Taking Care of Your Heart is Always Important

Functions of the Heart

Our heart is a muscle, divided into 4 chambers. The right and left atriums occupy the upper chambers while the right and left ventricles fill the bottom chambers. The right side of the heart receives blood from the body and pumps it through the lungs to re-oxygenate the blood. The left side of the heart pushes the replenished blood back through the body. This cycle repeats with every beat of the heart. Blood travels through the body’s circulatory system. Blood vessels, arteries, arterioles, capillaries, venules, and veins make up the circulatory system. This system delivers necessary oxygen and nutrients to our bodies. It also removes carbon dioxide and other waste products.

Types of Heart Disease

Heart disease is a term used to describe any disorder of the heart. There are many types of heart diseases. Some you may be born with while others develop overtime. For example, acquired heart valve disease develops over a person’s lifetime. It occurs when a normal functioning heart slowly declines due to family history, illness, or aging. Acquired heart valve disease typically affect the mitral and aortic valves. Congenital valve disease, which is present at birth, is a result of abnormalities where heart valves do not fully form or form into the wrong shape or size. Coronary heart disease, myocardial infarction, and arrhythmia are some examples of heart disease.

Risk Factors

  • Age/Gender
  • Men over the age of 65 are at greatest risk of developing heart disease
  • Women over the age of 75 are at greatest risk of developing heart disease
  • Family History
  • There are many congenital heart diseases that are passed through genetics
  • Health History
  • People with kidney disease, metabolic disease, certain infections, and hypertension are more predisposed to developing heart disease.
  • High Blood Pressure (Hypertension)
  • High blood pressure enlarges the heart. This results in the tissues within the heart stretching causing leaks.
  • Autoimmune Diseases
  • These types of diseases typically cause inflammation particularly within the heart which can lead to decreased function.
  • Chemotherapy and Radiation Treatments
  • These types of drugs can cause damage to the heart valves.
  • Diet Medications
  • Certain medication used for weight loss can lead to heart abnormalities. These conditions typically improve once the medications have been stopped.

How Hearts Change with Age

Heart disease is the most frequent condition found among the elderly. It also the number one cause of death for the elderly. Normal aging (wear and tear) is the most common cause of a multitude of adverse changes within the structure of the heart. For example, the heart of an elderly man does not beat as fast with increased activity causing his body to fatigue faster. Over time, fatty deposits build up on the walls of arteries, causing obstruction of blood flow. The most common change is the hardening of arteries leading to high blood pressure.

Symptoms

Something to keep in mind with Heart Disease is the severity of symptoms do not always correlate with the severity of the disease. One could experience mild symptoms but have a serious condition. It is important, if any of these symptoms are noted below, a doctor is consulted.

  • Shortness of breath
  • Headaches
  • Dizziness / Light Headedness
  • Chest Pain
  • Chest Palpitations
  • Sudden Weight Gain
  • Abdominal Pain
  • Fatigue
  • Decreased Appetite
  • Numbness or tingling
  • Cold Sweats
  • Living with Heart Disease

Heart disease requires lifelong precautions that can include but are not limited to:

  • Regular Physical Exams
  • Regular EKG’s, CT Scans, Chest X-Rays, etc.
  • Medications
  • Diuretics
  • Blood Thinners o
  • Medications that control rapid or irregular heart beats
  • Blood Pressure Medications
  • Exercise and Diet
  • Exercise aids in reducing cholesterol and blood pressure
  • Restricted salt intake. Salt causes the body to retain fluid which can stress the heart
  • Dental Care
  • Bacteria in the mouth can spread to blood and pass through the heart. This may cause endocarditis a potentially life-threatening condition.

Heart Healthy Lifestyle Choices for the Elderly

Safe exercises are a key component to defending the elderly against heart disease. Function and mobility in the muscles weaken as we age. Being active is the best way to slow muscle break down. Here is a list of low impact exercises that are safe for elderly to participate in.

