Ask the Nurse | Caring for a Parent

When it's your Mom, everything changes

by Christine Hammerlund, President of Assured Healthcare and "Mother"

You can become accustomed to the professional detachment of nursing. I've spent most of my adult life in that role and finding just the right balance among intellect, knowledge and emotion is one of the toughest hidden “jobs” of health care.

Good people care. You cannot hide from being human. But nursing means being smart in choices. Being smart and attentive for your patient is a never- ceasing quest. Medicine might be a science, but healing is an art.  

   Meet Virginia ,  one of our patients and mother of Assured Healthcare Staffing owner Chris Hammerlund.

Meet Virginia, one of our patients and mother of Assured Healthcare Staffing owner Chris Hammerlund.

A good nurse must listen to many voices inside her head, each asking for attention and validation. But I thought I had mastered the art of that heart/smart balance until I confronted the future for my Mom.

When it's Mom, everything changes, and even a nurse cannot shield herself from deep fears and concerns. Even a good nurse can be fooled by signs she does not see.

So, this is the first of four part series about me and my Mom. This will be a shared experience for us - you and I.  You see, the time had come to make some decisions about Mom's day-to-day health, and we all experience this, ready or not.

I can tell you right at the beginning that sharing the burdens of life can be a difficult task. But maybe you will see your life - your Mom or Dad - in this picture.  Maybe it will help to know you are not alone. It did for me.

First, Mom is a wonderful person. I won't tell you her age because it would be embarrassing to her, but let's just say she's old enough to remember runningboards on cars and phonographs that sped around the record turntable at 78 revolutions per minute. She is a proud person and independent. And smart.

But these are difficult times for her and for me.

I will have to care for her now. That much is certain. I don't know how much I had focused on that likelihood in other years, but when the time comes, there is no escape from that fact if you care.

My Mother has a few issues that make her care very challenging. She has macular degeneration (reduced eyesight), hearing loss, very unsteady gait and moderate dementia.

The changes that age can bring don't happen in one day. It's often a slow, steady progression. I did not see that slide at first.

When Mom was still at her home living alone, she was able to hold it together through a phone conversation, covering up her dementia and leading me to believe she was just forgetful.  

She then had a very serious fall, which landed her in the hospital for a week and drove my decision to have her move into my home. What I have found since she began living with me is how limited her ability is to function without help.  

I would suggest to others that have the responsibility of taking care of elderly and infirm parents or loved ones, first trust your gut.

And second, bring in a health care professional.  

By “trust your gut,” I mean that when you think something is wrong, it probably is worse than you think.  Second, either get in touch with the Doctor or have a nursing assessment done. Nothing is as useful as an independent evaluation of how well the senior performs activities of daily living and exercises their cognitive awareness. A doctor or independent nursecan see what you cannot.

The first job is to realistically determine whether it's safe for them to continue living alone. You have to become smarter about Mom. I did. It was the first lesson I had to learn.

As part of my business, I hire and manage home health care nurses all the time. I'm doing that now. If anything, the experiences with Mom have helped me see what those nurses need to know.

Next month, part 2 next: How did we wind up here?


Celebrate American Heart Month

Heart disease is the leading cause of death for men and women in the United States. Every year, 1 in 4 deaths are caused by heart disease.

The good news? Heart disease can often be prevented when people make healthy choices and manage their health conditions.

Communities, health professionals, and families can work together to create opportunities for people to make healthier choices.

Make a difference in your community: Spread the word about strategies for preventing heart disease and encourage people to live heart healthy lives.

How can American Heart Month make a difference?

We can use this month to raise awareness about heart disease and how people can prevent it — both at home and in the community.

Here are just a few ideas:

  • Encourage families to make small changes, like using spices to season their food instead of salt.
  • Motivate teachers and administrators to make physical activity a part of the school day. This can help students start good habits early.
  •  Ask doctors and nurses to be leaders in their communities by speaking out about ways to prevent heart disease.

Ask The Nurse: The Risks of Skipping Cardio Rehab Therapy

cardio rehab therapy

Dear Nurse Chris: After a heart attack two years ago, I took all the medicines my physician asked, but he also wanted me to commit to a long period of rehab. It seemed way too strenuous for me, and I was scared it might cause another attack so I didn’t go. I am 56 now. Was I right or wrong to skip the rehab?  Emily in Grayslake

Dear Emily: You took a big risk, and be sure to check with your cardiologist about this. Here’s what one study says: People who get all 36 sessions of cardiac rehabilitation that most Medicare plans cover are less likely to die or suffer a heart attack in the next three to four years than people who have fewer sessions.

You’re younger than that group, but if your insurance covers it, make use of the treatment.

