For more information about the author, click to view their website: Carson Eldercare Consulting & Management
Introduction:
I felt strongly compelled to write this blog on heart failure as it is such a pertinent issue in the aging population today. Before I go into details on this, I’d like to address the definition of this disease process. Heart failure occurs when the heart doesn’t pump well and fails to deliver adequate oxygen to the body. As a result, fluid builds up in the body and vital organs don’t get the blood that they need. This can make it harder for individuals to perform everyday tasks and can lead to eventual overall decline.
Problem:
Heart failure is the number one reason for hospital
admissions in older adults, and often leads to multiple readmissions (Agarwal
et. al., 2021). As a cardiac nurse for many years, I can attest to the fact
that heart failure is the biggest reason for multiple hospitalizations in
seniors. Patients come in and out for problematic symptoms, sometimes coming
into the hospital as often as every month. The three biggest symptoms I see
that result in hospital admissions are shortness of breath (particularly when lying
flat), weight gain, and swelling in the legs.
One reason for such frequent admissions is the complexity of
heart failure itself. It is a complicated clinical syndrome and is notoriously
difficult to manage. A lot is put on patients to manage their heart failure at
home, and this can be a challenge. In addition, individuals may have some level
of cognitive impairment or multiple other comorbidities, making it even more
challenging to perform the extensive monitoring needed to prevent heart failure
from worsening.
The importance of education:
Education is also important in the treatment of heart
failure. Unfortunately, this often does not get done. When I first started
working in acute care back in 2004, every patient received
extensive education in managing their heart failure prior to discharge. Nurses
would provide lengthy verbal education on the importance of medication
adherence, daily weights, low salt diet, and other factors, in addition to
providing the patient with a heart failure educational pamphlet prior to
discharge. Over the years, however, hospitals have increasingly faced staffing
shortages and high nurse turnover. As a result, a lot of important patient
education is not getting addressed. A lack of awareness and understanding in
patients on how to manage their heart failure is definitely a key reason for
worsening heart failure and repeated hospitalizations.
Management:
From a clinician standpoint, the goal in addressing heart
failure is twofold: we want to reduce symptoms and prevent mortality. The best
way to do this is through patient/family education and implementation of a
treatment plan. A proper treatment plan will include such lifestyle
modifications as a low salt diet, quitting smoking, and getting regular
physical activity. A low salt diet can be incredibly helpful in preventing
further fluid build up in the body. The American Heart Association recommends
that all individuals consume no more than 2,300 mg of sodium
per day (AHA, 2024). In today’s era of processed and packaged food, a majority
of the American population consumes much more than that, and it comes in the
food itself rather than the saltshaker. Maintaining a low sodium diet has one
other priceless benefit that I often do not see emphasized enough in heart
failure: it can help reduce blood pressure. Almost half of all heart failure
patients have uncontrolled hypertension (Heart Failure, 2022). It is a major
risk factor in the development of heart failure and managing it can greatly
reduce heart failure symptoms and decrease stress on the heart. Current
guidelines recommend maintaining a systolic blood pressure of less than 130.
Medication management is another important factor in the
management of heart failure. This often includes the use of diuretics, beta
blockers, and other medication classes that I will not go into detail on. I
wanted to discuss diuretics and beta blockers because these are the two
medications in heart failure that I see non-compliance with the most. I witness
individuals often not taking one or the other for two main
reasons: they either don’t understand the importance of them or they
don’t like the side effects. Seniors can often have difficulty getting up to go
to the restroom. Diuretics cause frequent trips to the restroom because their
purpose is to get excess fluid off the body. Many individuals do not comply
with their prescribed diuretic because of the hassle of frequent bathroom
trips. Unfortunately, ineffective diuresis causes heart failure to worsen and
puts further stress on the heart. I often see non-adherence to beta blockers
due to their side effects. The two biggest symptoms that get reported to me are
fatigue and dizziness. As in the diuretic, a beta blocker can also help reduce
the stress on the heart, and heart failure symptoms can worsen if the
prescribed dose is not adhered to. It’s important to maintain prescribed
medication regime and if any negative symptoms are experienced to discuss them
with the doctor.