  • Chair Squats
  • Wall Pushups
  • Single Foot Stand
  • Tip Toe Lifts
  • Wall Snow Angles
  • Walking
  • Swimming
  • Water Aerobics

Diet plays a big role in remaining healthy with heart disease. And it is not just about what not to eat. Since many people with heart failure are often short on important nutrients, we should focus on eating more foods that are healthy. This might include

Fruits – oranges, pears, berries, avocados, and apples

Vegetables – Dark green leafy vegetables, beans, and peas

Whole grains – Brown rice and oatmeal

Seafood – Oily fish such as salmon, trout, or herring. Try these in place of poultry or red meat about twice a week

Nuts and seeds – walnuts and sunflower seeds

Dairy – choose fat free or low-fat options

Olive oil – cook with this in place of solid fats like butter

Coping with Heart Disease

You may be experiencing a myriad of difficult emotions if you or someone you love has been diagnosed with heart disease. Learning as much as you can about the condition and the treatments available is a great way to become more hopeful. Actively managing your condition by tracking your treatment goals and celebrating your achievements will assist in promoting a higher quality of life.

Sharing your experiences with friends and family members can also give you hope. There are multiple support groups for people with heart conditions. Getting to know people going through the same things can build confidence in dealing with your diagnosis. Reading stories from other survivors is an excellent way to grow hope. You are not alone in your diagnosis.

“Is it Alzheimer’s?”

Alzheimer’s is different from the normal forgetfulness of aging. Alzheimer’s is one of many conditions that cause the radical changes in memory, reasoning, and behavior known as “dementia.” The normal forgetfulness of aging is just an inconvenience, a slowing down. The serious changes of dementia eventually result in the inability to live on your own.

Here are some helpful distinctions developed by the Alzheimer’s Association:

  • Memory failures that affect daily life. Trouble learning something new. Not recalling recent events. Asking the same question over and over. Normal aging: Not remembering something in the moment but recalling it later.
  • Difficulty with problem solving and reasoning. Inability to think abstractly (e.g., use numbers) and create logical plans. Signs include difficulty figuring a tip or following a recipe. Normal aging: Occasional addition or subtraction errors.
  • Trouble with familiar tasks. Drawing a blank while playing a beloved game or driving to a familiar location. Normal aging: Needing help with something recently learned.
  • Losing the anchor of time. Forgetting the season or the year. Normal aging: Briefly losing track of the day of the week. 
  • Spatial problems. Trouble judging distance. Difficulty with balance. Normal aging: Needing glasses to read.
  • Communication problems. Losing the thread of a conversation. Repeating a story or question. Normal aging: Occasional inability to find a word. 
  • “Losing” common objects. Putting belongings in odd places and not remembering. Inability to retrace steps. Accusing others of stealing. Normal aging: Forgetting why you went into a room and retracing your steps to remember.
  • Poor judgment. Falling for scams, overspending, wearing odd outfits. Normal aging: Periodically making a bad decision or skipping a bill payment.
  • Withdrawal from activities. Not socializing as much, especially as conversing becomes difficult. Normal aging: Consciously choosing to do something different.
  • Moody or irritable. Significant personality changes: Depression, anxiety, fear, and paranoia. Normal aging: Getting grouchy if cherished routines are disrupted.

Concerned about your memory? Let’s talk.
Give us a call at 916-524-5151.

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Driving as we age

Irritating but true: Aging brings changes that make safe driving more of a challenge. Slower reflexes. Reduced vision and hearing. Difficulty concentrating. Less flexibility in the neck and shoulders.

Fortunately, these changes do not come on suddenly. And adjustments in driving habits can offset them such that older drivers can be much safer than their younger counterparts.

Safe driving starts with a willingness to be honest with yourself about modifications.

A few signs that adjustments may be in order:

  • Thoughts wander when you drive
  • Frequently startled or uncertain in high-traffic conditions
  • Taking medicines that list drowsiness as a side effect
  • One or two tickets or verbal warnings from police in the past two years
  • Dents in the car, or even a collision in the past two years
  • Comments or concerns expressed by family or friends

Take a self-assessment. The American Automobile Association (AAA) offers a free, confidential test at seniordriving.aaa.com.

Consider a Mature Driver Course. AAA and AARP (American Association of Retired Persons) offer courses filled with tips. Your car insurance may even discount your premiums.

