Mastering Change: Senior Organizing Tailored to You

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  

Alzheimers disease impacts the lives of seven million Americans who suffer from this disease, but millions more feel the effects as the disease steals the memories of a loved one. According to the World Health Organization (WHO), 55 million individuals around the globe live with dementia; experts estimate that Alzheimers accounts for the majority of dementia cases (60 to 70 percent).As Alzheimers disease progresses, individuals lose the ability to manage everyday tasks, including crucial self-care (like getting dressed and eating independently). September 21 marks World Alzheimers Day, which seeks to increase awareness about the disease and its symptoms and fight the stigma linked to Alzheimers diagnosis.  Table of Contents:Dementia vs. Alzheimers DiseaseAlzheimers SymptomsEarly Signs of Alzheimers DiseaseStages of Alzheimers DiseaseWhat Is a Memory Care Facility?Signs Its Time For Memory CareCosts of Memory CareHow Senior Moves Helps Families of Alzheimers PatientsKey Takeaways:Alzheimers disease touches the lives of tens of millions of individuals across the world. World Alzheimers Day unites families as they strive to increase awareness, remove the stigma about this disease, and find the best care and support for their loved ones.Dementia Vs. Alzheimers DiseaseIndividuals diagnosed with Alzheimers disease have dementia as part of the disease progression. However, not all individuals with dementia are diagnosed with Alzheimers disease. Dementia, the loss of memory and judgment, is a symptom of numerous diseases and medical conditions. Race Against Dementia explains that dementia is also a symptom of Huntingtons disease, hydrocephalus, and Creutzfeldt-Jakob disease. In addition, numerous types of dementia exist; Parkinsons disease dementia, Lewy body dementia, frontotemporal dementia, and vascular dementia are independent diagnoses. However, Alzheimers disease accounts for the majority of dementia casesaround 70 to 80 percent!Alzheimers SymptomsOnly a doctor can properly diagnose Alzheimers disease. However, individuals should learn to understand and identify this disease's numerous warning signs and red flags. Early diagnosis ensures that patients may begin care and medication to help slow disease progression. Early Signs of Alzheimers DiseaseAge leads to common memory issues; misplacing car keys and retracing steps to find them is a common problem. Forgetting an occasional appointment also may be a common issue correlated to growing older. There are many red flags of Alzheimers disease or dementia that are not related to growing older, including:Forgetting conversations and asking the same questions repeatedlyGetting lost while going to a familiar location. Losing items and finding them in unusual places (a wallet may be in a kitchen cabinet)Struggling with basic problem solving (balancing a checkbook, making a familiar meal, etc.)Inability to track time (dressing for fall when its summer)Visual issues (struggling with depth perception)Communication struggles (forgetting a word is normal, but forgetting common objects is a red flag)Making poor judgements (dementia patients may give away possessions or make large donations without thinking of the impact)Disinterest in friends or social experiencesAnger, frustration, and other mood issuesThe Stages of Alzheimers DiseaseAlzheimers disease is progressive, and it is unfortunately fatal. According to the Alzheimers Association, the disease has three stages: early, middle, and late.The earliest stages of Alzheimers typically lead to subtle memory issues; at this point, family and friends may notice that their loved one struggles with memory issues. They may forget appointments or constantly ask the same questions. The early stage is when small red flags appear.Alzheimers middle stage leads to more serious memory concerns. The Alzheimers Association explains that patients may forget personal information, get lost in familiar areas, struggle with time, and their bladder or bowels may begin to fail as patients lose the ability to control these functions. Mood and personality also begin to change.The late stage of Alzheimers disease is the final and most severe stage. Communication may be difficult or impossible. Patients must receive 24/7 care, as they cannot eat or get dressed. Eventually, the disease overtakes the body, and eating and swallowing becomes impossible. The Alzheimers journey may endure for nearly two decades, from the beginning or early stages to the final stage of the disease. However, every patient is different.  What Is a Memory Care Facility?As an individual near the middle and late stages of Alzheimers, symptoms increase, and the ability to manage daily tasks becomes untenable. Alzheimers patients may wander, posing a risk to their safety. Judgment also wanes, and Alzheimers patients may jeopardize their financial wellbeing by making poor money management decisions.Eventually, Alzheimers patients require around-the-clock care and support. Family members may discover that they can no longer care for their parents or relatives and may begin to research future care and health management options.A memory care facility is a special residential facility that specializes in the unique care needs of dementia patients. Individuals receive 24/7 care and monitoring, with assistance for managing medications, safety, and support for activities of daily living (ADL) like getting dressed, bathing, going to the bathroom, eating, and mobility. Memory care facilities typically feature alarms at every exit that activates when a patient tries to leave.Signs Its Time for a Memory Care FacilityThe choice to move a parent or loved one into a memory care facility is very personal. How do you know its time for memory care? Many family members make the difficult decision to place their parent or family member in memory care when the individuals safety becomes compromised. While family members may provide care, dementia and Alzheimers disease gets worse over time. Individuals may start to leave their home and wander. They may make poor financial decisions or become openly hostile. As Alzheimers progresses, individuals need help with eating, bathing, and going to the bathroom. Family members may realize that they are unable to provide the level of care their loved one needs, and memory care becomes the bestand the safestoption. Costs of Memory CarePrivate insurance typically does not cover the cost of memory care facilities. However, some facilities could accept Medicaid. Dementia Care reports that memory care facilities cost around $54K annually (a national average). In some states, the cost could be higher or lower. Families may visit numerous facilities to find the best care for their parent or loved one. Prices may vary, but amenities also could be very different at each facility. How Senior Moves Helps Families of Alzheimers PatientsWhen the home is no longer safe and independence is no longer an option, families must begin to transition their loved ones to a residential care facility. Senior Moves works with families to make this transition easier for everyone. Our team helps families prepare a home for sale. Senior Moves works with family members to sort through every possession, labeling piles to keep, donate, or discard. Our team also organizes and cleans the home, staging it to appeal to the most buyers.Senior Moves helps with the move, too. We pack and unpack and arrange the new room to feel more like home. Our team also works with families to help ease the transition to a new space. Our team understands the difficulty of a dementia diagnosis. We walk family members through every step of the transition and help ease their minds (and hearts) as they prepare their parents (or loved ones) for a move to a memory care unit. Learn more about the services we offer, and reach out to our team to schedule a consultation. 