One final thing:
I wanted to touch on one final monitoring recommendation for
heart failure because it so often gets missed: daily weights. Weighing oneself
daily is of tantamount importance in heart failure and can identify early on if
heart failure is worsening. This can lead to early intervention, thus
decreasing potential hospitalization. Adherence to this all too often does not
occur. I see patients come into the hospital for large amounts of weight gain…
often 20 or more lbs. Many patients report that they never stepped on the scale
to assess for weight gain and often do not get admitted to the hospital until
symptoms are severe such as severe weakness and shortness of breath. In heart
failure it’s recommended to contact the doctor if weight goes up by more than 2
pounds in a day or greater than 4 pounds in a week. The doctor can make
modifications in the treatment regime and hence reduce potential
hospitalizations and mortality.
Conclusion:
Heart failure is complex but manageable. Early action can prevent hospital admissions, reduce mortality, and optimize quality of life. Having ongoing guidance from an experienced clinician can be of great benefit if you or your loved one is having difficulty managing heart failure and other disease processes. Please do not hesitate to reach out to me if you have any further questions. I want to help and make the process of aging as stress free as possible while promoting positive health outcomes.
My name is Laura Carson and I have been a Registered Nurse (RN) for over 20 years and have witnessed firsthand the challenges and complications that aging presents. It affects not only the aging themselves but also their families and loved ones. Health care is complex, and in this increasingly fragmented and overburdened system, it can be extremely helpful to have a professional oversee all aspects of care. As your eldercare manager, I will comprehensively assess the needs of your loved one and we will work together in establishing a care plan. I will assist you and your family with difficult decisions and help promote healthy communication on issues that are often difficult to address and navigate. Contact me for a 20 minute free consultation at 714-403-7040.
References:
Blood Pressure and Glycemic Control Among Ambulatory US Adults With Heart Failure: National Health and Nutrition Examination Survey 2001 to 2018 (April 28, 2022). Heart Failure. Almost half of heart failure patients have uncontrolled hypertension and diabetes
Agarwal, M., Fonarow, G., & Ziaeian, B. (February 10,
2021). National Trends in Heart Failure Hospitalizations and
Readmissions From 2010 to 2017. https://pmc.ncbi.nlm.nih.gov/articles/PMC7876620/
Weber, C. (May, 2023). Heart Failure Pharmacology. How much sodium should I eat per day? (2024). American Heart Association. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sodium/how-much-sodium-should-i-eat-per-day
Protecting Your Loved Ones Independence and Well-Being at HomeHelping a family member remain independent and living at home is a labor of love, but at times it can be overwhelming. There is so much to consider beyond just their overall health and well-being. Depending on the situation, a loved one may need immediate or future help coordinating medical care or managing finances. Having the proper Power of Attorney credentials established can help caregivers navigate the complexities of the system and avoid costly or time-consuming pitfalls during their loved ones aging journey.Here is a basic overview of two of the most common Power of Attorney documents:Financial Power of Attorney (Durable)With a Financial Power of Attorney (POA), a person known as the principal appoints an agent to carry out financial and other activities, as instructed by the principal. Often the person designated is a family member but note that it may be advisable to name a primary agent and an alternate agent. Principals may choose whether the POA becomes effective immediately or only in the event of illness/disability. Ideally, the POA document should have language indicating that it is durable (remains in effect even after the person is legally incapacitated). In Pennsylvania, the Financial POA must be notarized and witnessed. The law also stipulates that a POA must exercise the powers for the benefit of the principal, keep the assets of the principal separate from their own, and exercise reasonable caution and prudence. Financial Power of Attorney ceases after the principal passes away.Medical Power of AttorneyPennsylvania recognizes two types of advanced directives for healthcare decisions: Medical Power of Attorney and Living Wills. The Medical Power of Attorney, also known as a Healthcare POA or healthcare proxy, is broader in scope than a Living Will in that it empowers the caregiver to make all medical decisions if their loved one is unconscious, incapacitated, or mentally incompetent. The appointed person will be able to access medical records, speak to healthcare professionals, and make healthcare judgments and medical decisions based on their loved ones treatment (or non-treatment) preferences. A Medical POA is a crucial component of advance care planning, allowing your loved one to ensure that their healthcare preferences are honored. The document must have two witnesses and be notarized.Information and downloadable Power of Attorney pdf documents are available online. During the application process to Senior LIFE, a Senior LIFE outreach coordinator can also help you get started with the POA process. Contact us today.