Easy things you can do right now:

  • Flexibility exercises. Increase mobility in your neck and shoulders so you can readily turn your head to check for blind spots when changing lanes or backing up.
  • Reduce distractions. Turn off the radio. No eating or drinking while driving. Definitely no phone calls. Consider halting conversation with passengers when driving conditions are complicated (e.g., at intersections).
  • Drive mid-day. Avoid rush hour and freeways. And if you have trouble with night vision, plan your trips so you are home before twilight.
  • Make a left turn only at a left-turn light. If there is no stoplight, drive a block farther and make three right turns. (Three rights make a left.)

Wondering about your driving?
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How to pay for care

Most people are surprised to learn that Medicare pays for only a limited amount of the daily care you are likely to need in your lifetime (about 14%).

Medicare covers only services delivered by medically trained professionals. That means you need to have savings or insurance and rely on a collection of local programs. Or family and friends who may be able to pitch in with labor or funds.

Assisted living and memory care $$$–$$$$
As nonmedical services, these settings are usually paid for out of your own savings. If you are a qualifying veteran or you have long-term care insurance, your costs may be covered. Contact the Veterans Administration or state Veterans Council. Check your long-term care insurance policy for eligibility requirements. Also ask about waiting periods. Is there a lifetime cap on the total amount they will pay?

Skilled nursing/rehab or nursing home $–$$$$$
Provided your stay follows a qualifying hospitalization, original Medicare—the government’s health insurance for seniors—will typically cover some portion of the costs for the first 100 days. You use your supplemental insurance for your copay. Or pay out of pocket if you do not have supplemental insurance. Starting day 101, you pay 100% of the cost. Medicare Advantage plans vary, so review the coverage with your insurance provider. If you have private long-term care insurance, check your policy for skilled nursing coverage. The Veterans Administration offers special facilities for qualifying vets.

The very poor may qualify for Medicaid. This program will pay 100% of costs. However, there are only a limited number of Medicaid openings available in any given facility. Those living long term in a nursing home usually exhaust all personal savings and assets. Then they switch to Medicaid. If you think you may need Medicaid, consult an elder law attorney early. Also, your financial planner for advice about liquidating your assets.

Continuing care retirement communities $$$$$
This is a very different model of care that merges housing and insurance. With a continuing care retirement community—also known as a “Life Plan Community”—you invest a substantial sum up front (often in the six figures). You also pay a monthly service fee. Start while you are healthy and live on campus to enjoy the deluxe amenities. Move to the most appropriate building as your care needs change. This is paid for almost entirely out of your own savings. If you have long-term care insurance, check your policy to see if it covers continuing care retirement communities.

Worried about paying for care? Give us a call at 916-524-5151.

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Choosing a home care provider

Frank knows they need help at home. His wife’s dementia is getting worse, and he has his own health problems. She can’t be left alone anymore.

Doing all the cooking and cleaning, and now helping with bathing … it’s just too much.

Frank needs to take breaks. But a Google search reveals a dizzying array of home care providers. How to choose?

Allowing a stranger into your home can leave you feeling quite vulnerable. It’s important that you trust the individual and the company that does the background checks, verifies training, and puts together the schedule.

You also need to interview each company to find out pricing and minimum number of hours, and to see if they have independent quality ratings.

How do you know which one to trust?
This is where a Geriatric Care Manager can help.

On the basis of past experience with other clients, he or she knows which companies put an emphasis on training. Which have difficulty filling a shift if a caregiver calls in sick. Which have high staff turnover resulting in the need for you to orient a new employee every few months. Which have a strong team, with employees who love their work.

Wise home care companies will let you and your Geriatric Care Manager interview several caregivers before making a choice. They know that a Geriatric Care Manager understands you as the client and understands what will result in an optimal match.

Both you and the provider and the caregiver want a good fit the first time so all of you can work together positively for the duration of your need. It makes the difficult transition to home care that much easier if a knowledgeable advocate can set expectations and provide an objective viewpoint.

Even with adult day care and medically trained services, such as home health and hospice, not all providers are alike. A Geriatric Care Manager knows the reputation and the management style of each company. He or she can look up Medicare reviews and complaints.

A Geriatric Care Manager can also coordinate care across multiple service providers and work with your physician to ensure that all the different players are aware of your changing needs.

Want to find the best fit the first time? Give us a call at 916-524-5151.

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Choosing a long-term care facility

Judy had an emergency hip replacement after a fall. She needs to be discharged tomorrow to a skilled nursing facility. She needs several weeks of intensive physical therapy to be able to walk again. Then she may need to live in assisted living.

