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Lets Get Heart Smart  February Is American Heart MonthBy the time you read this, the reported deaths from COVID-19 and its variants in the U.S. will be close to 900,000. As staggering as that statistic is, its 400,000 short of the number of Americans killed by Heart Disease in the same time period. Heart disease is the leading cause of death for men and women of most racial and ethnic groups.Lets not allow the topic to overwhelm the fact theres a miracle inside your chest. Weighing about as much as a grapefruit, the heart is a powerful pump that drives five to six quarts of blood to every microscopic part of your body every second. And if it fails for even a second, the body is very unforgiving. Even though its the one piece of machinery driven by the brain, we tend to treat the heart like a kitchen appliance that we take for granted. Rarely serviced, rarely cleaned, and overworked until it burns out. Although heart bypass and transplant have become routine since the pioneering operations in the 1960s, its not like replacing the coffee maker you neglected too long.One Thing at a TimeThe better way to treat your heart with the respect it deserves is to start with changing just small habits. That way, youll avoid the relapse from trying to change everything at once and falling back to unhealthy heart habits inside of a month. The most obvious: if youre a smoker or heavy drinker, work on that first. Imagine a small team of remodelers arriving at your heart to do a makeover. The first thing theyre going to say is, Well, we cant do anything with the plumbing until we clear the smoke.Look for Help During Heart MonthQuitting smoking and reducing alcohol is never easy, but this is probably as good a time as any during the year to start a cessation program with help. February is American Heart Month, so youre likely to be reminded frequently of heart health and offered tips on modifying your routine to help your heart and prolong a happy life. If you only look to one place, trust the American Heart Association www.heart.org. Prediabetes and Heart DiseaseWhats your blood sugar level? If you dont know, you should find out from your doctor if youre not already monitoring it yourself. You could be pre-diabetic without knowing it or showing any symptoms. Theres a good chance you could avoid becoming diabetic and reverse your pre-diabetic blood sugar to normal with relatively little change to your diet and a slight increase inyour activity. Diabetes has long been linked to heart disease, but recent studies suggest that reversing prediabetes is also linked to fewer heart attacks and strokes. [Reversing Prediabetes linked to fewer heart attacks, strokes, heart.org, Jan. 26, 2021.]While youre at it, get your cholesterol tested and routinely monitor your blood pressure.If youre worried you might be at risk for heart disease, ask your doctor to perform a simple cholesterol test to let you know if youre at risk and should adjust your diet. Home blood pressure monitors are not expensive, theyre digital, and theyre easy to use. Blood pressure stations are common in supermarkets now, and you can also check your weight and pulse.Womens Heart HealthWhy the emphasis on womens heart health? The American Heart Association tells us that cardiovascular disease is the No. 1 killer of women, causing 1 in 3 deaths each year about one woman every minute. They devote an entire website to womens heart health: Go Red for Women (www.goredforwomen.org). Here are just a few of the common misconceptions about womens heart health:Myth: Heart disease is for men, and cancer is the real threat for womenFact: Heart disease is a killer that strikes more women than men and is more deadly than all cancer forms combined. While one in 31 American women dies from breast cancer each year, heart disease is the cause of one out of every three deaths.Myth: Heart disease is for old peopleFact: Heart disease affects women of all ages. For younger women, the combination of birth control pills and smoking boosts heart disease risks by 20 percent. Heart defects are more common than you might think: 1.3 million Americans alive today have some form of congenital heart defect and at least nine of every 1,000 infants born each year have a heart defect. Even if you live a completely healthy lifestyle, being born with an underlying heart condition can be a risk factor.Myth: I run marathons no way I could be at risk.Fact: Factors like cholesterol, eating habits, and smoking can counterbalance your other healthy habits. You can be thin and have high cholesterol. The American Heart Association says to start getting your cholesterol checked at age 20. Earlier, if your family has a history of heart disease.Age and Heart HealthMany things, like wine and most people, grow better with age. The heart, however, takes more tending than a glass of fine wine. Avoid things that weaken your heart beyond the normal aging process. These are the usual suspects: smoking and tobacco use, lack of exercise, diet, alcohol, overeating, and stress. Some preexisting conditions you cant control: irregular heartbeat, congenital (inherited) heart defects, sleep apnea (although this may be a product of obesity or alcohol consumption).Viruses and MyocarditisMyocarditis is an inflammation of the heart muscle mostly caused by a virus, including COVID-19, and can lead to left-sided heart failure. The left ventricle of the heart is the part that pumps oxygen-rich blood back to the body. This valve tends to stiffen with age. Thats one of the many reasons why age combined with a preexisting condition puts you at greater risk of death from COVID-19. Even survivors of the novel coronavirus infection can sustain permanent heart damage. All people must protect themselves and others from COVID-19 by observing precautions, not just because of its immediate lethality but also because of its impact on the heart, known and unknown.How to Start with Your HeartThe factors involved in heart health and the onset of heart disease are many, varied, and complicated. But the common preventions (listed here, from the Mayo Clinic) are simple. You probably already know them by heart, so to speak:Not smokingControlling certain conditions, such as high blood pressure and diabetesStaying physically activeEating healthy foodsMaintaining a healthy weightReducing and managing stressThose may seem like six significant challenges, especially if you take on all six. But you should notice something else about them. Almost every one of them can affect the other five. So, if you pick one, youll find it easier to take on the next one. People who quit smoking usually discover that they have more energy within the first week, and exercise becomes easier. A little exercise and switching out one unhealthy food will help with weight, stress, blood pressure, and diabetes. Easy does it, especially if youre 65 and older. Youve spent a whole life learning one way. You can take your time. Learn to enjoy your healthier heart. But start today.First, Get a Checkup!Most of the questions this article has raised in your mind (Whats my blood sugar level? Whats my blood pressure? I used to smoke am I at risk?) can all be answered in a single doctors visit with simple lab work done a few days before. Schedule it now, before you start a program of exercise and diet. And schedule a regular exam per your doctors recommendation. Relieving the stress of not knowing will be a good start on your way to a healthier heart.

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  

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.