Tailored caregiver services are designed to address the unique needs of each individual, ensuring personalized and compassionate care. Whether its assisting with daily activities, managing medical appointments, or offering companionship, caregivers focus on delivering support that aligns with personal preferences and lifestyle. Understanding that every situation is different, these services adapt to evolving requirements, providing a customized approach that enhances quality of life. By focusing on individual needs and preferences, tailored caregiver services ensure that each person receives the attentive and dedicated care they deserve.Understanding Tailored Caregiver ServicesTailored caregiver services are meticulously crafted to meet the distinctive needs of each person, ensuring that care is both personalized and compassionate. This individualized approach is essential for addressing specific preferences and health requirements. Caregivers are trained to handle various tasks, from assisting with everyday activities to coordinating medical appointments, all while adapting to the unique lifestyle of those they support.By focusing on the specific needs of each individual, tailored services foster a higher quality of life. This approach not only ensures that practical needs are met but also provides emotional and social support, enhancing overall well-being. Through attentive and dedicated care, these services create a supportive environment where individuals can thrive.Customized Care Plans for Every NeedCreating a customized care plan involves understanding each individual's personal needs and preferences. This personalized approach ensures that all aspects of care are tailored to fit specific circumstances, from managing chronic conditions to providing companionship. Care plans are developed in close collaboration with clients and their families, ensuring that all care goals are aligned with personal values and desires.Each care plan is flexible and adaptable, designed to evolve as needs change. Whether it's increasing support during a health crisis or adjusting activities to match changing abilities, these plans are continuously updated to ensure the highest level of care. This adaptability is key to maintaining quality and effectiveness in caregiving.Compassionate Companionship and SupportCompanionship is a fundamental aspect of tailored caregiver services, providing emotional support and reducing feelings of isolation. Caregivers offer more than just practical assistance; they engage with individuals through meaningful conversations, shared activities, and genuine emotional support. This compassionate connection helps enhance mental and emotional well-being.Beyond mere presence, caregivers build relationships based on trust and understanding. 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This ongoing adjustment helps ensure that individuals continue to receive the support they need, even as their needs change over time.Personalized Assistance for Daily ActivitiesTailored caregiver services provide personalized assistance with daily activities, ensuring that each individual's routine is managed according to their specific needs and preferences. From meal preparation and personal hygiene to light housekeeping, caregivers are trained to offer support in a way that respects personal habits and choices.This personalized assistance is crucial for maintaining independence while ensuring safety and comfort. By focusing on individual preferences and routines, caregivers help create a supportive environment that enhances overall quality of life. This approach ensures that daily activities are managed smoothly and in a manner that aligns with each person's unique lifestyle.Managing Medical Appointments EfficientlyEfficient management of medical appointments is a crucial component of tailored caregiver services. Caregivers help coordinate and manage appointments, ensuring that individuals receive timely and appropriate medical care. This includes scheduling visits, arranging transportation, and keeping track of medical records and prescriptions.By handling these logistics, caregivers help alleviate the stress and confusion that can come with managing multiple appointments. This support ensures that individuals adhere to their medical treatment plans and receive the care they need without the burden of administrative tasks.Building Trust through Reliable CareTrust is a cornerstone of effective caregiving, and tailored services are designed to build and maintain this essential element. Caregivers work diligently to establish a reliable and trustworthy relationship with each individual. This trust is built through consistent, respectful, and compassionate care, ensuring that individuals feel safe and supported.Reliable care fosters a sense of security and peace of mind, both for the individuals receiving care and their families. By demonstrating reliability and dedication, caregivers help create an environment where trust is a fundamental part of the caregiving experience.Enhancing Quality of Life with Personalized SupportTailored caregiver services are focused on enhancing quality of life through personalized support. By addressing individual needs and preferences, caregivers contribute to a more