Is It Time for My Colonoscopy Again?

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, Id like to address the definition of this disease process. Heart failure occurs when the heart doesnt pump well and fails to deliver adequate oxygen to the body. As a result, fluid builds up in the body and vital organs dont 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 todays 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 dont understand the importance of them or they dont 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. Its 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 its 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 diabetesAgarwal, 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  

It's a difficult decision to make, but sometimes it becomes clear that our older loved ones need more care than we can provide at home. If you're struggling with the decision of whether or not to place your parent or spouse in an assisted living facility, this blog post is for you. Here are some signs that it might be time to start considering assisted living.1. Are simple activities becoming difficult?Assisted living facilities are designed to help seniors with activities of daily living such as bathing, dressing, and grooming. If your loved one is struggling with any of these activities, it might be time to consider assisted living.2. Does your loved one have difficulty with living independently?Another sign that assisted living might be the best option is if your elderly loved one is having difficulty paying bills, getting around to run simple errands, or attending appointments. If getting from point A to point B has become a challenge, assisted living can help. Most facilities offer transportation services for their residents and have services on-site for a variety of needs. 3. Has there been a decline in your loved ones hygiene or appearance?Has your loved one started to neglect their personal hygiene? Are they no longer keeping up with their usual grooming routine? This could be a sign that they need assistance with activities like bathing and dressing.4. Are you noticing changes in mood or behavior?Sometimes changes in mood or behavior can be a sign of declining health. Has your usually cheerful loved one become withdrawn or depressed? Do they have sudden outbursts of anger? These changes could be indicative of a larger health issue that might be best addressed in an assisted living facility.Making the Decision TogetherOnce you have decided that assisted living is the best option, its important to involve your loved one in the decision-making process as much as possible. Let your Senior Care Authority advisor assess their care needs, explain the options, and schedule tours of places that best fit the needs of your family. Include your loved ones in the process as much as possible so they feel that they are part of the decision to choose the next place they will call home.  If possible, try not to wait too long as adaptive skills can decrease with the progression of age or cognitive decline.Finding the best senior living setting for your loved one can be an overwhelming task, but you dont have to go through it alone. The experts at Senior Care Authority are here to help! We offer a variety of services designed to help seniors live their best life possible. Contact us today to learn more about how we can help you and your family. 

As we enter the fall and winter season this year, things look a little different. Many seniors continue to isolate at home because of the Coronavirus pandemic and this can take a toll on their mental health.Its important for seniors to work with their families, caregivers and health professionals to develop a plan that allows them to safely take part in activities they love and maintain positive mental health through activity and connection.At any age, our health and wellbeing are enhanced by regularly participating in the things that bring us purpose, hope and joy. For seniors, taking part in these activities can be more difficult, older people who feel younger than their age show less brain aging, better memory and less depression. And studies show that staying engaged is important for a seniors mental and physical health. Medical professionals recognize that social determinants of health, especially those that affect mental, social, emotional and spiritual wellbeing, impact health outcomes and quality of life.There are always opportunities for meaningful moments and joyful days with a little planning, conversation and intentional action.Fall ActivitiesFall activities tend to focus on connecting with loved ones, enjoying the  turning season and spending time outside before the weather gets icy.This year, many people cant see their favorite sports teams play in person. But fall is a dream for seniors that enjoy football, baseball and hockey and there are ways to participate virtually. Seniors and their loved ones can watch together over a video call or have a socially distanced viewing party at home, as long as everyone adheres to recommended safety guidelines.Enjoying fall foliage is an activity in itself, and can be done sitting on the porch, going for a short walk or on a longer hike outside. Raking leaves can even be fun when done with loved ones.Eating is another activity that seems to be more fun in the fall family dinners for those isolating together, baking projects and Halloween fun are all opportunities for seniors to participate in activities they enjoy while maintaining their nutrition goals. Winter ActivitiesThe holidays are filled with opportunities to enjoy music, celebrations with family and community service.Holiday shopping is a fun activity usually done outside of the house. However, online shopping may be the best way for seniors to get their gifts without visiting the mall.Singing, dancing, playing instruments and listening to holiday carols are ways that seniors can enjoy music, no matter what the weather looks like outside. Streaming music services often have a wide selection, allowing seniors to pick their favorites to listen to through a phone, virtual assistant or computer.While there are ways that seniors can serve others year-round, volunteering can be even more meaningful around the holidays. Finding virtual volunteer opportunities is even easier this year writing letters, knitting blankets and finding old coats and sweaters to donate can all be done safely at home. Comfort Keepers can HelpAt Comfort Keepers, we create individual care plans for every client. These plans include wellness goals that consider physical, mental and emotional health. Our caregivers can help support physician-prescribed diet and exercise plans, provide medication reminders, provide transportation to appointments and help seniors engage in the activities they love the most. And, our caregivers can help senior stay connected with loved ones through video chats, phone calls and care updates. We believe that every senior should experience the best in life. If you have questions about Comfort Keepers uplifting in-home care services, please contact us today.