My interest in geriatrics actually started long before medical school. I earned my master's degree in Gerontology because I was fascinated by the aging process and everything that comes with it. Not just the medical changes, but the psychological, social, and emotional aspects of growing older.

When I eventually went to medical school, geriatrics felt like a natural fit. I loved the complexity of caring for older adults. You can't just look at one diagnosis or one organ system. You have to look at the whole person, their medical conditions, their relationships, their environment, and most importantly, what matters to them.

Over the years, I've had the privilege of caring for people in their 80s, 90s, and even beyond 100. I've learned so much from them. Some have taught me extraordinary lessons about resilience and finding purpose. Others have shown me how quickly independence can be lost when we focus on treating disease without considering how those treatments affect someone's everyday life.

My own experiences with loss have also influenced how I practice medicine. Losing my infant son changed the way I understand grief, suffering, and the importance of simply being present for someone during difficult moments.

I wrote about some of these experiences in my memoir, Life, Love, and the In-Between. It's really about the lessons we learn through medicine, love, loss, and everything that happens in between.

I think what has kept me in geriatrics all these years is the understanding that medicine isn't always about curing something. Sometimes it's about preserving independence, reducing suffering, supporting families, and helping someone continue living a life that matters to them.

I think geriatrics and lifestyle medicine complement each other beautifully.

Geriatrics helps us understand the changes that happen as we age and how to manage the complexity that often comes with those changes. Lifestyle medicine gives us tools to influence how we age, sometimes decades before someone ever needs a geriatrician.

We know that physical activity, nutrition, sleep, stress management, social connections, and avoiding harmful substances influence our risk of developing chronic diseases. But what I wish more people understood is that these habits also influence how well we function as we get older.

Can you get out of a chair without assistance? Can you walk comfortably? Can you continue doing the things you enjoy? Can you maintain your independence?

Those are the outcomes I care about.

This is one of the reasons I developed my HEALTH Framework, which focuses on six interconnected areas: How We Age, Energy, Activity, Longevity, Transformation, and Habits.

We spend so much time talking about lifespan, but I want people to think more about healthspan. Not just how many years we live, but how many of those years we spend functioning well, physically and cognitively.

And one of the most important messages I share is that it's never too early or too late to start making changes.

One of the biggest misconceptions is that aging and disease are the same thing.

They're not.

Yes, our bodies change as we age. We lose muscle mass, our physiology changes, and we may become more vulnerable to illness. But dementia is not a normal part of aging. Frequent falls are not something we should simply accept. Neither is becoming progressively weaker or losing the ability to do everyday activities without understanding why.

Another misconception is that once someone reaches a certain age, there's very little we can do to improve their health.

I've seen patients in their 80s and 90s make meaningful improvements in their strength, mobility, and quality of life.

We need to stop assuming that every symptom in an older adult is simply because they're old.

When someone tells me they're slowing down, my next question is why. Is it a medication? Poor sleep? Depression? Pain? Deconditioning? An underlying medical condition?

I want people to understand that aging is inevitable, but many of the things we associate with aging are preventable, treatable, or modifiable.

If I could emphasize one thing, it would be to start thinking about your future function now.

What you do in your 40s and 50s can have a tremendous influence on how you function in your 70s, 80s, and beyond.

Strength training is one of the most important things we can do. Muscle isn't just about how we look. It's essential for mobility, metabolic health, balance, and maintaining independence.

I also encourage people to pay attention to cardiovascular health, nutrition, sleep, and social relationships. These things are deeply connected to brain health as well.

But I don't want people to feel overwhelmed by everything they're told they should be doing.

Start small.

One of the concepts I emphasize in my HEALTH Framework is that consistency matters much more than perfection.

You don't have to change everything tomorrow. You just have to begin.

I often tell families that the most important thing to look for is a change from someone's baseline.

With cognition, occasional forgetfulness can happen with normal aging. But when memory problems begin interfering with everyday activities, we need to investigate.

For example, someone who has always managed their finances suddenly starts missing payments. A person who has cooked for decades begins struggling with familiar recipes. Someone starts getting lost in familiar places or has difficulty managing medications.