The discharge planner has a list of options. Judy and her daughter, who lives an hour away, don’t know how to make a wise choice.  

For short-term, urgent needs, you may be at the mercy of which facility has an opening at the time.

It pays to consult a Geriatric Care Manager who knows the reputation and personality of the local institutions. It’s best to have a relationship with the Geriatric Care Manager before you have an urgent need. They can combine extensive knowledge of local resources with a thorough understanding of your medical history, your insurance and financial resources, your personality and preferences, and your social support system. As a result, you are more likely to get a match that will help you maintain good spirits and enjoy a speedy recovery.

Touring these communities can be daunting
A Google search delivers a dizzying array of choices. They all put their best foot forward. But architectural features and social amenities are only superficial measures of quality. A Geriatric Care Manager has had other clients who live in these facilities. As professionals, they have a firm grasp on deeper metrics, such as the tone of the administrative leadership, the training and stability of the staff, the solvency of the company, and the overall personality of the community.

No charge to you
At Advanced Wellness Geriatric Care Management we can help you identify your priorities and make recommendations that meet your needs—at no extra charge. Our time is paid for by a referral fee from the facility you ultimately choose.

Looking for assisted living recommendations? Give us a call at 916-524-5151.

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Assembling your support team

Much as we would like to imagine an elderhood free from troubles, the truth is, we are all likely to need help eventually. And on several levels.

Informal support. This is the kind of help that friends and family members can provide short term. Someone to run errands or mow the lawn, etc. Make a list of the

  • people you feel emotionally close to
  • people who live close by who are reliable

When the going gets tough. If you were hospitalized, who would you call to

  • make medical decisions for you if you were unable to speak for yourself
  • pay bills or perhaps even manage your financial affairs long term

Your health care team. Medically trained support:

  • Your primary care provider and any specialists
  • Your pharmacist
  • Allied health providers (e.g., therapists, home health)

Professional advisors

  • An elder law attorney for important documents. You will need an attorney to set up a trust or will for dispersing your assets after you are gone. Or, if you have no relatives, to arrange for a guardian to make medical and financial decisions for you when you can no longer do so yourself. In addition, an attorney can review contracts and catch important details about senior housing. And an attorney’s advice is critical if you are considering a reverse mortgage or spending down your assets to be eligible for Medicaid.
  • A financial planner to manage assets and strategize to liquidate them to pay for care.
  • A CPA to highlight the tax implications in any of the above situations.
  • An insurance broker for prescription, Medicare supplemental, life insurance, etc.

A Geriatric Care Manager. The choices are boggling when it comes to assembling your team. It’s difficult to assess quality of professionals or compare pricing. A Geriatric Care Manager is a “meta-advisor” whose experience can help you choose your team wisely and coordinate whom to call when.

Want help assembling your team? Give us a call at 916-524-5151.

Learn more about our aging life care planning services.

Paying for care at home

How you pay for care at home depends on whether the service is by medically trained staff or by nonmedical caregivers. Also, what you can mix and match in terms of community programs and help from friends and family.

Medicare pays only for care in the home that requires the skills of a nurse, nursing assistant, physical therapist, or other medically trained professionals.

Home care $$–$$$$
The cost of nonmedical home care is NOT covered by Medicare. As a result, you must contract directly with providers. Fees depend on how many hours a week your care requires.

Consider that caregivers coming to your home need a livable wage. Add to this agency costs of staff recruitment, vetting, training, and scheduling. The price can mount up quickly.

  • Long-term care (LTC) insurance. These policies can be purchased privately and are the least expensive when begun in middle age. Typically, to draw upon the insurance, you must pay for home care services out of pocket for a waiting period. Insurance will contribute afterwards and pay up to the lifetime cap. Check policy details.
  • Veterans assistance. For qualifying vets who saw active duty with at least one day during a war, there may be benefits available to help with the costs of home-based care.
  • Personal savings. Consult with a financial planner and elder law attorney to determine the best strategy for liquidating assets to cover your care.

Adult day care $–$$$
You must pay privately. Many programs are run by nonprofits so are underwritten by donations and grants. Medicaid, LTC insurance, and veterans benefits may also help.

