You Are Never Too Old to Learn

By 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 stress Those 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.

As our population ages, managing healthcare for seniors becomes increasingly critical. One significant concern is hospital readmissions, which can be costly and detrimental to a seniors health and well-being. In-home care has emerged as a promising solution to reduce hospital readmissions, providing seniors with the support they need to recover and maintain their health at home. This blog explores how in-home care impacts hospital readmissions for seniors, offering insights into its benefits and the role it plays in enhancing overall health outcomes. Understanding Hospital Readmissions What Are Hospital Readmissions? Hospital readmissions occur when a patient is discharged from the hospital but has to return for the same or related medical condition within a specific period, usually 30 days. Readmissions can be a sign of inadequate care, complications, or a lack of proper follow-up. For seniors, who often have complex health needs, the risk of readmission is higher, making it a significant concern for healthcare providers and families. Causes of Hospital Readmissions in Seniors Several factors contribute to hospital readmissions among seniors, including: Chronic Conditions: Conditions such as heart disease, diabetes, and respiratory issues can lead to frequent hospital visits if not managed properly. Medication Management: Incorrect use or misunderstanding of medications can result in complications and readmissions. Inadequate Follow-Up Care: Lack of proper follow-up after discharge can lead to complications or deterioration of health. Limited Support Systems: Seniors who live alone or have limited support may struggle with post-discharge care and recovery. The Role of In-Home Care in Reducing Hospital Readmissions Personalized Care PlansIn-home care provides a tailored approach to managing a seniors health. Care plans are developed based on the individuals specific needs and medical conditions, which can help prevent complications and reduce the likelihood of readmission. This personalized approach includes: Medication Management: Ensuring that medications are taken as prescribed and monitoring for potential side effects. Chronic Disease Management: Providing support for managing chronic conditions through regular monitoring and adjustments to care plans.  Continuous Monitoring and SupportOne of the key benefits of in-home care is continuous monitoring and support. Caregivers can observe changes in the seniors condition and respond quickly to any issues that arise. This ongoing support includes: Health Monitoring: Regularly checking vital signs and tracking health indicators to catch potential problems early. Emergency Response: Being available to handle emergencies and provide immediate assistance if needed.  Post-Discharge CareAfter a hospital discharge, in-home caregivers play a crucial role in ensuring a smooth transition and recovery process. Post-discharge care services include: Follow-Up Appointments: Assisting with scheduling and transportation to follow-up medical appointments. Wound Care and Physical Therapy: Providing necessary care for wounds or facilitating physical therapy exercises as prescribed by the doctor.  Education and TrainingIn-home caregivers educate seniors and their families about managing health conditions, medication use, and lifestyle changes. This education helps in: Understanding Health Conditions: Ensuring that seniors and their families are well-informed about the seniors health conditions and treatment plans. Self-Care Techniques: Teaching techniques for managing symptoms and preventing complications.  Companionship and Emotional SupportEmotional well-being is an important aspect of recovery. In-home care provides companionship and emotional support, which can positively impact a seniors overall health. This support includes: Reducing Loneliness: Offering social interaction and companionship to alleviate feelings of isolation. Encouraging Compliance: Motivating seniors to follow care plans and engage in healthy behaviors. Conclusion In-home care plays a vital role in reducing hospital readmissions for seniors by providing personalized, continuous, and compassionate support. By addressing specific health needs, managing medications, offering post-discharge care, and providing emotional support, in-home caregivers help seniors maintain their health and prevent complications. Investing in in-home care not only improves health outcomes but also enhances the quality of life for seniors, making it a valuable component of comprehensive healthcare management. For more information on in-home care services and how they can benefit your loved one, contact us at 412-810-6595. We are committed to providing exceptional care and support to help seniors thrive in their own homes. 

   If you are satisfied with the clinicians at your primary care office, cherish those relationships.  For many reasons, it is getting more difficult to find primary care clinicians who go the extra mile for you and your loved ones.  If you are not content with your primary care team, I offer the following suggestions.    First, find a clinician (physician, nurse practitioner, or physician assistant) who enjoys listening to you and your stories.  The art of medicine is mostly about the art of listening.and believing what you share.  Listening and understanding build trust, essential for any good relationship.  Every city and small town in our country has such clinicians.     Second, appreciate that young nurse practitioners and physician assistants can listen to you and help sort out your problems every bit as well as a seasoned physician who is overworked and/or approaching retirement.  In my 40 + year career, Ive had the opportunity to train hundreds of NPs and PAs.  They gain the knowledge, expertise, and confidence to become great providers within 9-12 months of graduating from professional schools.  Often, they have more technical skills than older physicians.  This works to your advantage in the following ways.  Assume you have an unusual combination of symptoms.  They know how to explore the Internet and rely on specialists to find the best plan of care for you.  Now assume you need a steroid injection in a joint.  Many NPs and PAs can provide procedures that overworked physicians never learned.     Third, see the entire practice as your primary care provider.  A good practice has all members working together as a team.  The members include front office staff who greet you for in-person visits, medical assistants and nurses who answer your phone calls, and the clinicians who care for you in person or with tele-health visits.  If you find that any team member isnt respectful, you should feel free to discuss this with the office manager.  All good practices should welcome feedback.      Fourth, if you have the means and value extra attention, consider a concierge practice.  Unfortunately, concierge physicians are beyond the reach of the vast majority of seniors in our country.  Further, we are seeing a shortage of these physicians just as we are seeing a shortage of all primary care physicians.  This brings us back to my key message: you can find trust and comfort with a dedicated NP or PA.  When we consider the evolution of geriatric practice over the last 4 decades, we understand that it is NPs and PAs providing the vast majority of visits in nursing homes, assisted living facilities, and in-home visits.Finally, it is important to understand the pressure and demands on your primary care office.  The advent of the electronic health records in the 1990s added a massive burden to all practices.  The hope (and the myth) was that EHRs would lead to higher quality medical care.  The reality is that EHRs havent improved true quality.  EHRs are the main reason so many good clinicians are feeling burned out.  The clinicians feel they have to pay more attention to the EHR (and quality metrics) than to the patient in front of them.  When you express your understanding of this dilemma to your clinical team, they greatly appreciate this.  Again, building understanding and trust leads to the best quality of care and beneficial outcomes. The article was written by Dr. Don Murphy, Geriatrician and Hospice Physician who plans to run for Governor of Colorado, on behalf of. He can be reached at murphdoc@comcast.net, his cell, 720-490-6757, or his main YouTube channel, TheCrazyMurphys5560.