If anyone pays attention, which they should, this research could encourage heart patients who don't follow doctors' orders to heed their advice. Only about one-fifth of heart patients even try rehab. Of those who do, few get all the sessions that are recommended. The new study is one of the first big efforts to look at how survival is affected by the "dose" of rehab that heart patients get. Researchers saw a clear trend in this 65-and-older group.
"What this study shows in a very convincing manner is that the more sessions a cardiac patient goes to, the better off they are," Dr. Stanley Hazen, preventive cardiology and rehabilitation chief at the Cleveland Clinic, told the Associated Press.

Say "rehab" and many people envision weak heart patients being pushed to run on a treadmill. Exercise is crucial, but it can be just a brisk walk or swimming or a stationary bike. That's important. Find something you enjoy and are willing to do.

More than three years later, 18 percent of those who attended fewer than 12 cardiac rehab sessions had died versus 11 percent of those who went to all 36 sessions. After taking into account age and other differences in these groups of patients, that works out to a 47 percent reduction in the risk of death for those attending 36 sessions. Heart attacks also were less common in that group.

There was a strong trend: as the number of classes went up, the risk of having a heart attack or dying in the next few years went down.

5 Tips for Walking Your Way to Better Health

Spring is just around the corner, and after the long winter months most of us are ready for sunnier days and more time spent outdoors.  Even if you've been following an indoor exercise regimen or participating in winter sports, there's just something special about that first springtime walk—lacing up your shoes, heading out the door and pausing to inhale a deep breath of fresh air, fragrant with the promise of blooming plants and flowers.  Here are a few tips for getting the most out of your walking routine:

Read More

Four Heart Health Myths You Should Know About

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As American Heart Month draws to a close, it's important to encourage continued, year-round awareness of heart health as well as correct some of the common heart health myths or misconceptions people may have about heart disease: People who are physically fit and active are not at risk for heart disease.   While it's great to be fit and get plenty of exercise, it's not a guarantee of good heart health.  Cholesterol levels, genetics and other factors can contribute to heart issues -- and no matter how fit and active you are, smoking and overindulging in less-than-healthy foods will still take a toll on your body.

Women are at higher risk of dying from breast cancer than heart disease.  Wrong, by a long shot. Statistics indicate that across all age groups (including childbearing years), death from heart disease is more common among women than breast cancer.  Young women especially should begin taking care of heart health right now -- the combination of smoking and birth control increases their heart risks by as much as 20%.

When blood sugar levels are under control, diabetes is not a heart threat.  Think again.  Though good levels are healthier for diabetics, what many people don't realize is that the diabetes itself can cause inflammation, which in turn can damage blood vessels.  Monitoring and maintenance of  blood pressure, cholesterol and weight remain important to overall health.

Heart disease primarily affects the aging and the elderly.  Yes, many of the symptoms of heart disease manifest as we age - but the seeds of risk are often planted early in our lives.  They range from poor eating habits acquired in early childhood (including over-consumption of fast-foods or processed foods containing high levels of fat, sugar and sodium) to discreased levels of physical activity, increasingly sedentary lifestyles, smoking, excessive alcohol consumption and more.

Plaque does not accumulate in our arteries overnight.  It can take years to develop, so the earlier we become conscious  of healthier heart habits for ourselves and our children, the better our odds of avoiding heart disease later in life.   

Article by Kim Washetas, contributing writer and enthusiastic whole health advocate.  Sources:  USA Today, Ochsner Health Center

5 Amazing Heart Facts

Appropriately enough, February is American Heart Month.  Below are five fascinating facts about this vital organ:

  1. Your heart beats about 100,000 times a day.  That means that in an average lifetime, a human heart beats close to 2.5 billion times!  There's a powerful incentive to keep your ticker in good shape.
  2. When you're in exercise mode, it takes about 10 seconds for your blood to make the circuit from your heart to your big toe and back again.
  3. Your heart is always on the job!  Even when you are at rest, your heart is working twice as hard as the leg muscles of a person who is sprinting.
  4. Your heart pumps the blood, which is then circulated by means of arteries, veins and capillaries to the rest of the body.  Sizewise, your largest artery (the aorta) is nearly the diameter of a garden hose.  Contrast that with the tiniest of your capillaries; it would take ten of them to equal the thickness of one hair on your head.
  5. How hard is your heart working?  Think of it this way:  All that pumping equals about 1 million barrels of blood for an average person - enough to fill 3 super tankers!

Article by Kim Washetas, contributing writer and enthusiastic whole health advocate.  Sources:  National Geographic, PBS

Better Breathing for Better Health

breathing

With the confusing myriad of exercise programs out there, people often have difficulty choosing -- and sticking to -- a healthy physical regimen.  It's not all about burning up the calories, either.  The reason aerobic exercise is good for us is because it enables us to take in more oxygen, expel carbon dioxide and give that muscle known as our heart a healthy workout. Do you know that you can also begin improving your health by simply changing the way you breathe throughout the day?   When we breathe too shallowly, which many of us do, over time our chest and lung tissue can become constricted.  This reduces the flow of oxygen to all our tissues.  Consciously practicing deep, rhythmic breathing throughout the day has a number of benefits, including expansion of the diaphragm, the cone-shaped muscle beneath our lungs.  It also expands the air pockets in our lungs, which triggers a relaxation response in our bodies.