Home health and hospice $

  • Medicare. This is typically deducted from your Social Security check and will cover home health services (80%) and hospice (often 100%).
  • Supplemental insurance. This is insurance you buy to cover the 20% balance not paid by Medicare.
  • Medicaid. Those with VERY low income and minimal assets may qualify for state government support. The eligibility requirements are stiff. Coverage includes 100% of most medically trained care, with some restrictions. Coverage for nonmedical care is spotty and varies by county.

We can help you sort out your options. Give us a call at 916-524-5151.

Learn more about our aging life care planning services.

Medical emergencies: Are you prepared?

Judy fell and broke her hip. She calls 911. She lacks a medication list. As a result, the hospital team is unaware of her chronic conditions. Her daughter lives far away and doesn’t know if she should fly in.

Accidents by their very nature are unplanned. That doesn’t mean you need to be unprepared for a fall or a serious incident (e.g., a heart attack or stroke).

Those who are prepared and have a professional advocate, such as [tacm], are more likely to get the care and the outcomes they desire. Plus, they can recuperate in a setting most in line with their personal needs and preferences.

To be prepared, you need

  • current documents. Key to avoiding problems is the ability to give emergency and hospital personnel a list of current medications, your medical history, and an up-to-date list of your doctors and their phone numbers. Copies of all your insurance cards will speed the clerical side of the process. You will also need an advance directive that names your health care decision maker(s) and your preferred treatments.
  • up-to-date decision makers. Does the person you have chosen know and understand your treatment preferences? Does the rest of the family know and respect that he or she “speaks for you”? Does your decision maker have a medical background? Is he or she nearby enough or able to drop everything and come to your side?
  • a professional advocate. Often family or trusted friends cannot be present at a moment’s notice. And most people are not conversant with medical procedures. A professional advocate, such as a Geriatric Care Manager, has met with you prior to the emergency. He or she can fill in the medical team and communicate your personal priorities. A Geriatric Care Manager can advise decision makers by providing insight about treatment choices: Pros and cons and likely outcomes vis-à-vis your values. A Geriatric Care Manager can keep long-distance relatives informed and make recommendations regarding the need to travel. When it’s time to leave the hospital, a Geriatric Care Manager can recommend the best support facilities on the basis of your resources and personal preferences. As you plan ahead for emergencies, you will want to make decisions about hiring a professional advocate. Some Geriatric Care Managers offer the option of 24/7 emergency, on-call coverage. Others do not.

Ideally, all this information is available on your person or is readily accessed should you get into an emergency situation.

Want help getting prepared for a medical emergency? Give us a call: 916-524-5151.

Learn more about our aging life care planning services.

What is a Geriatric Care Manager?

Imagine your life as a movie. If you are the director, a Geriatric Care Manager is your production manager.

He or she is a deeply knowledgeable guide (usually a nurse, social worker, or allied professional) who finds you high-quality help, arranges care “locations,” and advises you about needed services.

Geriatric Care Managers are part of a national organization with training requirements, codes of ethics, and a nationwide network of experienced colleagues in case you need to move to a different part of the country.

Specialized knowledge and skills
Aging affects all aspects of life, so a Geriatric Care Manager draws upon many areas of expertise:

  • Advocacy. Communicating with doctors and navigating the very confusing eldercare network to get you the care you want.
  • Health and disability. Conducting an assessment and making recommendations so you and your family members can rest assured that a plan is in place if you need extra help.
  • Local resources. Recommending area service providers. Anyone can Google. But a Geriatric Care Manager intimately knows quality and reputation and can match best services for your budget and priorities.
  • Family. Helping relatives understand their role and work together to support your wishes.
  • Housing. Providing recommendations for the best fit based on your needs, priorities, and resources. No charge to you for this service. Referral fees paid by the facility.
  • Legal. Assembling needed paperwork and referring you to reputable attorneys as needed so you are well covered by a professional team.
  • Finances. Reviewing your options to identify eligibility for programs and ways to stretch your dollar wisely.
  • Crisis support. Helping you create a safety net you can depend on in emergencies.

As the director of your later years, how do you want your story to unfold? While not all of it is within your control, you do have agency. With planning, there is much you can do ahead of time to prepare for the elderhood you want and create a network to support it.

Would you like a guide for aging well? Give us a call at 916-524-5151.

Learn more about our aging life care planning services.