fulfilling and comfortable daily experience. This personalized approach ensures that all aspects of care are designed to improve overall well-being and satisfaction.From managing health conditions to providing emotional support, tailored services aim to create a positive impact on daily living. By focusing on each person's unique requirements, caregivers help enhance the quality of life, allowing individuals to enjoy a more meaningful and enriching life experience.Personalized SupportCaregivers offer support that is customized to meet each individual's specific needs and preferences. This personalized approach ensures that care is not only practical but also aligned with the person's lifestyle and desires. By focusing on what matters most to each individual, caregivers enhance comfort and satisfaction in daily living.Enhanced Quality of LifeTailored caregiver services contribute to a significantly improved quality of life by addressing both physical and emotional needs. This holistic approach ensures that all aspects of well-being are considered, leading to a more balanced and fulfilling life. Personalized care helps individuals feel more secure, valued, and content in their daily routines.Management of Health ConditionsCaregivers provide essential assistance with managing health conditions in a manner that suits each person's unique situation. This includes medication management, monitoring health metrics, and coordinating with healthcare providers. By tailoring these services, caregivers help individuals achieve better health outcomes and maintain their well-being effectively.Emotional SupportIn addition to practical care, caregivers offer crucial emotional support that enhances mental well-being. Engaging in meaningful conversations, providing companionship, and offering a listening ear help reduce feelings of loneliness and anxiety. This emotional support is integral to maintaining a positive outlook and overall mental health.Meaningful ExperienceBy focusing on the unique needs and preferences of each individual, caregivers help create a more engaging and enriching daily experience. This personalized approach ensures that each person can enjoy their routines and activities in a way that feels meaningful and fulfilling. Enhanced personal interactions contribute to a more satisfying and connected life.ConclusionTailored caregiver services are essential for meeting unique needs and enhancing overall well-being. At Home Matters Caregiving, we prioritize personalized support to ensure that each individual receives care that aligns with their specific preferences and requirements. Our dedicated caregivers focus on both practical assistance and emotional support, creating a nurturing environment that fosters a fulfilling and comfortable daily experience. By addressing each persons distinct needs, we contribute to a higher quality of life and promote greater satisfaction. For those seeking specialized caregiver services in Pittsburgh, PA, Home Matters Caregiving is committed to delivering exceptional, customized care that makes a meaningful difference in everyday living.
Visit any critical care unit, childrens hospital, or other specialty inpatient facility, and youll find a common feature: therapy dogs. For decades, healthcare practitioners have understood the surprisingly positive effects on patients of time spend with cute and cuddly dogs. Therapy dogs reduce stress, improve mood, and can help patients reframe their outlook on whatever condition ails them. The positive effects of patient interactions with therapy dogs are a well-documented fact of the medical world. Senior citizens with limited mobility and other health conditions also benefit from the companionship of dogs. Owning a pet reduces feelings of loneliness among seniors living at home or in a retirement facility, which in turn greatly reduces the risk of diseases associated with loneliness and isolation. Pets can also decrease the number of stress hormones in a persons blood, lower blood pressure, and contribute to a more positive outlook on life. Dogs and other pets, it seems, have tremendous healing powers!Since Alzheimers patients cannot adequately care for a pet, owning one is out of the question. Considering the nature of Alzheimers dementia, it is easy to assume that a loved one may not benefit from a pet since they will not remember the interaction. Researchers, convinced therapy dogs would have a positive effect on Alzheimers patients, put this question to the test: Do Therapy Dogs Help Alzheimers Dementia Patients?Short-Term Benefits of Therapy Dogs for Patients with Alzheimers Dementia.A study conducted in the early 2000s looked carefully at the subject of therapy dogs and Alzheimers dementia patients. They measured the incidence of behavioral disturbances among patients in a nursing home for a period of four weeks, then introduced therapy dogs. Their initial findings showed that the dogs helped to reduce behavioral disturbances in the short term, meaning they helped to immediately calm patients. The short-term effects proved that therapy dogs do have a positive effect on patients with Alzheimers disease, particularly in regards to anxiety, anger, and changes in behavior associated with the disease.Long-Term Benefits of