Thanksgiving is my favorite holiday. I love the cooking, the noise, the parade, the extra side dishes no one really has room for. Every year I tell my parents I want to “go bigger”: more food, more people, more traditions. And every year, my mother looks at me with a mix of love and exasperation and says some version of, “Can we please do a little less this year? My …
Aging parents and Thanksgiving: a gentle check-in
The greatest challenge for all who practice geriatrics is reducing polypharmacy, the addition of medications that either provide no benefit or cause harm to seniors. Millions of seniors end up on many medications that are not helping them and could be causing side effects. Geriatricians are the experts in what we call de-prescribing, cutting down on unnecessary medications.
The key reasons seniors end up on too many medications are the following. …
How to reduce unnecessary medications
Canada’s primary health care crisis has garnered news headlines and political attention, but an equally alarming crisis is ongoing in long-term care (LTC). More than five years after COVID-19’s deadly sweep through LTC homes, exposing long-standing deficiencies in funding, infrastructure, infection control, staffing and working conditions, many problems remain, driving a critical staffing shortage, burning out workers and impacting resident care. With the need for LTC …
The burnout crisis in long-term care
The day before the attack, a senior physician at a Catholic university hospital in Taiwan sat with young medical students at noon, talking not about lawsuits or hospital finances, but about Brahms. He loved four-hand piano pieces, especially Brahms’s Hungarian Dances, and he would explain how two players must breathe together, listen to one another, and balance passion with discipline. For him, this was also a lesson about medicine: You …
Protecting elder clinicians from violence
Extreme longevity
People claim they want to live to be 100, yet is that a good thing? How you get there may make all the difference. Here’s my take on Blue Zones and the prospect of living to 100. “Blue Zone” is a nonscientific term popularized twenty years ago by Dan Buettner, a National Geographic explorer who studied five geographic regions where many people live to be over ninety or 100. …
Who wants to live to be a hundred?
I can sit with patients and families and talk about hospice, dementia, or end-of-life care without hesitation. Years of training as a physician and geriatric psychiatrist have prepared me for those conversations. But when my own parent needed care, all that training suddenly felt useless.
Medical knowledge didn’t shield me from fear or guilt. It didn’t stop the second-guessing that came with every decision. It didn’t help me navigate the family …
Why caring for a parent is hard for doctors
A demographic shift in viewership
With the rise of streaming, one platform is surging to prominence. According to Nielsen’s March 2025 report, YouTube now commands the highest total TV usage share of any media company at 11.6 percent. This marks a 53 percent increase in viewership compared to two years ago. But it is not because of younger generations sensationalized “addiction” with phones. It is a surge driven largely by …
How older adults became YouTube’s steadiest viewers and what it means for Alphabet
Aging well is not solely a matter of luck or genes, in my experience as a gerontologist. The choices we make, the connections we nurture, and the support systems we build shape it. There is no better time than now to start—the latest research from 2024 and 2025 supports this.
Let us begin with a crucial insight: midlife is more important than we once imagined. In new studies, it has been …
Why what you do in midlife matters most
Commercial airline pilots are required to retire at 65 under Federal Aviation Administration regulations. It’s not ageism; it’s safety. Yet physicians, whose decisions can be just as life-or-death, face no such requirement. As a former internist, chief medical officer, and hospital CEO, I have seen what happens when physicians practice past their prime. The results can be dangerous, heartbreaking, and entirely preventable.
When “going out on top” doesn’t happen
During my tenure …
Should older physicians face competency tests?
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Physician Jessie Mahoney discusses her article “Why physicians struggle with caregiving and how to cope with grace,” reflecting on the unique challenges doctors face when caring for aging parents and ill family …
Why doctors struggle with family caregiving and how to find grace [PODCAST]
I have been a physician for 44 years.
Besides my office and hospital practice, I also make house calls for less mobile older adults. We all want to stay in the homes where we raised our children, cared for our gardens, and became part of the community. The reality is that we lack the tools and financial resources needed for seniors to “age in place.”
My house calls, though, have provided insights …
Aging in place: Why home care must replace nursing homes
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Psychiatrist Sabooh S. Mubbashar discusses his article, “Why ‘do no harm’ might be harming modern medicine.” He reveals that the principle “First, do no harm,” or Primum non nocere, is not part of the original Hippocratic Oath but a later, misattributed addition that has become a dangerously oversimplified slogan. …
Is “do no harm” the most misunderstood phrase in medicine? [PODCAST]
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Cardiologist and author Eric Topol discusses his article, “What super agers can teach us about longevity and health span,” which is an excerpt from his new book, Read more…
Eric Topol explores the science of super-agers and healthy aging [PODCAST]
Tucked along the edge of the frigid James Bay, Moosonee stands as one of Northern Ontario’s most remote and storied communities—a place often referred to as the “Gateway to the Arctic.” While towns like Thunder Bay or Rainy River echo similar titles, Moosonee carries its own unique distinctions.
This isolated town of about 3,000 people is shaped by its subarctic climate, deep cultural roots, and resilient spirit. Read more…
How community paramedicine impacts Indigenous elders
We all know the population is aging, but did you know that close to half of all adults over age 65 in the U.S. have some kind of disability? The Americans with Disabilities Act (ADA) includes as a disability any “physical or mental impairment that limits one or more life activities” or a history or record of such impairment.
Thus, disabilities include: physical limitations such as mobility issues, pain, and fatigue; …
Why health care must adapt to meet the needs of older adults with disabilities
An excerpt from Super Agers: An Evidence-Based Approach to Longevity.
For many years, my colleagues and I have been fascinated by individuals like Mrs. L. R., who are so lucky to be so resilient to diseases. In 2008, we set up a research project called “Wellderly,” to study people who were at least eighty years old and had never been sick or had a chronic illness. It took almost six …
What super agers can teach us about longevity and health span
Age should not define a person or diminish respect from others. There is a generation of people overlooked every day, and little attention is paid to this growing problem.
As people age, they may become less visible within their communities. It can seem like people who once smiled as they walked by begin passing without a glance. Seniors may feel like unwanted outsiders in society. Sadly, many participate in their own …
How society forgets the invisible elderly and why their stories matter
The COVID-19 pandemic accelerated medical communication as patients and doctors utilized computer technology to manage health care that was not available a decade ago.
Hospitals and doctors maintain online medical records that enable patients to access personal information about ongoing issues. “Portals” allow users to view lab tests, imaging results, pathology reports, and progress notes. The computer “message” system also enables patients to communicate with their physicians or other health care …
Communicating with your doctor online could cost you
As health care providers working in long-term care (LTC), we’ve seen firsthand how antipsychotic medications are prescribed to residents, and why. Antipsychotics are often used to help manage behaviors such as agitation and aggression in older adults living with dementia. They may be helpful for some patients, but antipsychotics can do more harm than good for many, especially when used long-term.
Now a new report has highlighted this as a …
Antipsychotic use has been rising in long-term care homes, but we can do something about it
As a gerontologist, it is disheartening to engage with older adults who express disinterest in routine medical check-ups. Many of these individuals outright refuse to follow doctors’ orders or take prescribed medications. This troubling trend is not only a growing problem in America but also a critical issue that warrants our collective attention and action.
The advancements in modern medicine have significantly prolonged life spans and improved the quality of life …
Solving the health care dilemma: Why older adults are skipping vital care
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