Whether you're traveling from across the street or across the country, holiday gatherings provide an excellent opportunity to assess the well-being of your aging family members. These festive occasions, filled with dinners, gift exchanges, and parties, offer a natural setting to observe any changes in behavior or lifestyle that may have occurred since your last visit.Changes in an elderly relative's condition can range from obvious to subtle. To help you gauge their current physical and mental state, we've compiled a comprehensive list of areas to observe and questions to consider during your time together.EnvironmentThe condition of your loved one's living space can offer valuable insights into their ability to maintain their home and overall well-being. Look for the following:Signs of damage or disrepair in and around the houseAccumulation of trash or clutterBurned-out light bulbs left unchangedDecline in cleanliness, particularly in the kitchen and bathroomUnopened mail piling upItems stored in unusual or potentially hazardous locationsDamage to their vehicle, such as unexplained scratches or dentsThese observations can indicate difficulties with home maintenance, mobility, or cognitive function.Food and NutritionProper nutrition is crucial for seniors. During your visit, pay attention to:The quantity and quality of food in the refrigerator and pantryPresence of expired or spoiled food itemsSigns of weight loss or malnutritionIndications that meals are being skipped or forgottenPoor nutrition can significantly impact an elderly person's health and may signal the need for additional support.Mood and BehaviorChanges in mood or behavior can be early indicators of cognitive decline or other health issues. Watch for:Withdrawal from social activities or abandonment of once-enjoyed hobbiesNew friendships or organizational affiliations, especially those involving frequent contact or requests for donationsIncreased confusion or repetition in conversationsSigns of irritability, apathy, or sadnessGeneral withdrawal or changes in typical demeanorThese behavioral shifts may warrant further investigation or professional assessment.Personal HygienePersonal care habits can provide valuable clues about an individual's physical and mental state. Look for:Decline in overall grooming and appearanceWearing dirty clothes or not changing clothes regularlySkipping showers or bathsBruises or injuries that might indicate falls or accidentsPoor hygiene can be a sign of physical limitations, depression, or cognitive impairment.Financial ManagementWhile not always easy to observe, changes in financial management can be crucial indicators of cognitive decline or potential exploitation. If possible, discreetly assess:Bill payment habits and any signs of financial distressUnusual or large purchasesUnfamiliar names on financial documentsSudden changes in banking habits or account managementFinancial mismanagement can have serious consequences and may require prompt intervention.Medication ManagementFor seniors taking multiple medications, proper management is essential. Observe:Organization of medicationsPresence of expired prescriptionsSigns of missed doses or confusion about medication schedulesMedication errors can lead to serious health complications and may indicate the need for additional support.Social ConnectionsMaintaining social connections is vital for seniors' mental and emotional well-being. Take note of:Frequency and quality of interactions with friends and neighborsParticipation in community activities or religious servicesUse of technology to stay connected with family and friendsSocial isolation can contribute to depression and cognitive decline in older adults.Remember, this list is not exhaustive but serves as a guide to help you check in on your aging loved ones. By observing these areas and initiating conversations early, you can identify potential issues and provide timely support. If you notice concerning changes, consider consulting with healthcare professionals or senior care experts for guidance.The holiday season offers a wonderful opportunity to spend quality time with your elderly relatives. Use this time to observe, listen, and engage meaningfully. Your attentiveness can make a significant difference in ensuring their continued well-being and quality of life.Aging Life Care Managers are an excellent resource for support. Working with families, an Aging Life Care Manager is a strategic planner offering options and solutions that best fit a persons individual needs and resources. Their guidance leads families to the actions and decisions that ensure quality care and an optimal life for those they love, thus reducing worry, stress, and time away from work for family caregivers.