What to Do When a Loved One Refuses to Recognize Health Concerns

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  

AltaVita Senior Residences is a dream come to fulfillment for the Macy Family. The longtime Longmont locals desired a way to give back to the community in which they grew up. And what better way to deliver on that commitment than to provide a multigenerational housing opportunity for Colorado families: three levels of continuing senior care on one campus in an unmatched, upscale environment. Filling a niche for older folks who want a place to call home for years to come, AltaVita has thought of every lifestyle element that seniors desire and deserve in an adult living community. Here a foundation for a brighter future is built on a unifying philosophy: Always put the resident first. This means providing for all aspects of the aging process 24 hours a day, 365 days a year. People are living longer and healthier lifestyles, and theyre remaining active, says Linda Berens, the campus Executive Director. Because of that many are looking for a multi-tiered campus offering continuing care within the familiar lifestyle. From involving family members in each residents life to creating a secure residence for those with advanced memory-related illnesses, AltaVitas well-designed campus and comprehensive services are built from the ground up to address and enhance every moment of daily living. One AltaVita residents family member said it best recently: I cant truly convey the appreciation I have for all that you have done. You have all been such a blessing to my mom and our family. The AltaVita team holds one another to a higher standard, which honors the important work they do, assisting the people who need them most. Enrich and enhance the lives of everyone we serve with respect and excellence: the AltaVita mission is confirmed daily by all the smiling faces. Three levels of care on one campus AltaVitas Longmont campus consists of the Memory Care Community, which opened in 2012; the Assisted Living Community, which followed in 2016; and the Independent Senior Living Community, which opened in June 2019. By building the community in three phases, planners have been able to thoughtfully design each building with residents in mind, taking into consideration the type of care they need and the amenities that will best suit them, explains Don Macy, owner.Memory Care Dr. Haleh Nekoorad-Long, M.D., a certified geriatric psychiatrist, is the medical director of AltaVita Senior Residences and works primarily with aging adults and issues regarding dementia, depression, and bipolar disorder. Recognized by the Alzheimers Association as a Leader in Dementia Care, the AltaVita Memory Care Centre is setting a new standard in Colorado for exceptional care for people with memory-related issues. AltaVita Memory Care Centre runs an adult day program, with respite services in suites specially designed for residents with Alzheimers and dementia. Additionally, care is customized for every residents level of dementia, ranging from acute medication management to the sense of freedom that comes with visiting AltaVitas beautiful garden patios and spacious, secure courtyard.Assisted Living With access to the same welcoming outdoor landscape, the AltaVita Assisted Living Community offers an upscale service focused intention. On the main level a great room welcomes visitors with a cozy fireplace, tavern, bistro and ice-cream parlor, and plentiful seating areas. The second floor overlooks the great room and features a large community room for varied activities as well as a comfortable lounge. Inclusive to the Assisted Living lifestyle are three meals every day, housekeeping and laundry services, social and recreational activities, 24-hour staffing, medical transportation, and emergency and nurse call systems. Independent Senior Living This is AltaVitas newest addition to the campus, a community for active adults who would like the enrichment of community life free of the responsibilities of home repairs. This maintenance-free lifestyle, including housekeeping, dining and transportation services, is designed to maximize that freedom and minimize those pesky daily duties. The new three-story building contains 84 stylish apartments with nine different floor-plan designs ranging from one bedroom, one bath to two bedrooms plus den and two baths. All include full kitchens, walk-in closets, large showers, washers and dryers, and private patios. The independent lifestyle program includes top-notch services and amenities like a full-service salon, fitness center, wellness programs, Tai chi classes, bistro and bar, housekeeping, and restaurant-style dining room. And when the outdoors beckons there is easy access to hiking, biking, and walking trails. On behalf of the family, we wish to extend our gratitude to such an excellent place for Vern to live, report family members of the experience of their loved one at AltaVita. The friendliness of the staff is beyond compare. We are very impressed with the quality and freshness of the food; the execution of meals; the presentation of such meals.Whole-life WellnessAltaVita believes one of the most important aspects of maintaining good mental and physical health among an aging population is lifestyle. And thats where AltaVita really shines. Supporting every part of the individual, AltaVita subscribes to Whole-Life Wellness. The methodology is envisioned to enhance residents health through seven critical aspects of wellness: social, emotional, spiritual, environmental, vocational, physical, and intellectual. For more information on AltaVitas progressive approach to maximizing the lifestyle of seniors, visit altavitaliving.com or call 888.745.8268 to schedule a free tour. 

Located in the heart of Maple Grove, Garland Commons offers a brand-new, affordable living option for adults 55 and older. Opened in 2024, this thoughtfully designed community combines modern amenities, spacious floor plans, and a prime location to create the perfect home for active adults seeking comfort and convenience.Modern Apartments Designed for Your LifestyleGarland Commons features a variety of one- and two-bedroom floor plans, ensuring you can find the layout that meets your needs. Each apartment is designed with convenience and style in mind, offering:In-unit washer and dryerAvailable quartz countertopsWalk-in closetsPrivate balconiesFree underground heated parking, with electric vehicle charging stations availableAmenities to Enhance Your Everyday LifeGarland Commons boasts an impressive array of community amenities designed to foster social connection, relaxation, and entertainment:Fitness center for maintaining a healthy lifestyleLibrary with a fireplace, perfect for quiet readingGame room featuring a pool tableCommunity and activity rooms for gatherings and eventsSunroom for unwinding in natural lightOutdoor patio with grillsDog run for furry companionsA playground for visiting grandchildrenPrime Location in Maple GroveLocated at 9651 Garland Lane N, Garland Commons is surrounded by conveniences and attractions. Residents can enjoy walking to Walgreens, Walmart, Aldi, Culvers, and other restaurants and shops. With easy access to I-94, the entire Twin Cities metro area is within reach.Visit Garland Commons TodayManaged by Velair Property Management, Garland Commons is open seven days a week for tours. Call (763) 298-3113 to schedule your visit and see why this vibrant community is the perfect place to call home.If youre looking for a safe, modern, and affordable living option in Maple Grove, Garland Commons is ready to welcome you. Experience the perfect blend of comfort, convenience, and community today!