Those are changes we need to pay attention to.

Physically, I look for changes in walking speed, difficulty getting out of a chair, unexplained weight loss, repeated falls, and increasing difficulty with everyday activities.

Sometimes the earliest sign of a medical problem isn't a dramatic symptom. It's a subtle change in function.

Families often notice these changes before anyone else.

I encourage them to trust those observations and bring them to their healthcare provider rather than dismissing them as normal aging. Sudden confusion or an abrupt change in function is different and needs urgent medical evaluation.

Falls are one of the most important things we address in geriatrics because a single fall can completely change someone's life.

I've cared for patients who were living independently before a fall and never regained their previous level of function.

But fall prevention isn't simply about telling someone to be careful.

We need to look at strength, balance, medications, vision, blood pressure, footwear, and the home environment.

Strength training and balance exercises are incredibly important. Physical therapy can be especially helpful for someone who has already fallen or is becoming less confident walking.

Medication review is another critical piece. Certain sleep medications, sedatives, and medications that lower blood pressure can increase fall risk.

And then there's the home environment. Poor lighting, loose rugs, clutter, stairs, and bathrooms without appropriate safety equipment can all contribute.

I also remind families that a walker is only helpful if it's the correct walker, properly fitted, and used correctly.

We need to be proactive about fall prevention rather than waiting until someone has a serious injury.

This is something I feel very strongly about.

I see caregiver burnout all the time.

I've cared for families where the caregiver is sleeping only a few hours a night, missing their own medical appointments, neglecting their nutrition, and becoming increasingly isolated.

Many are dealing with anxiety, depression, chronic stress, and profound exhaustion.

And what makes it even more difficult is the guilt.

Caregivers often feel that taking time for themselves means they're somehow failing the person they love.

I try to remind them that caregiving should not mean sacrificing their own health.

You cannot provide sustainable care if you're becoming physically and emotionally depleted.

Sometimes support means asking another family member to help. Sometimes it's an adult day program, respite care, or a caregiver support group. And sometimes it's simply having someone who understands what you're going through.

I recently found myself becoming emotional thinking about how much suffering I see among my patients and their caregivers. No matter how many resources I share or how much guidance I provide, sometimes it still feels like it's not enough.

And I think that's when we have to remember the importance of the small moments.

Even in the middle of dementia, serious illness, and tremendous uncertainty, there can still be moments of connection, laughter, and love.

I think sometimes caregivers need permission to hold on to those moments without feeling guilty about everything else.

Those moments matter.

One of the biggest problems I see is that we often discharge patients based on whether they're medically stable without fully considering whether they and their families are prepared to manage at home.

Someone may be medically ready to leave the hospital but still be unable to get out of bed independently, manage medications, or safely use the bathroom.

Families may suddenly find themselves responsible for wound care, transfers, complicated medications, or medical equipment without adequate training.

Medication discrepancies are another major concern. Patients may leave the hospital with medications that have been added, stopped, or changed, and the family may not understand why.

Before discharge, I encourage families to ask very practical questions.

And if a caregiver is expected to perform a task, I think they should be shown how to do it before leaving the hospital.

A safe discharge isn't just about leaving the hospital. It's about having a realistic plan for what happens afterward.

I think one of the biggest misconceptions about hospital discharge is that once someone is home, the difficult part is over.

In reality, the first several weeks after hospitalization can be an incredibly vulnerable period for older adults.

Some of the most common potentially preventable reasons for readmission include medication errors, dehydration, falls, worsening heart failure or other chronic conditions, infections, and complications related to immobility.

But I also see another problem that doesn't receive enough attention. Families who are simply not prepared for the level of care their loved one now requires.

An older adult may have been walking independently before hospitalization but now needs help getting out of bed. They may have developed confusion or delirium during their hospital stay. They may be eating poorly or struggling with new medications.

These changes can quickly create a crisis at home.

During the first 30 days, I encourage families to focus on a few things.

And perhaps most importantly, don't wait until a small problem becomes an emergency.

Families need to know who to call when something changes.

I believe a successful hospital discharge requires more than instructions on a piece of paper. It requires communication, education, appropriate equipment, and a support system that can realistically meet the patient's needs.