Therapy Dogs for Patients with Alzheimers Dementia.The same study did not stop at the short-term effects of therapy dogs on Alzheimers patients. Previous assumptions suggested that since patients would not remember their encounters with the therapy dogs, the effects of spending time with them would vanish from one day to the next. Not true, the study authors found. Although most of the patients did not remember their interactions with the therapy dogs (some did), the behavioral disturbances noted in the four weeks prior to the study reduced. In fact, the longer and more frequently patients interacted with the therapy dogs, the less they exhibited behavioral disturbances.Therapy Dogs As A Long-Term Therapy.The study findings confirmed what clinicians suspected all along: dogs are an excellent long-term therapy for persons with Alzheimers dementia to reduce the incidence of behavioral disturbances. Therapy dogs also had the same effect on Alzheimers patients as they do on other kinds of patients, including reduced stress and anxiety, lower blood pressure, better appetite, and fewer feelings of loneliness. These effects continued to increase the longer and more frequently patients interacted with the dogs.What Makes Dogs Such Good Therapy?Dogs are wired to give unconditional love and devotion. They can provide physical and social contact where it is missing, and they are not picky. what sets dogs apart, particularly those trained as therapy dogs, is that they will approach anyone regardless of their physical or mental deterioration, and initiate contact. Patients can pet, hug, and cuddle dogs unlike any other kind of pet. These positive interactions provide a distraction to the other goings-on around them and provide relief for those suffering from sadness, anger, or angst.The Takeaway.Dogs have a tremendous healing power. While studies have focused specifically on Alzheimers dementia patients, their positive effects will benefit anyone suffering from general dementia. Families of patients will feel relief that their loved ones have fewer outbursts of anger, sadness, or angst. While dementia impairs memory, it does not interrupt the long-term benefits of regularly interacting with a therapy dog. In fact, the more they interact with a therapy dog, the fewer behavioral problems they exhibit.
Are you feeling overwhelmed by the complexities and difficulties associated with aging? Have the responsibilities in caring for your loved one become unmanageable? Do you live far away and are unable to provide reliable senior care management? If you answered yes to any of the above questions, you may want to consider hiring an eldercare manager. Hi, my name is Laura. I have been a Registered Nurse (RN) for over 20 years and have witnessed firsthand the challenges and complications that aging presents. It affects not only the aging themselves but also their families and loved ones. Health care is complex, and in this increasingly fragmented and overburdened system, it can be extremely helpful to have a professional oversee all aspects of care. As your eldercare manager, I will comprehensively assess the needs of your loved one and we will work together in establishing a care plan. I will assist you and your family with difficult decisions and help promote healthy communication on issues that are often difficult to address and navigate. An expanded version of my core services are summarized below: MANAGE health care needs, chronic conditions, illnesses, and coordination of careOPTIMIZE health outcomes via my extensive knowledge and experience in the healthcare system. I provide necessary education on chronic diseases and treatment plans, promote collaboration and communication amongst the health care team, ask the right questions of health care personnel, and any other needed activities in order to promote the safety and wellness of my clientsNAVIGATE the complex health system ADVOCATE for individuals to receive high quality care. I do this by such actions as asking the right questions of health care personnel, requesting a referral, second opinion, or further resources when appropriate, and anticipating/ planning for future health care needsTRANSITION clients to appropriate living conditions and proper levels of care. This may be from out of a private home into independent or residential living. It can also entail transition to a skilled nursing facility, assisted living, long term acute care, and hospice. There are many factors and variables to be considered when making these changes, and I provide assistance and support. The above services represent the bulk of my client/family needs. Some other services provided are:Comprehensive health status assessmentAssistance with medication complianceAssessing safety of the home and providing measures to reduce falls Helping clients/ families make difficult health decisions while navigating familydynamics and promoting effective communicationBeing present with client during doctor appointments etc. to ask the rightquestions and help assimilate health informationVisiting and interacting with clients at hospitals and facilities to assess healthstatus, monitor progress, and assist with any needs upon discharge or transfer Contact me today for a free 20-minute consultation!