have shown survival benefit. You guessed it:metoprolol,carvedilol, andBystolic.Metoprololandcarvedilolare generic and much cheaper so there is no reason to pay money here.
Celecoxib (Celebrex).Celebrex, used for arthritis, has just recently become available as genericcelecoxib so it’s still quite expensive and many folks pay a high price for it. However,meloxicam(Mobic), another Cox-2 inhibitor similar tocelecoxib, is much cheaper and also works well for the treatment of osteoarthritis and rheumatoid arthritis.
Pristiq.This is an expensive brand-name SNRI antidepressant used for depression and fibromyalgia. There is no evidence thatPristiqis any better than the cheaper genericduloxetine(Cymbalta) for fibromyalgia. For depression, there are two generic SNRI options in this class,venlafaxineandduloxetine. You should try those first before paying forPristiq.
Pataday.These antihistamine eye drops are used for red, itchy eyes related to allergies.PatanolandPatadayare expensive brand name eye drops in this class which includesazelastine (Optivar) as a good generic option that is much cheaper.Patadaycarries the advantage of once daily dosing compared to twice a day but is it worth the cost?
Avodart.Two 5-alpha-reductase inhibitors are approved in the US for symptoms related to enlarged prostate:Proscar(finasteride) andAvodart(dutasteride). One is cheap, one is not. In a large one-year study,finasterideand the more expensiveAvodartworked just as well for reduction in prostate volume, urinary flow rate and urinary symptom scores, and adverse effects were similar. Don’t waste your money onAvodartwhen you can save onfinasteride.
Even the most healthy and active among us, if fortunate to live long enough, may face some of the biggest threats of aging: hunger, isolation and loss of independence. With an average life expectancy nearing 80, living longer means more years spent in the struggles that accompany old age. Add to that the increase in geographic separation of our families and the result is millions of seniors left behind, hungry and alone.
While we all celebrate the increase in lifespan, maintaining health while aging comes at a price. Without support from programs like Meals on Wheels, millions of seniors are forced to prematurely trade their homes for more costly alternatives.
10.2 million seniorsin America face the threat of hunger -that's 1 in 6!
15.2 million seniorsare isolated, living alone
18.4 million seniorshave difficulty paying for basic living needs
The senior population isprojected to double by 2050
Processed sugar is a killer. That is a proven fact. (Look at this.) food manufacturers put in certain foods for flavor, especially 'low-fat' options. The following list of 'sugary' foods you should look at if you want to control your sugar consumption. For reference, there are about 33 grams of sugar in 12 ounces of Coca-Cola.
1. Pasta Sauce - 6-12 grams per half-cup
2. Granola Bars - 8-12 grams per bar
3. Yogurt - 17-33 grams per 8-ounce cup
4. Instant Oatmeal - 10-15 grams per 'fruit-flavored' packet.
5. Breakfast Cereal- 10-20 grams per cup (even popular oat and bran brands.)
6. Packaged Fruits - 33 grams per cup of canned fruit in light syrup.
7. Bottled Tea - 32 grams per bottle, leading brands of lemon-flavored iced tea.
8. Dried Fruit - 25 grams , a small box of raisins.
9.- Fancy Coffee Drinks - 30-60 grams of added sugar per 16 oz.
10- Pomegranate Juice - 62 grams per bottle of this 'heart-healthy' drink.
Geriatricians are “experts in complexity,” said Dr. Eric Widera, director of the geriatrics medicine fellowship at the University of California, San Francisco.
No one better understands how multiple medical problems interact in older people and affect their quality of life than these specialists on aging. But their role in the health care system remains poorly understood and their expertise underused.
Interviews with geriatricians offer insights useful to older adults and their families:
Basic knowledge. Geriatricians are typically internists or family physicians who have spent an extra year becoming trained in the unique health care needs of older adults.
They’re among the rarest of medical specialties. In 2016, there were 7,293 geriatricians in the U.S. — fewer than two years before, according to the American Geriatrics Society.