The first thing I would emphasize is that equipment needs to be individualized.

Not every older adult needs a hospital bed, a walker, or a patient lift. The right equipment depends on their mobility, cognition, medical conditions, and the level of assistance they require.

I usually start by asking a very practical question: What does this person need to do safely throughout the day?

Can they get in and out of bed? Can they reach the bathroom? Can they transfer from a chair? Can their caregiver help them without risking injury?

For someone with mobility limitations, an appropriately fitted walker, bedside commode, shower chair, or grab bars may make an enormous difference.

For someone who has difficulty repositioning, requires specific positioning for medical reasons, or has significant mobility limitations, a hospital bed may be medically appropriate.

For patients who cannot safely transfer independently, a patient lift may be necessary, along with proper caregiver training.

Incontinence supplies, skin protection products, and pressure redistribution surfaces can also be important for patients with limited mobility or impaired continence.

But I want families to understand something else.

The goal of equipment isn't simply convenience. It's safety, dignity, and preserving as much independence as possible.

And we need to protect caregivers, too.

I've seen family members injure themselves trying to lift or transfer someone without the appropriate equipment or training.

The right equipment, combined with education and a realistic care plan, can make an enormous difference in whether someone can remain safely at home.

I created GeriAcademy because I realized how much information families need and how difficult it can be to find reliable guidance. My mission as a fellowship program director was also community outreach. When the pandemic happened, we couldn't do that. So I thought of a blog.

There simply aren't enough geriatricians to meet the needs of our aging population. And the reality is that every single one of us is aging, whether we're thinking about it or not.

I spent years studying gerontology, medicine, geriatrics, and healthcare administration. And I realized that so much of what I've learned could benefit people long before they ever become my patients.

I wanted to make that knowledge accessible.

Through GeriAcademy, I talk about healthy aging, cognitive health, caregiving, medications, and resources that many families don't even know exist.

What has surprised me most is how many people are desperately searching for basic information about available services.

When I share resources such as PACE, the State Health Insurance Assistance Program, or caregiver support services, I receive questions from people all over the country asking whether they're eligible, how much programs cost, or whether they're available in their communities.

That tells me something important.

We don't just have a healthcare access problem. We have an information and navigation problem.

Families are trying to manage extraordinarily complicated situations without knowing where to begin.

My hope is that GeriAcademy can help bridge some of that gap while also helping people understand what they can do today to protect their health as they age. I also wanted to give back, and this is one way I think I can give back.

I would change the way we think about aging itself.

We've created a healthcare system that is largely reactive. We wait until people become ill, lose function, or experience a crisis before we intervene.

I would love to see us place much more emphasis on preserving function, supporting caregivers, and helping people understand how their everyday choices influence their future health.

I also think we need to stop viewing older adults primarily through the lens of their diagnoses.

A person with dementia is still a person with a history, relationships, preferences, and a need for dignity. Someone who needs assistance walking may still have an incredibly meaningful and fulfilling life.

One of the greatest lessons I've learned, both as a geriatrician and through my own life experiences, is that we spend so much time preparing for the big moments in life that we sometimes overlook everything happening in between.

That's part of what inspired me to write Life, Love, and the In-Between.

Through caring for patients, experiencing personal loss, and navigating the challenges of life, I've come to appreciate that meaning isn't found only in our accomplishments or how long we live. It's found in our relationships, the moments we share, and how we show up for one another.

That philosophy also influences how I think about healthy aging.

My HEALTH Framework focuses on helping people preserve their physical and cognitive health, but ultimately, the purpose of doing that is to give us more opportunities to experience life.

I don't want people to simply live longer. I want them to live better, with strength, connection, independence, and purpose for as long as possible.

And when life doesn't go according to plan, as it inevitably won't, I hope we remember that there can still be love, meaning, and even joy in the in-between.

If I could tell a new caregiver three things, they would be these.

And one last thing I would add is to hold on to the small moments of joy.

There will be difficult days. There may be uncertainty, frustration, and grief. But there can still be moments of connection, humor, and love.

Sometimes those moments are what carry us through.