But it's not just about the lungs and the heart.  When we breathe our circulatory system carries oxygen and nutrients throughout our body; the lymphatic system completes the equation by eliminating what we don't need.  Deep, regular breathing stimulates and enhances the functioning of our lymphatic system, which in turn carries away toxins, dead blood cells and other matter that our body no longer requires.

Start being healthier and more relaxed right now.  Before you get up from your chair, take a few moments to sit up straight.  Breathe in deeply, expanding your chest and filling your lungs with air.  Slowly exhale.  Repeat three or four times.  You've just taken a great first step toward better health!

Article by Kim Washetas, contributing writer and enthusiastic whole health advocate.

Laughter and Health - How They are Interrelated

laughter

While you might think that you need to see many doctors and take many medications in order to remain healthy, researchers now believe that laughter is actually the best medicine and the best way to stay healthy. Laughing can relax the body and reduce the risk of high blood pressure, heart disease, strokes, arthritis, and other serious illnesses. It can rid the body of negative emotions -such as stress, anger, anxiety, and depression, which have all been proven to lead to heart disease. Some other benefits are:

  1. Laughter can help lower blood pressure. Research has shown that people who laugh on a regular basis tend to have lower blood pressure than the average person. When laughing, breathing becomes heavier and this sends more oxygen through the body. This allows for blood pressure to rise when laughing and then fall to levels below normal after laughing.
  2. A good laugh can actually be equivalent to a good workout. Laughing can work out your diaphragm, respiratory, back, leg, and facial muscles. It also is a great way to boost your heart rate and increase digestion. Researchers believe that a good laugh can burn approximately the same number of calories as riding an exercise bike for a few minutes. One study concluded that laughing for 10-15 minutes can burn about 50 calories.
  3. Laughter can change the biochemical makeup of the body. It will decrease the amount of stress hormones that the body is releasing, while increasing beneficial infection-fighting antibodies.
  4. While relieving stress, laughter can also help improve brain functioning. Since the body is producing less stress-causing hormones, the muscles in the brain relax. This allows the brain to become more alert and retain more information.
  5. Finally, laughing can protect the heart from heart attacks. Research has shown that people with heart disease laugh approximately 40% less than people without heart disease.

In order to gain the benefits of laughter, it is important to allow yourself time to laugh every day. For example, watch comedy TV, listen to comedy when driving, and make friends with funny people. You should understand that humor is good, so don't take life and yourself so seriously! Be sure to laugh at yourself and have fun!

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Angio Procedures - Consider Them Carefully

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 The various angio procedures have become so common that consumers may start to think of them as sort of a lube job. As if they’re routine maintenance like changing your car’s oil.  But that perception is dangerous and also expensive. There are always risks with any invasive medical procedure and an angiogram is an invasive procedure, therefore it should only be done when warranted. A physician who would do an angiogram on you because you insisted may be fearful of a lawsuit and will do procedures to cover himself. If you are worried, on your next visit to the doctor take a list of your concerns. Discuss these concerns one by one until you are satisfied with the answers. You are the consumer. Be smart.

There are other ways of assuring that your heart is healthy such as regular visits to a physician you trust, knowing your cholesterol level and blood pressure, eating a well balanced diet and making sure you are consistently exercising.

A troublingly high number of U.S. patients who are given angiograms turn out not to have a significant problem, according to the latest National  Institute of Health study to suggest Americans get an excess of medical tests. In the case of an angiogram or angioplasty, the hospital bill can run to $20,000 which your insurance might pay.  So, if your insurance pays, who cares about the bill? The hidden equation is that someone will pay and if your insurers make less money on your policy, they will make it up on someone else, either by raising rates or denying coverage. Someone always pays.

The researchers said the findings suggest doctors must do better in determining which patients should be subjected to the cost and risks of an angiogram. The test carries a small but real risk — less than 1 percent — of causing a stroke or heart attack, and also entails radiation exposure.

“We can do better. There is no doubt in my mind,” said Dr. Ralph Brindis of the University of California San Francisco, one of the study’s authors.

Angiograms are often given to patients who might be having a heart attack or have symptoms that suggest a serious blockage. They are also sometimes done on people who may have some less clear-cut symptoms, like shortness of breath, or no symptoms but some risky traits and an abnormal result on another heart test. This group accounts for about 20 to 30 percent of angiogram cases.

In the study, nearly two-thirds of the patients in this second group were found to have no serious blockages.  The researchers could not establish why so few proved to have heart disease. But Dr. Harlan Krumholz, a health-outcomes researcher unconnected to the study, said he thinks the problem arises because doctors are afraid of missing something, and also getting sued.

Copyright © Christine Hammerlund – 2010.Christine Hammerlund is a registered nurse and the owner of Assured Healthcare, a healthcare staffing service headquartered in Gurnee, Illinois.