Geriatricians can serve as primary care doctors, mostly to people in their 70s, 80s and older who have multiple medical conditions. They also provide consultations and work in interdisciplinary medical teams caring for older patients.
Recognizing that training programs can’t meet expected demand as the population ages, the specialty has launched programs to educate other physicians in the principles of geriatric medicine.
“We’ve been trying to get all clinicians trained in what we call the ‘101 level’ of geriatrics,” said Dr. Rosanne Leipzig, a professor of geriatrics at the Icahn School of Medicine at Mount Sinai in New York City.
Essential competencies. Researchers have spent considerable time over the past several years examining what, exactly, geriatricians do.
A 2014 article by Leipzig and multiple co-authors defined 12 essential competencies, including optimizing older adults’ functioning and well-being; helping seniors and their families clarify their goals for care and shaping care plans accordingly; comprehensive medication management; extensive care coordination; and providing palliative and end-of-life care, among others skills.
Underlying these skills is an expert understanding how older adults’ bodies, minds and lives differ from middle-age adults.
“We take a much broader history that looks at what our patients can and can’t do, how they’re getting along in their environment, how they see their future, their support systems, and their integration in the community,” said Dr. Kathryn Eubank, medical director of the Acute Care for Elders unit at the San Francisco Veterans Affairs Medical Center. “And when a problem arises with a patient, we tend to ask ‘How do we put this in the context of other concerns that might be contributing?’ ”
Geriatric syndromes. Another essential competency is a focus on issues that other primary care doctors often neglect — notably falls, incontinence, muscle weakness, frailty, fatigue, cognitive impairment and delirium. In medicine, these are known as “geriatric syndromes.”
“If you’re losing weight, you’re falling, you can’t climb a flight of stairs, you’re tired all the time, you’re unhappy and you’re on 10 or more medications, go see a geriatrician,” said Dr. John Morley, professor of geriatrics at Saint Louis University.
“Much of what we do is get rid of treatments prescribed by other physicians that aren’t working,” Morley continued.
Recently, he wrote of an 88-year-old patient with metastasized prostate cancer who was on 26 medications. The older man was troubled by profound fatigue, which dissipated after Morley took him off all but one medication. (Most of the drugs had minimal expected benefit for someone at the end of life.) The patient died peacefully eight months later.
Eubank tells of an 80-year-old combative and confused patient whom her team saw in the hospital after one of his legs had been amputated. Although physicians recognized the patient was delirious, they had prescribed medications that worsened that condition, given him insufficient pain relief and overlooked his constipation.
“Medications contributing to the patient’s delirium were stopped. We made his room quieter so he was disturbed less and stopped staff from interrupting his sleep between 10 p.m. and 6 a.m.,” Eubank said. “We worked to get him up out of bed, normalized his life as much as possible and made sure he got a pocket talker [hearing device] so he could hear what was going on.”
Over the next four days, the patient improved every day and was successfully discharged to rehabilitation.
Finding help. A geriatric consultation typically involves two appointments: one to conduct a comprehensive assessment of your physical, psychological, cognitive and social functioning, and another to go over a proposed plan of care.
The American Geriatrics Society has a geriatrician-finder on its website — a useful resource. Also, you can check whether a nearby medical school or academic medical center has a department of geriatrics.
Many doctors claim competency in caring for older adults. Be concerned if they fail to go over your medications carefully, if they don’t ask about geriatric syndromes or if they don’t inquire about the goals you have for your care, advised Dr. Mindy Fain, chief of geriatrics and co-director of the Arizona Center on Aging at the University of Arizona.
Also, don’t hesitate to ask pointed questions: Has this doctor had any additional training in geriatric care? Does she approach the care of older adults differently — if so, how? Are there certain medications she doesn’t use?
“You’ll be able to see in the physician’s mannerisms and response if she takes you seriously,” Leipzig said.
If not, keep looking for one who does.
By Judith Graham- Kaiser Health News,
Geriatricians Can Help Aging Patients Navigate Multiple Ailments